Clinical features of neonatal sepsis caused by resistant Gram-negative bacteria

2009 ◽  
Vol 51 (3) ◽  
pp. 332-336 ◽  
Author(s):  
Mohammad Khassawneh ◽  
Yousef Khader ◽  
Nadeen Abuqtaish
Keyword(s):  
Clinical Features ◽  
Neonatal Sepsis ◽  
Gram Negative Bacteria ◽  
Gram Negative

scholarly journals Neonatal sepsis in a Nigerian Tertiary Hospital: Clinical features, clinical outcome, aetiology and antibiotic susceptibility pattern

2017 ◽  
Vol 32 (4) ◽  
pp. 127-131 ◽  
Author(s):  
Adediwura O. Arowosegbe ◽  
David A. Ojo ◽  
Iyabode O. Dedeke ◽  
Olufunke B. Shittu ◽  
Olusola A. Akingbade
Keyword(s):  
Clinical Outcome ◽  
Clinical Features ◽  
Antimicrobial Susceptibility ◽  
Neonatal Sepsis ◽  
Case Fatality ◽  
Tertiary Hospital ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Early Onset Sepsis ◽  
Klebsiella Spp

Background:Neonatal sepsis is a significant cause of neonatal mortality in developing countries. The aetiological agents and their antimicrobial susceptibility patterns are dynamic.Objectives: This study determined clinical features, aetiology, antimicrobial susceptibility and clinical outcome of neonatal sepsis in a Nigerian Tertiary Hospital.Methods: Neonates undergoing sepsis evaluation at a Nigerian Tertiary Hospital were included in the study. Demographic and clinical information were obtained using standard questionnaires. Blood samples were cultured on MacConkey, Blood and Chocolate agar. Isolated bacteria were identified based on morphology, Gram stain appearance and standard commercially prepared biochemical tests. Antimicrobial susceptibility testing was performed on Mueller-Hinton agar using the Kirby-Bauer method.Results: Eighty-five of the 180 neonates admitted during the study period were recruited. Fifty-five neonates presented with early-onset sepsis and 30 with late-onset sepsis. Culture-proven sepsis was detected in 19 (22.4%) neonates. The incidence of culture-proven sepsis in the hospital was 2.8/100 live-births. The most common clinical feature at presentation was respiratory distress. Gram-negative bacteria accounted for 78.9 percent of all isolates and were the only organisms encountered in earlyonset sepsis. Isolated pathogens were predominantly Klebsiella spp (31.6%), Enterobacter spp (21.1%) and coagulase-negative Staphylococci (15.8%). The isolates were most sensitive to ofloxacin. Gram-negative bacteria showed high resistance to cefuroxime and ampicillin. The case-fatality rate was 26%.Conclusion: Gram-negative bacilli, especially Klebsiella spp, was predominant. Neonatal sepsis persists as a cause of mortality in this region. Regular antimicrobial surveillance for empirical treatment remains an important component of neonatal care.

scholarly journals Clinical and epidemiological features and organ dysfunction in newborns with neonatal sepsis

2019 ◽  
Vol 64 (5) ◽  
pp. 176-182 ◽  
Author(s):  
Kh. S. Khaertynov ◽  
V. A. Anokhin ◽  
S. V. Khaliullina ◽  
S. A. Lubin ◽  
N. V. Dontsova ◽  
...  
Keyword(s):  
Organ Dysfunction ◽  
Neonatal Sepsis ◽  
Fatal Outcome ◽  
Blood Lactate Level ◽  
Gram Negative Bacteria ◽  
Elevated Blood ◽  
Gram Negative ◽  
Gram Positive Bacteria ◽  
Epidemiological Features ◽  
Causative Agents

Purpose. To evaluate clinical and epidemiological features of neonatal sepsis and assess the impact of organ dysfunction on its outcome.Characteristics of children and research methods. The authors carried out a retrospective analysis of 66 patients with neonatal sepsis hospitalized to the neonatal intensive care unit of the Kazan City Children’s Hospital No. 1 from 2013 to 2017. The diagnosis was based on the development of a systemic inflammatory response syndrome, an increase in C-reactive protein concentration in the blood more than 1 mg/dl, the presence of one or more foci of infection, the development of organ dysfunction and the isolation of the microorganism from venous blood. Bacteremia was a mandatory inclusion criterion.Results. In the most cases (54.5%) neonatal sepsis was caused by gram-negative bacteria. 41 and 4.5% of cases were caused by gram-positive bacteria and fungi, respectively. Among the gram-negative bacteria, the main causative agents of sepsis were Klebsiella pneumoniae (27 cases, 41%), among the gram-positive bacteria –staphylococci (24 cases, 36.5%). Fungal sepsis was caused by Candida kruzei (2 cases) and Candida albicans (1 case). In 11 (17%) cases there was a dysfunction of a single organ, in 31 (47%) cases – dysfunction of 2 organs and in 24 (36%) cases – dysfunction of more than 2 organs. The most common impairments were respiratory dysfunction (86%) and hemostatic disorders in the form of thrombocytopenia (58%). Neonatal sepsis was fatal in 11 (17%) cases. It was found that the multiple organ dysfunction was associated with a risk of death (odds ratio – OR = 29.3; 95% CI 3.4–249.7). Among the signs of organ dysfunction, coma (OR = 30.8; 95% CI 3.0–316.6), elevated blood lactate level of more than 5 mmol/l (OR = 22.1; 95% CI 3.5–139,6) and a low platelet count of less than 50 · 109/l (OR = 5; 95% CI 1.2–21.3) had the prognostic significance.Conclusion. Modern neonatal sepsis has a diverse etiology with gram-negative bacteria as causative agents in half of the cases. Despite modern treatment methods, neonatal sepsis remains a formidable infectious pathology. The risk of fatal outcome is associated with organ dysfunction. Coma, elevated blood lactate level and severe thrombocytopenia are the most significant predictors of fatal outcome in neonatal sepsis.

scholarly journals Bacteriological Profile and their Susceptibility Pattern in Neonatal Intensive Care Unit at Tertiary Care Hospital in Wah

2020 ◽  
Vol 24 (3) ◽  
pp. 219-224
Author(s):  
Saba Mushtaq ◽  
Sohail Ashraf ◽  
Lubna Ghazal ◽  
Rida Zahid ◽  
Basharat Hussain ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Gram Negative Bacteria ◽  
Gram Positive ◽  
Blood Samples ◽  
Gram Negative ◽  
Gram Positive Cocci

Introduction: Neonatal sepsis is a clinical syndrome characterized by multiple symptoms and signs of infection during the first month of life. The objective of this study is to determine the frequency of commonly isolated bacteria from patients of neonatal sepsis and their susceptibility patterns in POF hospital at Wah. Methods: This cross-sectional study was carried out in POF Hospital Neonatal intensive care unit and Microbiology laboratory from January 2018 to December 2019. The blood samples of patients suspected with neonatal sepsis were processed as per standard methodology. Results: Out of ninety blood samples, fifty-one (56.7%) yielded the growth of Gram-negative rods and thirty-nine (43.3%) yielded Gram-positive cocci. Among Gram-positive bacteria, coagulase-negative staphylococci were the most common pathogen isolated from 53.8% cases followed by methicillin-resistant Staphylococcus aureus (15.3%). Among Gram-negative bacteria, Klebsiella pneumoniae (54.90%) was the most frequently identified bacteria followed by Serratia marcescens (27.45%). The Gram-positive cocci were the most susceptible to linezolid (100%) followed by vancomycin (87.2%). The Gram-negative rods depict remarkable resistance to ciprofloxacin (92.2%), gentamicin (100%), and meropenem (54.9%). Conclusions: The study concluded a predominance of Gram-negative bacteria as a causative agent of neonatal sepsis in our setup. The bacterial isolates are highly resistant to commonly prescribed oral as well as injectable antibiotics. Implementation of infection control policies is a dire need to combat the grave situation of increasing antibiotic resistance.

scholarly journals Evaluation of bacterial pathogens in neonatal sepsis and their susceptibility pattern: A Hospital Based Study

2014 ◽  
Vol 3 (1) ◽  
pp. 35-40
Author(s):  
Biplob Kumar Raha ◽  
Nasim Jahan ◽  
Md Abdul Baki ◽  
Tahmina Begum ◽  
Nazmun Nahar ◽  
...  
Keyword(s):  
Neonatal Sepsis ◽  
Antimicrobial Agents ◽  
Clinical Laboratory ◽  
Blood Cultures ◽  
Diffusion Method ◽  
National Committee ◽  
Gram Negative Bacteria ◽  
Susceptibility Pattern ◽  
Gram Positive ◽  
Gram Negative

Neonatal sepsis is one of the major causes of neonatal morbidity and mortality, particularly in developing countries. Epidemiology and surveillance of neonatal sepsis helps in implementation of rational empirical antibiotic strategy. A cross-sectional prospective study was conducted in the special care baby unit under department of Paediatrics and Neonatology, BIRDEM General Hospital during the period of November 2008 to September 2009 to determine the pattern of bacterial agents causing neonatal sepsis and their susceptibility pattern to various antimicrobial agents. Blood cultures were performed on admitted newborn babies (0-28 days) to rule out sepsis. Antimicrobial susceptibility testing was done for all blood culture isolates according to the criteria of the National Committee for Clinical Laboratory Standards by disk diffusion method. Out of 720 screened blood cultures, 64 (8.9%) reported as positive and the gram positive and gram negative bacteria accounted for 6 (9.4%) and 58 (90.6%) respectively. The most common gram positive organisms were Staphylococcus aureus (6.3%) and Enterococci (3.1%) & gram negative organisms were Klebsiella pneumoniae (37.5%), Serratia (25%), Pseudomonas aeruginosa (10.9%), Citrobacter (10.9%) and Acinetobacter (6.3%). The susceptibilities were remarkably low to Ampicillin (3.12 %) & Cefotaxim (10.9%) for both gram positive & gram negative isolates. Gram positive group had susceptibilities of 66.7% to Ciprofloxacin and Imipenem, 83.3% to Gentamicin, & 100% to Amikacin & Vancomycin. Gram negative isolates showed higher sensitivities to Imipenem (94.8%), Ciprofloxacin (89.7%), Amikacin (72.4%) respectively. Gram-negative bacteria showed high level of resistance to commonly used antibiotics (Ampicillin, Ceftazidim and Cefotaxim). Gentamicin, Amikacin, Imipenem and Ciprofloxacin were the most effective drugs compared to others. Routine bacterial surveillance and their sensitivity patterns must be an essential component of neonatal care. CBMJ 2014 January: Vol. 03 No. 01 P: 35-40

scholarly journals Organism Specific Response of Platelet Count in Neonatal Sepsis

2014 ◽  
Vol 4 (2) ◽  
pp. 79-83
Author(s):  
Biplob Kumar Raha ◽  
Md Abdul Baki ◽  
Tahmina Begum ◽  
Nazmun Nahar
Keyword(s):  
Platelet Count ◽  
Neonatal Sepsis ◽  
Specific Response ◽  
Gram Negative Bacteria ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria ◽  
Prolonged Duration ◽  
Fungal Sepsis ◽  
Culture Positive

Background: Neonatal sepsis is one of the major causes of neonatal morbidity and mortality, particularly in developing countries and it is caused by Gram positive bacteria, Gram negative bacteria and fungi. Thrombocytopenia has been used as an early but nonspecific marker for sepsis. About 75% of culture positive neonates have thrombocytopenia. The severity and duration of thrombocytopenia varies in different types of organism. So, the objectives of this study were to examine platelet counts and platelet indices in neonates with culture proven sepsis and to determine if there was an organism specific platelet response.Methods: This cross- sectional prospective study was carried out in the special care baby unit (SCABU) under department of Paediatrics and Neonatology, BIRDEM General Hospital, Dhaka from November 2008 to September 2009.Results: Total 120 newborn babies with culture positive sepsis were included in this study. Gram positive bacteria was found in 06 (5%), Gram negative bacteria was found in 58(48.3%) and fungi was found in 56 (46.7%) neonates. Thrombocytopenia was found in 95% of culture positive neonates. When compared with neonates with Gram positive sepsis, those with Gram-negative or fungal sepsis had a significantly lower platelet count, platelet nadir and prolonged duration of thrombocytopenia (p=<0.05). Fungal sepsis was also associated with prolonged duration of thrombocytopenia when compared with that of Gram negative sepsis (p=0.03).Conclusion: Neonatal sepsis is frequently associated with thrombocytopenia. However, Gram negative and fungal sepsis is associated with a lower platelet count, platelet nadir and prolonged duration of thrombocytopenia compared with that of Gram positive sepsis.Birdem Med J 2014; 4(2): 79-83

scholarly journals Bacterial etiology and antibiotic resistance pattern of neonatal sepsis: a study in a tertiary care hospital, in Bangladesh

2019 ◽  
Vol 6 (5) ◽  
pp. 1839
Author(s):  
Mahfuza Shirin ◽  
M. Monir Hossain ◽  
Manifa Afrin ◽  
Mohammad Abdullah Al Mamun
Keyword(s):  
Neonatal Sepsis ◽  
Tertiary Care ◽  
Resistance Pattern ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Gram Positive ◽  
Cross Sectional ◽  
Gram Negative ◽  
Mortality And Morbidity ◽  
Gram Positive Bacteria

Background: Neonatal sepsis is a leading cause of neonatal mortality and morbidity. The objective of the study was to detect causative microorganisms of neonatal sepsis and their antimicrobial resistance patterns.Methods: This prospective cross-sectional study was conducted from July 2017 to June 2018 in the Department of Neonatal Medicine and NICU of Dhaka Shishu (Children) Hospital (DSH). Neonates diagnosed with probable sepsis were studied. After enrollment, 1 mL blood was taken and sent to Microbiology department of DSH for culture and sensitivity. With baseline characteristics, clinical examination findings and outcome, were also recorded.Results: Rate of isolation of single organism was 9.2% (84/913). Out of 84 isolates, gram negative bacteria were 77.4% with Klebsiella pneumonae being the commonest (35, 41.7%), gram positive bacteria were 11.9% with Staphylococcus aureus and Streptococcus were equal (5, 5.95% each) and the remaining (9, 10.7%) isolated organism was Candida. Most of the isolated gram-negative bacteria were resistant to ampicillin, gentamicin, and ceftazidime; but gram-positive bacteria preserved 20-80% sensitivity. Klebsiella was more resistant than Acinetobacter to amikacin, netilmicin, ciprofloxacin and levofloxacin. Around 45-65% of gram-negative bacteria were resistant to imipenem and meropenem but gram-positive bacteria showed lesser resistance. Among the gram-negative bacteria, Klebsiella and Acinetobacter were resistant to piperacillin as same as carbapenem group, but gram-positive bacteria were 100% sensitive to piperacillin. All the gram-negative bacteria showed more resistance to 4th generation cephalosporin, cefepime than carbapenem. Out of culture positive 84 neonates, 63 (75.0%) were cured but 21 (25.0%) died. Among the 21 expired neonates, 47.6% (10/21) were infected with Klebsiella.Conclusion: This study observed that gram-negative bacteria causing neonatal sepsis predominantly, with emergence of Candida. All the isolated gram-positive and gram-negative organisms were mostly resistant to available antibiotics

scholarly journals Alarming Pattern of Antimicrobial Resistance in Neonatal Sepsis Observed in Neonatal Intensive Care Unit of a Tertiary Care Hospital in Bangladesh

KYAMC Journal ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 3-7
Author(s):  
Tania Rahman ◽  
Sharmeen Sultana ◽  
Taslima Akber Happy ◽  
Kamrunnahar Alo ◽  
Momtaz Begum
Keyword(s):  
Antimicrobial Resistance ◽  
Neonatal Sepsis ◽  
Antimicrobial Agents ◽  
Tertiary Care ◽  
Diffusion Method ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Isolation And Identification ◽  
Gram Positive ◽  
Gram Negative

Background: Resistance of micro-organisms to multiple broad-spectrum antimicrobial agents is a major problem in treating neonatal sepsis. It is a matter of utmost importance to have knowledge of trends in changing pattern of antimicrobial resistance. Objective: This study was done to observe antimicrobial resistance of gram-positive and gram-negative bacteria isolated from cases of neonatal sepsis Material and Methods: This cross sectional descriptive study was conducted in Department of Microbiology in collaboration with Department of Neonatology, Dhaka Medical College Hospital, Dhaka. Antimicrobial resistance of all the isolated bacteria was performed by Modified Kirby-bauer disk diffusion method following standard guideline after isolation and identification of bacteria from blood samples of suspected septicemic neonates by automated blood culture and standard microbiological protocol. Results: All of the isolated Staphylococcus aureus, Coagulase negative Staphylococcus, Group-B Streptococcus and Micrococcus showed 100% resistance to ceftriaxone, cefotaxime and ceftazidime. Among the isolated gram-negative bacteria, all of Enterobacter spp., Pseudomonas aeruginosa and Citrobacter spp. showed 100% resistance to amoxiclav, amikacin, ceftriaxone, cefixime, ceftazidime. Conclusion: Majority of the gram-positive and gram-negative bacteria are developing resistance to multiple antimicrobial agents and surveillance is necessary to tackle this alarming situation. KYAMC Journal.2021;12(01): 03-07

Serum levels of CD14 in neonatal sepsis by Gram-positive and Gram-negative bacteria

1996 ◽  
Vol 85 (6) ◽  
pp. 728-732 ◽  
Author(s):  
A Blanco ◽  
G Solis ◽  
E Arranz ◽  
GD Coto ◽  
A Ramos ◽  
...  
Keyword(s):  
Neonatal Sepsis ◽  
Serum Levels ◽  
Gram Negative Bacteria ◽  
Gram Positive ◽  
Gram Negative

Antimicrobial Sensitivity Pattern of Isolates from Neonatal Sepsis in Yekatit 12 Teaching Hospital, Addis Ababa, Ethiopia

2020 ◽  
Vol 36 (1) ◽  
pp. 67-72
Author(s):  
Oumer Sada Muhammed ◽  
Getachew Alemkere ◽  
Beshir Bedru Nasir
Keyword(s):  
Teaching Hospital ◽  
Neonatal Sepsis ◽  
Addis Ababa ◽  
Cross Sectional Study ◽  
Gram Negative Bacteria ◽  
Sectional Study ◽  
Gram Positive ◽  
Cross Sectional ◽  
Gram Negative ◽  
Sensitivity Pattern

Sepsis is one of the commonest reasons of neonatal deaths. It is accountable for about 30 - 50% of the whole baby deaths in the developing  ountries. The current study aimed to assess drug susceptibility patterns of isolates from cases of neonatal sepsis. Institution based cross-sectional study was conducted among 132 neonates admitted to Yekatit 12 teaching hospital with the diagnosis of sepsis and who had a positive result for culture and sensitivity test. Data was collected through medical chart review using data abstraction tool. The data was analyzed using excel and reported using descriptive tables. Gram-negative bacteria were the commonest organisms identified 124 (93.9%), followed by gram-positive isolates (6.1%). Klebsiella (87.9%) was the predominant gram-negative bacteria. Of the gram-positive organisms, coagulase negative staphylococci (3.03%) were the commonest pathogen, followed by Staphylococcus aureus (2.27%). Among the gram-negative isolates, overall sensitivity was high to meropenem (96.0%), amikacin (94.3%) and amoxicillin + clavulanate (74.2%) but sensitivity was very low to ampicillin (2.7%), and amoxicillin (7.3%).Generally, the isolated pathogens were resistant to commonly used antibiotics in the study setting and resistance of gram-positive pathogens  Against penicillins and cephalosporins was also high. Hence, rational and tailored antibiotic use based on the susceptibility data is recommended and regular antibiotic susceptibility surveillance should be conducted. Keywords: neonatal sepsis, cross-sectional study, antibiotics, culture, sensitivity, resistance

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