Distinguishing coagulase-negative Staphylococcus bacteremia from contamination using blood-culture positive bottle detection pattern and time to positivity

Background: Sepsis remains a leading cause of mortality and morbidity, especially during the first five days of life and in low and middle-income countries. The purpose of this study was to note the clinical features and analyze the relationship between the septic screen and blood culture positive sepsis in the neonatal unit.Methods: A one-year descriptive cross-sectional study was carried out at the NICU of a teaching hospital in India.Results: The incidence of clinically suspected septicemia was 19.3 per 1000 live births and the incidence of blood culture positive septicemia was 2.9 per 1000 live births among the inborn of the hospital. The most common clinical features were poor suck and lethargy in culture positive sepsis. The most common organisms causing sepsis were Coagulase negative staphylococci and Klebsiella. In the septic screen CRP was found to have a statistically significant association with blood culture positive sepsis. CRP also had the highest sensitivity and negative predictive value among the studied parameters.Conclusions: Incidence of blood culture positive sepsis was 2.9 per 1000 live births among the inborn of the hospital. The most common clinical features were poor suck and lethargy in culture positive sepsis. The most common organism isolated in neonatal sepsis in the NICU was Coagulase negative staphylococcus. In resource poor settings, CRP continues to be an important tool in diagnosis and treatment of neonatal sepsis.

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Study of the immediate clinical outcome of neonatal sepsis in the neonatal I.C.U. of a tertiary care hospital

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20172674 ◽

2017 ◽

Vol 4 (4) ◽

pp. 1401

Author(s):

Mohamed Reshad ◽

Tania Mundol ◽

Mithun H. K. ◽

Anitha S. Prabhu

Keyword(s):

Staphylococcus Aureus ◽

Blood Culture ◽

Neonatal Sepsis ◽

Tertiary Care ◽

Coagulase Negative Staphylococcus ◽

Care Hospital ◽

College Hospital ◽

Neonatal Deaths ◽

The Status ◽

Culture Positive

Background: According to the status of newborns report 2014, about 0.76 million neonatal deaths occur in India, the highest for any country in the world. Although the neonatal mortality rate (NMR) has declined in the last 2 decades, the early NMR has been the slowest to decline. The three major causes of neonatal deaths are preterm birth complications, infections, and intrapartum related complications; together, they contribute to nearly 90% of total neonatal deaths. The aim of the study was to study the immediate clinical outcomes of culture proven neonatal sepsis in the NICU of Yenepoya Medical College Hospital during the period January 2016 to June 2016.Methods: Retrospective hospital based study of records of all neonates admitted to the NICU with blood culture positive neonatal sepsis from January 2016 till June 2016. Blood cultures were done using the BACTEC 460. Data analysed using SPSS version 20.Results: A diagnosis of probable sepsis was made in 84 (54%) of the total neonates (154) admitted to the NICU during the study period of which 6 were out born babies. Culture positive sepsis was found in 11.6% (18). The most commonly isolated organisms were Escherichia coli, Enterococcus and coagulase negative Staphylococcus aureus. Of the total 18 culture positive cases, urine culture was positive in only 2 cases while the remaining had a positive blood culture. Among the 18 cases of culture positive neonatal sepsis, 8 died while 10 survived.Conclusions: Incidence of neonatal sepsis was relatively high in YMCH with the most predominant organism being coagulase negative Staphylococcus aureus. 12.7% of the sepsis cases died. Resistance to cefotaxime and ampicillin was prevalent.

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ANTIMICROBIAL SUSCEPTIBILITY IN CULTURE POSITIVE ENTERIC FEVER

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i7.357 ◽

2019 ◽

Vol 3 (7) ◽

Author(s):

Dr. Manish Kulshrestha ◽

Dr. Anjali Kulshrestha

Keyword(s):

Bone Marrow ◽

Blood Culture ◽

Nalidixic Acid ◽

Antimicrobial Susceptibility ◽

Salmonella Enterica ◽

Enteric Fever ◽

Multidrug Resistant ◽

Bone Marrow Culture ◽

Diffusion Method ◽

Culture Positive

INTRODUCTION: Enteric fever includes typhoid and paratyphoid fever. Peak incidence is seen in children 5–15 years of age; but in regions where the disease is highly endemic, as in India, children younger than 5 years of age may have the highest infection rates. There are about 22 million new typhoid cases occur each year. Young children in poor, resource limited areas, who make up the majority of the new cases and there is a mortality figures of 215,000 deaths annually. A sharp decline in the rates of complications and mortality due to typhoid fever is observed as a result of introduction of effective antibiotic therapy since 1950s. MDR-ST became endemic in many areas of Asia, including India soon after multidrug-resistant strains of Salmonella enterica serotype typhi (MDR-ST) that were resistant to all the three first-line drugs then in use, namely chloramphenicol, amoxycillin and co-trimoxazole emerged in early 1990s. MATERIAL AND METHODS: Only blood culture or bone marrow culture positive cases were included. The patients with culture isolated enteric fever were included in the study. Antimicrobial susceptibility testing was carried out by disk diffusion method using antibiotic discs. The analysis of the antimicrobial susceptibility was carried out as per CLSI interpretative guidelines. RESULTS: A total of 82 culture positive cases were included in the present study. 80 culture isolates were from blood culture and 2 from the bone marrow culture. Salmonella entericasubspecies enterica serovartyphi (S typhi) was isolated from 67 (81.70%) patients while Salmonella enterica subspecies entericaserovarparatyphi (S paratyphi A) was isolated from 13 (15.85%) cases and 2 (2.44%) were Salmonella enterica subspecies entericaserovarschottmuelleri (S paratyphi B). Of the 82 cases 65(79.3%) isolates were resistant to ciprofloxacin, 17 (20.7%) were resistant to nalidixic acid, one (1.2%) case each was resistant to Cefotaxime and ceftriaxone, 2 (2.4%) were resistant to chloramphenicol, 10 (12.2%) were resistant and to cotrimoxazole 3 (3.7%) were resistant. CONCLUSION: In a culture positive cases 65(79.3%) isolates were resistant to ciprofloxacin and 17 (20.7%) were resistant to nalidixic acid. Multidrug resistant isolates were 65(79.3%).

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A comparative study of the typhidot (Dot-EIA) and Widal tests in blood culture positive cases of typhoid fever

Tropical Doctor ◽

10.1258/td.2011.100406 ◽

2011 ◽

Vol 41 (3) ◽

pp. 136-138 ◽

Cited By ~ 4

Author(s):

Haji Khan Khoharo

Keyword(s):

Blood Culture ◽

Comparative Study ◽

Typhoid Fever ◽

Culture Positive

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Diversity and Prevailing Antimicrobial Resistance in Blood Stream Pathogens at NICU of a Tertiary Care Institute in Kolkata

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/167 ◽

2021 ◽

Vol 8 (14) ◽

pp. 854-860

Author(s):

Nandita Pal ◽

Sanat Kumar Dolui ◽

Bhuban Majhi ◽

Manisha Das

Keyword(s):

Antimicrobial Resistance ◽

Blood Culture ◽

Klebsiella Pneumoniae ◽

Late Onset ◽

Tertiary Care ◽

Burkholderia Cepacia Complex ◽

Multi Drug Resistance ◽

Coagulase Negative Staphylococcus ◽

Neonatal Septicaemia ◽

Early Onset Sepsis

BACKGROUND Septicaemia is a leading cause of morbidity and mortality in neonates. Antimicrobial prescription for neonatal septicaemia (NS) should be wisely used depending on the regional spectra of infecting microbes and their antimicrobial resistance (AMR) patterns which vary over time, place and host factors. METHODS This was a descriptive cross-sectional study conducted from January 2017 to June 2017 among 102 cases of NS admitted in neonatal intensive care units (NICU). Demographic data of the concerned neonates was collected through a predesigned checklist. Blood collected from neonates was processed for culture and sepsis screen. Antimicrobial susceptibility testing was performed for the cultured isolates and phenotypic AMR patterns were observed. RESULTS Most of the studied neonates had subnormal birth weight (86). Blood culture showed predominance of gram-negative bacilli (GNB) among which Klebsiella pneumoniae was the most common followed by Burkholderia cepacia complex. Coagulase negative staphylococcus species (CoNS) was most numerous among the cultured gram-positive cocci (GPC). Candidemia of late onset was confirmed in 25 neonates. Early onset sepsis was predominantly caused by GNB (29 / 31) predominated by Klebsiella pneumoniae. Multi drug resistant (MDR) pathogens viz., extended spectrum beta-lactamase (ESBL) producing GNB, carbapenem resistant-GNB (CR-GNB) and methicillin resistant staphylococcus (MRS) phenotypes were notably prevalent. CONCLUSIONS Multidrug resistant microorganisms are notably prevalent in neonatal septicaemia. In clinically suspected very sick septicaemic neonates not showing much improvement with guideline-led empirical antimicrobial therapy, an early antibiogram guided change over to meropenem and amikacin or even to colistin in case of reported carbapenem resistance, is highly recommended. KEYWORDS Antimicrobial Resistance, Blood Culture, Multi Drug Resistance, Neonatal Septicaemia

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Comparison of Pharmacist-Directed Management of Multiplex PCR Blood Culture Results with Conventional Microbiology Methods on Effective and Optimal Therapy within a Community Hospital

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.01575-18 ◽

2018 ◽

Vol 63 (1) ◽

Cited By ~ 3

Author(s):

Allison M. Porter ◽

Christopher M. Bland ◽

Henry N. Young ◽

David R. Allen ◽

Sabrina R. Croft ◽

...

Keyword(s):

Blood Culture ◽

Multiplex Pcr ◽

Positive Blood Culture ◽

Antimicrobial Therapy ◽

Community Hospital ◽

Intervention Group ◽

Standard Of Care ◽

Pharmacist Intervention ◽

Coagulase Negative Staphylococcus ◽

Optimal Therapy

ABSTRACT Multiplex PCR combined with a pharmacist-driven reporting protocol was compared to the standard of care within a community hospital to evaluate initial changes after notification of a positive blood culture. The intervention group demonstrated decreased times to changes in antimicrobial therapy (P = 0.0081), increased changes to optimal antimicrobial therapy (P = 0.013), and decreased vancomycin use for coagulase-negative staphylococcus contaminants (P < 0.01) with multiplex PCR implementation and pharmacist intervention.

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Clinical and Bacteriological Profile of Early Onset Neonatal Sepsis Admitted in NICU of Tertiary Hospital in Biratnagar

Birat Journal of Health Sciences ◽

10.3126/bjhs.v3i1.19764 ◽

2018 ◽

Vol 3 (1) ◽

pp. 370-376

Author(s):

Arun Giri ◽

Vijay Kumar Sah ◽

Bikash Sharma Poudel ◽

Niraj Niraula ◽

Raju Sedai

Keyword(s):

Escherichia Coli ◽

Staphylococcus Aureus ◽

Blood Culture ◽

Neonatal Sepsis ◽

Early Onset ◽

Clinical Signs ◽

Signs And Symptoms ◽

Coagulase Negative Staphylococcus ◽

Sensitivity Pattern ◽

Clinical Signs And Symptoms

Introduction: Neonatal sepsis is one of the major causes of neonatal morbidity and mortality especially in developing countries. The clinical signs and symptoms of neonatal sepsis are non specific and blood culture report is considered gold standard for confirmation of neonatal sepsis. Organisms and their sensitivity pattern vary from place to place. The confirmation of diagnosis and management of neonatal sepsis is challenging and time consuming.Objective: The aim of this study was to find incidence of blood culture proven sepsis in suspected early onset neonatal sepsis, find out sensitivity pattern of isolated organism and to find association of risk factors and clinical signs and symptoms with blood culture proven sepsis.Methodology: Prospective study was conducted in Nobel Medical College, Biratnagar from November 2016 to November 2017. Sample size was calculated to be 300 and blood culture was sent of each neonates admitted with suspected early onset neonatal sepsis before giving neonates with first dose of antibiotics and report of 72 hours was taken into consideration.Results: Out of 300 cases of suspected early onset neonatal sepsis 70.3% presented with lethargy, followed by other symptoms like poor feeding, respiratory distress, fever, hypothermia, feeding intolerance, abnormal body movement and abdominal distension. Low birth weight neonates, preterm neonates, prolonged duration of per vaginal leaking and low platelets count were significantly associated with blood culture proven sepsis in this study. Incidence of blood culture positive sepsis in suspected early onset neonatal sepsis was 27%. Coagulase negative Staphylococcus aureus(21%) was predominant organism isolated followed by Klebsiella Pneumonia, Pseudomonas, Escherichia coli. All of the isolated Klebsiella and Pseudomonas and 86% of Escherichia coli were found to be resistant to ampicillin. All isolated Coagulase negative Staphylococcus aureus were sensitive to vancomycin.Conclusion: Coagulase negative Staphyloccus aureus was predominant organism detected but majority of organisms were gram negative organisms. High resistance to ampicillin was found and cefotaxime was also less sensitive to isolated organism. Vancomycin was found to be sensitive to all isolated Staphylococcus aureus and coagulase negative Staphylococcus aureus. Amikacin was highly sensitive among causative organisms isolated. BJHS 2018;3(1)5 : 370-376

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Clinical profile and outcome of early onset sepsis in high risk very low birth weight neonates

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20180480 ◽

2018 ◽

Vol 5 (2) ◽

pp. 389 ◽

Cited By ~ 1

Author(s):

Omprakash S. Shukla ◽

Aditi Rawat

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Blood Culture ◽

Low Birth Weight ◽

Neonatal Sepsis ◽

Early Onset ◽

Very Low Birth Weight ◽

Gram Negative ◽

Early Onset Sepsis ◽

Culture Positive

Background: Neonatal sepsis is one of the main causes of mortality and morbidity, especially in very low birth weight neonates (birth weight <1499 grams) despite the progress in hygiene, introduction of new and potent antimicrobial agents for treatment and advanced measures for diagnosis. The aim of the study was to find correlation of clinical features and risk factors of neonatal sepsis in culture positive cases.Methods: A cross- sectional study was carried out in one hundred neonates with risk factors of septicemia after obtaining informed consent. Blood culture was done using Bactec Peds Plus/F Culture as a gold standard to diagnose septicaemia. Correlation of risk factors, clinical features with laboratory findings was obtained by using chi-square test. p-value of less than 0.05 was considered as significant.Results: Out of 100 neonates with suspected sepsis, BACTEC culture proven sepsis was seen in 40% cases. Gram negative sepsis was seen in 62.5% cases. The most common bacteria for early onset sepsis were Klebsiella, Pseudomonas and MRSA contributing 17% each to the bacteriological profile. The most common predisposing factor and clinical feature in culture positive cases were Premature rupture of membrane >24 hours (67%) and bleeding/petechia/pupura (72%) respectively. The major cause of mortality was pulmonary hemorrhage.Conclusions: Gram negative organism were more common and associated with higher mortality. Blood culture positivity increases with increase in number of risk factors in neonatal septicemia. A detailed history and thorough clinical examination is vital for early recognition of sepsis.

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Susceptibility Pattern of Pathogens Causing Blood Stream Infections in a Tertiary Care Hospital: A Two-year Retrospective Study from Southern Nigeria

Microbiology Research Journal International ◽

10.9734/mrji/2021/v31i330306 ◽

2021 ◽

pp. 53-60

Author(s):

Bassey Ewa Ekeng ◽

Ubleni Ettah Emanghe ◽

Bernard Ekpan Monjol ◽

Anthony Achizie Iwuafor ◽

Ernest Afu Ochang ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Blood Culture ◽

Blood Stream ◽

Multidrug Resistant ◽

Diffusion Method ◽

Disc Diffusion ◽

Blood Stream Infections ◽

Gram Negative ◽

Antimicrobial Sensitivity ◽

Culture Positive

Aim: Bloodstream infections are a major cause of morbidity and mortality worldwide. The prevalence of causative microorganisms varies from one geographical region to another. This study was aimed at determining the etiological agents prevalent in our environment and their susceptibility profile. Study design: This is a retrospective study carried out at the University of Calabar Teaching Hospital, Calabar, Nigeria. Methodology: Blood culture results of patients documented over a two-year period were retrieved and analyzed. Blood culture positive isolates were detected using conventional method and Oxoid signal blood culture systems. Antimicrobial sensitivity tests were carried out by Kirby-Bauer disc diffusion method. Methicillin resistance in Staphylococcus aureus and coagulase negative Staphylococcus species (CoNS) was detected by disk diffusion method using 30 µg cefoxitin disk. ESBL production was detected by phenotypic confirmatory disc diffusion test (PCDDT) and the double disc synergy test (DDST). Results: A total of 413 blood culture antimicrobial susceptibility test results were analyzed, of which 116 (28.09%) were identified as culture positive. Sixty-nine (59%) of the positive isolates were from female patients. Out of 116 positive cultures, 58.62% (68/116) were Gram positive organisms, 40.52% (47/116) were Gram negative organisms, non albicans Candida accounted for 0.86% (1/116). Staphylococcus aureus (n=41, 35.3%) was the predominant isolate and showed high sensitivity to levofloxacin (100%), Linezolid (100%) and Amikacin (100%). Twelve isolates of S. aureus were methicillin resistant, while 1 isolate was inducible clindamycin resistant. Of the 116 isolates identified in this study, forty-three (43) were multidrug resistant with highest number of multidrug resistant isolates from Staphylococcus aureus (n=20). 21.28% (n=10) of the Gram-negative isolates were positive for extended spectrum beta lactamases. Conclusion: A high rate of antimicrobial resistance is observed among microorganisms causing blood stream infections. This emphasizes the need for antimicrobial sensitivity testing in the management of blood stream infections.

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Blood culture time to positivity in non-β-hemolytic streptococcal bacteremia as a predictor of infective endocarditis—a retrospective cohort study

European Journal of Clinical Microbiology & Infectious Diseases ◽

10.1007/s10096-021-04339-7 ◽

2021 ◽

Author(s):

David Krus ◽

Fredrik Kahn ◽

Bo Nilson ◽

Torgny Sunnerhagen ◽

Magnus Rasmussen

Keyword(s):

Cohort Study ◽

Infective Endocarditis ◽

Blood Culture ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Population Based ◽

Culture Time ◽

Time To Positivity

AbstractNon-β-hemolytic streptococci (NBHS) cause infective endocarditis (IE) and a short blood culture time to positivity (TTP) is associated with risk of IE in bacteremia with other pathogens. In this retrospective population-based cohort study, we investigate if TTP is associated to IE or mortality. Of 263 episodes with NBHS bacteremia, 28 represented IE and the median TTP did not differ significantly between episodes with IE (15 h) and non-IE (15 h) (p=0.51). TTP was similar among those who survived and those who died within 30 days. However, TTP significantly differed when comparing the different streptococcal groups (p<0.001).

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