Rising threat of Multidrug-Resistant Sepsis in newborns at India’s District Hospitals: Study

A recent study conducted in five district hospitals across India has revealed alarming findings about the prevalence of sepsis in newborns. Published in The Lancet Global Health, the study highlights that a significant number of newborns admitted to Special Newborn Care Units (SNCUs) suffer from sepsis, with most cases being caused by multidrug-resistant bacteria.

Key Findings of the Study

The study included 6,612 newborns, out of which 3,357 (50.8%) showed clinical signs of sepsis.

Among them, 213 (3.2%) had confirmed culture-positive sepsis, with variations ranging from 0.6% to 10% across different hospitals.

The incidence of sepsis in outborn newborns (5.0%) was 2.5 times higher than in inborn newborns (2.0%).

The case-fatality rate was 36.6%, indicating a severe risk of death from sepsis.

Gram-negative bacteria accounted for 70% of infections, with Klebsiella pneumoniae, Escherichia coli, and Enterobacter spp being the most common pathogens.

Rising Antibiotic Resistance: A Major Concern

The study further revealed that a significant proportion of the sepsis-causing bacteria were resistant to multiple antibiotics:

84.3% of Klebsiella pneumoniae, 84.8% of Escherichia coli, and 88.5% of Enterobacter spp were multidrug-resistant.

75% of Acinetobacter baumannii samples were also resistant to multiple antibiotics.

Need for Infection Control and Better Treatment Strategies

The researchers stressed the urgent need for improving infection control practices in district hospitals, establishing blood culture facilities, and implementing strict antibiotic stewardship programs.

Key Recommendations:

1. Strengthening Infection Control: Improving hygiene and sanitation in hospitals.
2. Mandatory Blood Culture Testing: Ensuring proper diagnosis before administering antibiotics.
3. Responsible Antibiotic Use: Training healthcare professionals to use antibiotics judiciously to reduce resistance.

Government Policy and Future Action

The study emphasizes that the National Health Mission (NHM) and state governments should introduce dedicated programs to strengthen infection control measures in district hospitals.

This study was conducted by experts from the All India Institute of Medical Sciences (AIIMS) New Delhi, JIPMER Puducherry, AIIMS Raipur, Assam Medical College, and AIIMS Jodhpur and was funded by the Bill & Melinda Gates Foundation.

With newborn sepsis posing a significant threat to infant mortality in India, urgent steps are needed to address this growing challenge and prevent future outbreaks of multidrug-resistant infections.