scholarly journals Incidence of early-onset sepsis in infants born to women with clinical chorioamnionitis

2018 ◽  
Vol 46 (8) ◽  
pp. 926-933 ◽  
Author(s):  
Tara M. Randis ◽  
Madeline Murguia Rice ◽  
Leslie Myatt ◽  
Alan T.N. Tita ◽  
Kenneth J. Leveno ◽  
...  
Keyword(s):  
Clinical Diagnosis ◽  
Apgar Score ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
Antibiotic Administration ◽  
Nulliparous Women ◽  
Early Onset Sepsis ◽  
Adverse Neonatal Outcomes

Abstract Objective To determine the frequency of sepsis and other adverse neonatal outcomes in women with a clinical diagnosis of chorioamnionitis. Methods We performed a secondary analysis of a multi-center placebo-controlled trial of vitamins C/E to prevent preeclampsia in low risk nulliparous women. Clinical chorioamnionitis was defined as either the “clinical diagnosis” of chorioamnionitis or antibiotic administration during labor because of an elevated temperature or uterine tenderness in the absence of another cause. Early-onset neonatal sepsis was categorized as “suspected” or “confirmed” based on a clinical diagnosis with negative or positive blood, urine or cerebral spinal fluid cultures, respectively, within 72 h of birth. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by logistic regression. Results Data from 9391 mother-infant pairs were analyzed. The frequency of chorioamnionitis was 10.3%. Overall, 6.6% of the neonates were diagnosed with confirmed (0.2%) or suspected (6.4%) early-onset sepsis. Only 0.7% of infants born in the setting of chorioamnionitis had culture-proven early-onset sepsis versus 0.1% if chorioamnionitis was not present. Clinical chorioamnionitis was associated with both suspected [OR 4.01 (3.16–5.08)] and confirmed [OR 4.93 (1.65–14.74)] early-onset neonatal sepsis, a need for resuscitation within the first 30 min after birth [OR 2.10 (1.70–2.61)], respiratory distress [OR 3.14 (2.16–4.56)], 1 min Apgar score of ≤3 [OR 2.69 (2.01–3.60)] and 4–7 [OR 1.71 (1.43–2.04)] and 5 min Apgar score of 4–7 [OR 1.67 (1.17–2.37)] (vs. 8–10). Conclusion Clinical chorioamnionitis is common and is associated with neonatal morbidities. However, the vast majority of exposed infants (99.3%) do not have confirmed early-onset sepsis.

scholarly journals Early-Onset Neonatal Sepsis

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Marija Jovicic ◽  
Marko Folic ◽  
Slobodan Jankovic
Keyword(s):  
Neonatal Sepsis ◽  
Early Onset ◽  
Clinical Symptoms ◽  
Late Onset ◽  
Pediatric Population ◽  
Consensus Conference ◽  
Antibiotic Administration ◽  
Perinatal Medicine ◽  
Suspected Sepsis ◽  
Early Onset Sepsis

Abstract Despite the great progress made in neonatal and perinatal medicine over the last couple of decades, sepsis remains one of the main causes of morbidity and mortality. Sepsis in pediatric population was defined at the Pediatric Sepsis Consensus Conference in 2005. There is still no consensus on the definition of neonatal sepsis. Neonatal sepsis is a sepsis that occurs in the neonatal period. According to the time of occurrence, neonatal sepsis can be of early onset, when it occurs within the first 72 hours of birth and results from vertical transmission, and of late onset, in which the source of infection is found most often in the environment and occurs after the third day of life. The most common causes of early-onset sepsis are Group B Streptococcus (GBS) and E. coli. Risk factors can be mother-related and newborn-related. Clinical symptoms and signs of sepsis are quite unspecific. The dysfunction of different organs may imitate sepsis. On the other hand, infectious and non-infectious factors may exist simultaneously. The start of the antimicrobial therapy in any newborn with suspected sepsis should not be delayed. Pentoxifylline may have potential benefits in preterm newborns with sepsis. The only proven intervention that has been shown to reduce the risk of early-onset neonatal sepsis is intrapartum intravenous antibiotic administration to prevent GBS infection. It is still a great challenge to discontinue antibiotic treatment in non-infected newborns as soon as possible, because any extended antibiotic use may later be associated with other pathological conditions.

NEONATAL SEPSIS AND IDENTIFICATION OF RISK FACTORS: STUDY IN AVBRH HOSPITAL SAWANGI

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Pramod P. Singhavi
Keyword(s):  
Risk Factors ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Late Onset ◽  
Signs And Symptoms ◽  
Premature Rupture ◽  
Maternal Risk ◽  
Late Onset Sepsis ◽  
Early Onset Sepsis ◽  
Meconium Stained Amniotic Fluid

Introduction: India has the highest incidence of clinical sepsis i.e.17,000/ 1,00,000 live births. In Neonatal sepsis septicaemia, pneumonia, meningitis, osteomyelitis, arthritis and urinary tract infections can be included. Mortality in the neonatal period each year account for 41% (3.6 million) of all deaths in children under 5 years and most of these deaths occur in low income countries and about one million of these deaths are due to infectious causes including neonatal sepsis, meningitis, and pneumonia. In early onset neonatal sepsis (EOS) Clinical features are non-specific and are inefficient for identifying neonates with early-onset sepsis. Culture results take up to 48 hours and may give false-positive or low-yield results because of the antenatal antibiotic exposure. Reviews of risk factors has been used globally to guide the development of management guidelines for neonatal sepsis, and it is similarly recommended that such evidence be used to inform guideline development for management of neonatal sepsis. Material and Methods: This study was carried out using institution based cross section study . The total number neonates admitted in the hospital in given study period was 644, of which 234 were diagnosed for neonatal sepsis by the treating pediatrician based on the signs and symptoms during admission. The data was collected: Sociodemographic characteristics; maternal information; and neonatal information for neonatal sepsis like neonatal age on admission, sex, gestational age, birth weight, crying immediately at birth, and resuscitation at birth. Results: Out of 644 neonates admitted 234 (36.34%) were diagnosed for neonatal sepsis by the paediatrician based on the signs and symptoms during admission. Of the 234 neonates, 189 (80.77%) infants were in the age range of 0 to 7 days (Early onset sepsis) while 45 (19.23%) were aged between 8 and 28 days (Late onset sepsis). Male to female ratio in our study was 53.8% and 46% respectively. Out of total 126 male neonates 91(72.2%) were having early onset sepsis while 35 (27.8%) were late onset type. Out of total 108 female neonates 89(82.4%) were having early onset sepsis while 19 (17.6%) were late onset type. Maternal risk factors were identified in 103(57.2%) of early onset sepsis cases while in late onset sepsis cases were 11(20.4%). Foul smelling liquor in early onset sepsis and in late onset sepsis was 10(5.56%) and 2 (3.70%) respectively. In early onset sepsis cases maternal UTI, Meconium stained amniotic fluid, Multipara and Premature rupture of membrane was seen in 21(11.67%), 19 (10.56%), 20(11.11%) and 33 (18.33%) cases respectively. In late onset sepsis cases maternal UTI, Meconium stained amniotic fluid, Multipara and Premature rupture of membrane was seen in 2 (3.70%), 1(1.85%), 3 (5.56%) and 3 (5.56%) cases respectively. Conclusion: Maternal risk identification may help in the early identification and empirical antibiotic treatment in neonatal sepsis and thus mortality and morbidity can be reduced.

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

2018 ◽  
Vol 5 (2) ◽  
pp. 389 ◽  
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. 

scholarly journals The Effect of Epidural-Spinal Anesthesia on Labor Outcome and Satisfaction in Parturient Mothers: A Randomized Controlled Trial

2017 ◽  
Vol 2 (4) ◽  
pp. 178-183
Author(s):  
Faegheh Golalizadeh Bibalan ◽  
Fatemeh Shobeiri ◽  
Akram Ranjbar ◽  
Pooran Hagian
Keyword(s):  
Randomized Controlled Trial ◽  
Pain Relief ◽  
Apgar Score ◽  
Controlled Trial ◽  
Labor Pain ◽  
Normal Vaginal Delivery ◽  
Second Stage Of Labor ◽  
Randomized Controlled ◽  
Nulliparous Women ◽  
Significant Difference

Introduction: One of the health system concerns is the use of medications for pain relief during labor and its side effects. Therefore, the aim of this study was to investigate the effect of epiduralspinal anesthesia (combined anesthesia [CA]) on labor outcome and satisfaction in pregnant women. Methods: In this randomized controlled trial study, we included 80 nulliparous women who had been admitted to Fatemieh hospital (Hamadan, Iran) during 2015-2016 due to spontaneous onset of labor. They were randomly assigned into 2 groups of 40, one group with CA versus normal vaginal delivery (NVD) group. Data were collected by using of demographic questionnaire, satisfaction questionnaire, and baby truck scales. Data were analyzed by descriptive and analytical statistics in SPSS version 16.0. Results: Average maternal age (mean ± SD) in the CA group was 26.94 ± 4.34 and in the NVD group was 25.89 ±5.18, respectively. There was a significant difference between the 2 groups in terms of length of second stage of labor (P=0.001), headache (P=0.04), and Apgar score (first minute) (P=0.001). Chi-square test showed a significant difference between the 2 groups in terms of satisfaction with childbirth (P=0.004). Conclusion: In this study, labor pain relief by using the spinal-epidural anesthesia (CA) increased the labor satisfaction. Nevertheless, this approach was associated with some maternal and neonatal complications such as: headaches, length of third stage of labor, and low Apgar score. It seems that the use of this method for painless delivery requires further studies.

scholarly journals Clinicobacteriological profile, antibiotic sensitivity patterns and mortality of neonatal sepsis in a tertiary care hospital in Kashmir, Jammu and Kashmir, India

2019 ◽  
Vol 6 (3) ◽  
pp. 917
Author(s):  
Gh Rasool Wani ◽  
Nazir Ahmed ◽  
Mohd Irshad ◽  
Mohd Ashraf ◽  
Bashir Ahmed Teli
Keyword(s):  
Blood Culture ◽  
Neonatal Mortality ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Late Onset ◽  
Antibiotic Sensitivity ◽  
Government Medical College ◽  
Gram Negative ◽  
Medical College ◽  
Early Onset Sepsis

Background: Neonatal sepsis refers to generalized bacterial blood stream infection in first 28 days of life documented by positive blood cultures. It is one of leading causes of neonatal mortality. Objectives was to study clinicobacteriological, antibiotic sensitivity patterns and mortality of neonatal sepsis.Methods: This prospective study was conducted in the Department of Pediatrics of Government Medical College Srinagar in collaboration with Department of Microbiology of same medical college after ethical clearance from ethical committee of Government Medical College Srinagar. One hundred (100) neonates out of 731 neonates admitted between octomber2007 and September 2008 with signs and symptoms of neonatal sepsis were included in our study by random sampling method. After history, examination and laboratory investigation blood culture results were analyzed by standard statistical methods.Results: The blood culture was positive in 40% of neonates. Fifty one (51) neonates were males while as 49 were females. Sixty three (63) neonates had late onset of sepsis while as 37 had early onset sepsis. The positive  blood culture was more common in males, late onset sepsis, babies born in rural areas, home born, vaginal births, preterm and other  low birth weight neonates .The gram negative isolates were most common followed by positive ones .The best sensitivity of gram negative isolates was to ciprofloxacin followed by amikacin and cephalosporins while as gram positive isolates were sensitive to imipenum followed by vancomycin. Pseudomonas was most responsive to pipercillin +tazobactum combination. The neonatal mortality was 35% being higher in early onset sepsis and low birth weights.Conclusions: This study depicts a high rate of neonatal sepsis, mainly caused by gram negative organisms followed by gram positive organisms with rising drug resistance that could bear far reaching implications to the times to come, mandating the implementation of sepsis preventive measures and administration of specific antibiotics.

scholarly journals Clinico-epidemiological spectrum of early onset neonatal sepsis in neonates admitted in NICU of a tertiary care institute

2019 ◽  
Vol 6 (3) ◽  
pp. 1046
Author(s):  
Ashwani Kumar ◽  
Gursharan Singh Narang ◽  
Gurmeet Singh ◽  
Navneet Virk ◽  
Ashiana Singh
Keyword(s):  
Staphylococcus Aureus ◽  
Respiratory Distress ◽  
Acinetobacter Baumannii ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Late Onset ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Total Leukocyte Count ◽  
Early Onset Sepsis

Background: Neonatal  sepsis  is  a  clinical syndrome  characterized by signs and symptoms  of  infection  with  or  without  accompanying  bacteremia  in  the  first  month  of  life. Neonatal  sepsis  may  be  classified  into  two  groups : early onset  sepsis and  late onset  sepsis . Early onset neonatal sepsis  is  generally  associated  with  the  acquisition  of  microorganisms  from  the  mother  and  usually  presents  with  respiratory  distress  and  pneumonia.Methods: The study included one hundred  term  neonates with early onset neonatal sepsis. A septic screen including total leukocyte count, absolute neutrophil count, blood smear evaluation, blood cultures and C-reactive protein (CRP) were performed in all neonates with suspected sepsis to corroborate early onset sepsis diagnosis. Epidemiological parameters including gender of the neonate, mode of delivery, rural/urban residence were recorded in addition to clinical profile.Results: Respiratory distress was the most common presentation in the form of tachypnea, seen in 63 (63.0%) neonates. In present study, Staphylococcus aureus was the most common organism isolated followed by Staphylococcus epidermidis, Staphylococcus hominis, Acinetobacter baumannii and Klebsiella pneumonae.Conclusions: Early onset neonatal sepsis  was seen more in males. Among the gram-positive Staphylococcus aureus and among gram negative Acinetobacter baumannii and Klebsiella pneumonae were most common organisms to be isolated.

scholarly journals Patient characteristics, Bacteriological profile & outcome of Neonatal Sepsis: A Hospital Based Study

2013 ◽  
Vol 2 (1) ◽  
pp. 49-54
Author(s):  
Nasim Jahan ◽  
Zabrul SM Haque ◽  
Md Abdul Mannan ◽  
Morsheda Akhter ◽  
Sabina Yasmin ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Late Onset ◽  
Female Ratio ◽  
Gram Negative ◽  
Common Pathogen ◽  
Late Onset Sepsis ◽  
Early Onset Sepsis

Neonatal sepsis is a major cause of mortality and morbidity in newborn. The spectrum of bacteria which causes neonatal sepsis varies in different parts of the world. The organisms responsible for early onset and late onset sepsis are different. The objective of the study was undertaken to determine the pattern of bacterial isolates responsible for early and late onset neonatal sepsis. A prospective descriptive study over the period of one year was conducted at the Department of Neonatal Intensive care unit of Ad-din Women’s Medical College and Hospital, Dhaka, Bangladesh.Organisms were isolated from 8.7% of collected blood samples. The male female ratio of culture proven sepsis was 1.7:1. More than half (52.8%) of the evaluated neonates were preterm. & 56.3% had low birth weight. The gram positive and gram negative bacteria accounted for 24.1% and 75.9% of the isolates respectively. Around three fourth of the neonates (75.8%) presented with early onset sepsis, while 24.2% presented with late onset sepsis. Acinetobacter was the most common pathogen both in early onset (70%) and late onset (30%) sepsis. Pseudomonas (89.4%) was the second most common pathogen in early onset sepsis. Total mortality rate was 5.7%. Pre term, low birth weight and gram negative sepsis contributes majority of mortality.Gram negative organism especially Acinetobacter found to be commonest cause of sepsis. Pseudomonas was second most common but contributed highest in late onset sepsis and neonatal death due to sepsis. DOI: http://dx.doi.org/10.3329/cbmj.v2i1.14184 Community Based Medical Journal Vol.2(1) 2013 49-54

scholarly journals Stenotrophomonas maltophilia: a rare cause of early onset neonatal sepsis

2018 ◽  
Vol 5 (5) ◽  
pp. 2006
Author(s):  
Chapay Soren ◽  
Snigdha Jagtap ◽  
V. Malathi ◽  
Lakshmi Aparnadevi V. V.
Keyword(s):  
Respiratory Distress ◽  
Antimicrobial Therapy ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Stenotrophomonas Maltophilia ◽  
Morbidity And Mortality ◽  
Significant Morbidity ◽  
Early Onset Sepsis

Stenotrophomonas maltophilia is a rare cause of early onset neonatal sepsis. The extensive resistance of this organism to several antibiotics leaves fewer options for antimicrobial therapy. A few cases were reported in neonates. We present a case of early onset sepsis in a neonate caused by Stenotrophomonas maltophilia. The newborn was born preterm and presented with respiratory distress within two hours of birth. Stenotrophomonas maltophilia is a rare cause early onset neonatal sepsis with significant morbidity and mortality.

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