scholarly journals Early neonatal sepsis: prevalence, complications and outcomes in newborns with 35 weeks of gestational age or more

2022 ◽  
Vol 40 ◽  
Author(s):  
Juliana Fernandes de Camargo ◽  
Jamil Pedro de Siqueira Caldas ◽  
Sérgio Tadeu Martins Marba
Keyword(s):  
Hospital Discharge ◽  
Gestational Age ◽  
Neonatal Sepsis ◽  
Descriptive Analysis ◽  
Neonatal Unit ◽  
Cross Sectional ◽  
Live Births ◽  
Early Onset Sepsis ◽  
Discharge Status ◽  
Early Neonatal Sepsis

ABSTRACT Objective: To analyze the incidence, complications, and hospital discharge status in newborns with ≥35 weeks of gestational age with early neonatal sepsis. Methods: This is a cross-sectional, retrospective study. Cases of early-onset sepsis registered from January 2016 to December 2019 in neonates with gestational age of 35 weeks or more were reviewed in a level III neonatal unit. The diagnoses were performed based on the criteria by the Brazilian Health Regulatory Agency (Anvisa), and the episodes were classified according to microbiological classification and site of infection. The following complications were evaluated: shock, coagulation disorders, and sequelae of the central nervous system. The conditions at hospital discharge were also assessed. The collected data were analyzed with the descriptive analysis. Results: In the period, early neonatal sepsis occurred in 46 newborns, corresponding to 1.8% of all newborns admitted to the neonatal unit, with a prevalence of 4/1,000 live births. Culture confirmed sepsis ocurred in three patients (0.3/1,000 live births), with the following agents: S. pneumoniae, S. epidermidis and S. agalactiae. As to site of infection, there were 35 cases of primary bloodstream infection, seven cases of pneumonia and four cases of meningitis. Most patients (78.3%) had at least one risk factor for sepsis, and all were symptomatic at admission. There were no deaths. Complications occurred in 28.2% of the cases, especially shock (10 cases – 21.7%). Conclusions: The prevalence of proven early neonatal sepsis was low. Despite the common occurrence of complications, there were no deaths.

scholarly journals Serum Procalcitonin and C Reactive Protein in as early markers neonatal sepsis- A prospective study

2020 ◽  
Vol 8 (2) ◽  
pp. 73-77
Keyword(s):  
Blood Culture ◽  
Prospective Study ◽  
Gestational Age ◽  
Neonatal Sepsis ◽  
Statistical Significance ◽  
Developed Countries ◽  
Early Onset Sepsis ◽  
The Developed Countries ◽  
One Year ◽  
A Prospective Study

Neonatal sepsis is one of the commonest causes of morbidity and mortality in neonates in India compared to the developed countries. Aim: To evaluate the Procalcitonin level this is an early marker in the diagnosis of neonatal sepsis and to assess the suitability of this test in the diagnosis of early-onset sepsis. Method: The prospective study was conducted in the Neonatal Division of Department of Pediatrics, Prathima Institute of Medical Sciences over a period of one year. The blood samples from 100 babies meeting the inclusion and exclusion criteria constituted the material for study. Result: Among the n=100 cases n=39 were procalcitonin positive, compared with gestational age 10 (43.5%) cases were positive with a gestation of <37 weeks and 24 (31.2%) cases positive of cases >37 weeks and there was no statistical significance concerning gestational age the association of material characteristics with procalcitonin positive and CRP positive levels. Blood culture was positive in n=9 (9%) of babies with (90% CI, 5.3-14.9) and negative in n=91 (91%) of babies with (90% CI, 85.2-94.7). Conclusion: A positive blood culture is the only definitive and gold standard for confirming a case of sepsis. Since the culture and sensitivity test requires a minimum period of 48 hours which is a precious time in deciding on the treatment of sepsis in the newborn. Rapid diagnosis by using Procalcitonin and CRP gives a reasonable degree of accuracy in diagnosing neonatal sepsis and will also guide antibiotic therapy. Procalcitonin in comparison with CRP has better sensitivity and hence can detect most cases of neonatal sepsis and better negative predictive value.

scholarly journals Early-Onset Sepsis Risk Calculator: A Review Of Its Effectiveness And Comparative Study With Our Evidence-Based Local Guidelines

2021 ◽  
Author(s):  
Gianluigi Laccetta ◽  
Massimiliano Ciantelli ◽  
Cristina Tuoni ◽  
Emilio Sigali ◽  
Mario Miccoli ◽  
...  
Keyword(s):  
Gestational Age ◽  
Early Onset ◽  
Clinical Signs ◽  
Risk Calculator ◽  
Live Births ◽  
Early Onset Sepsis ◽  
Number Of Patients ◽  
Sepsis Risk ◽  
Empirical Antibiotics ◽  
Sepsis Calculator

Abstract Background According to most early-onset sepsis management guidelines, approximately 10% of the total neonatal population are exposed to antibiotics in the first postnatal days with subsequent increase of neonatal and pediatric comorbidities. Early-onset sepsis risk calculator has been developed with the purpose of avoiding antibiotic overtreatment among neonates ≥ 34 weeks’ gestational age: a review of literature demonstrates its effectiveness in reducing antibiotic overtreatment, laboratory testing, painful procedures and NICU admission; however, some missed cases of culture-positive early-onset sepsis have also been described. Methods All neonates with birth weight ≤ 1500 g, 34–36 weeks’ gestational age neonates with suspected intraamniotic infection and neonates with three clinical signs of early-onset sepsis or two signs and one risk factor for early-onset sepsis receive empirical antibiotics. Neonates ≥ 34 weeks’ gestational age with risk factors for early-onset sepsis or with one clinical indicator of early-onset sepsis undergo serial measurements of C-reactive protein and procalcitonin in the first 48–72 hours of life; they receive empirical antibiotics in case of abnormalities at blood exams with one or more clinical signs of early-onset sepsis. We therefore compared the number of patients for which antibiotics were needed, based on early-onset sepsis calculator, and the number of patients we treated with antibiotics during the study period. Comparisons between the groups were performed using McNemar’s test and statistical significance was set at p < 0.05. Results During the study period (1st January 2018-31st December 2018) 32/265 (12.1%) neonates ≥ 34 weeks’ gestational age at risk for early-onset sepsis received antibiotics within the first 12 hours of life. According to early-onset sepsis calculator: 55/265 (20.7%) patients would have received antibiotics with early-onset sepsis incidence 2/1000 live births (p < 0.0001); 44/265 (16.6%) patients would have received antibiotics with early-onset sepsis incidence 0.1/1000 live births (p < 0.025). One patient with culture-negative early-onset sepsis would not have received antibiotics with an early-onset sepsis incidence of 0.1/1000 live births. Conclusion Our evidence-based protocol for treatment decision-making of neonatal early-onset sepsis entails a further decrease of antibiotic overtreatment compared to early-onset sepsis risk calculator. No negative consequences for patients were observed.

scholarly journals Frequency of maternal risk factors in diagnosed cases of early neonatal sepsis.

2019 ◽  
Vol 26 (12) ◽  
pp. 2044-2047
Author(s):  
Faraz Ahmed ◽  
Mohsin Ali ◽  
Hussan Ali Sarwar ◽  
Miqdad Haider ◽  
Muhammad Bilal Safdar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Preterm Delivery ◽  
Neonatal Sepsis ◽  
Neonatal Morbidity ◽  
Cross Sectional Study ◽  
Maternal Risk Factors ◽  
Cross Sectional ◽  
Maternal Risk ◽  
Early Neonatal Sepsis ◽  
Study Setting

One of the major and important but preventable causes of neonatal morbidity and mortality is Neonatal sepsis. Objectives: To determine the frequency of maternal risk factors in diagnosed cases of early neonatal sepsis. Study Design: Descriptive cross sectional study. Setting: Nursery, Department of Children Hospital and the institute of child health, Lahore. Period: 15-01-2016 to 15-07-2016. Material and Methods: After approval from hospital ethical committee, according to inclusion and exclusion criteria, 250 patients were enrolled in the study from nursery department of children hospital, Lahore. Maternal risk factors i.e. PROM, meconium stained liquor and preterm delivery were recorded along with the demographic information of each case. Results: In our study, out of 250 cases, cases between 1-2 days were 64.8% (n=162) while cases between 3 days of life were 35.2% (n=88), mean+sd was resulted as 2.17+0.69 days. Frequency of maternal risk factors in diagnosed cases of early neonatal sepsis was turned out as 64.8% (n=162) PROM, 29.6% (n=74) meconium stained liquor and preterm delivery was resulted in 21.2% (n=53). Conclusion: The leading maternal risk factor is PROM followed by meconium stained liquor and preterm delivery in diagnosed cases of early neonatal sepsis.

scholarly journals Survival rate and length of stay of preterm babies less than 1500 grams in a neonatal unit in Port Harcourt, Nigeria

2021 ◽  
Vol 8 (2) ◽  
pp. 213
Author(s):  
Boma A. West
Keyword(s):  
Birth Weight ◽  
Survival Rate ◽  
Length Of Stay ◽  
Gestational Age ◽  
Survival Rates ◽  
Neonatal Unit ◽  
University Teaching ◽  
P Value ◽  
Early Onset Sepsis ◽  
Preterm Babies

Background: The survival rate and length of stay of preterm babies which is usually of concern to both parents and clinicians is critical in counselling parents at the time of admission and also assesses the efficiency of the neonatal unit thus necessitating the present study.Methods: A prospective study carried out over 30 months in the neonatal unit of Rivers State University Teaching Hospital, Nigeria.Results: Of 115 preterm babies <1500 gm studied, commonest gestational age and birth weight were 30 weeks 25 (21.7%) and 1000-1199 gm, 35 (30.4%) respectively. There were 100% survival rates for preterms delivered at 31 weeks, 33 weeks, 34 weeks and 36 weeks gestation; 0% survival at 25 weeks and 25% at 24 weeks and 26 weeks gestation. Survival rate was highest among birth weight 1400-1499 gm (89.2%) and lowest with birth weight <1000 gm (30.4%). Length of stay was longest with gestational age of 24 weeks (62.00±0.00 days) and birth weight <1000 gm (57.71±9.96 days) and shortest for gestational age of 35 weeks (20.00±0.00 days) and birth weights 1400-1499 gm (31.92±12.12 days). Survival status was significantly associated with gestational age and birth weight, p value <0.0001. Preterms with early onset sepsis and severe anaemia were significantly associated with length of stay, p value <0.05.Conclusions: The survival rate of preterms <1500 gm increase with increasing gestational age and birth weights while the length of stay increase with decreasing gestational age and birth weight. These findings will therefore form part of the counselling given to parents/caregivers during admission of their preterm babies.

scholarly journals Risk Factors for Neonatal Sepsis in Pregnant Women with Premature Rupture of the Membrane

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Dwiana Ocviyanti ◽  
William Timotius Wahono
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Gestational Age ◽  
Neonatal Sepsis ◽  
Sampling Method ◽  
Cross Sectional Study ◽  
Premature Rupture ◽  
Cross Sectional ◽  
Mortality Risks ◽  
Autoimmune Condition

Background. Premature rupture of the membrane (PROM) is associated with high maternal as well as perinatal morbidity and mortality risks. It occurs in 5 to 10% of all pregnancy while incidence of amniotic membrane infection varies from 6 to 10%. This study aimed to determine the incidence of neonatal sepsis in Cipto Mangunkusumo Hospital and the risk factors. Methods. A cross-sectional study was done in Cipto Mangunkusumo Hospital, Jakarta, from December 2016 to June 2017. The study used total sampling method including all pregnant women with gestational age of 20 weeks or more experiencing PROM, who came to the hospital at that time. Samples with existing comorbidities such as diabetes mellitus or other serious systemic illnesses such as heart disease or autoimmune condition were excluded from the analysis. Results. A total of 405 pregnant women with PROM were included in this study. There were 21 cases (5.2%) of neonatal sepsis. The analysis showed that risk of neonatal sepsis was higher in pregnant women with prolonged rupture of membrane for ≥ 18 hours before hospital admission (OR 3.08), prolonged rupture of membrane for ≥ 15 hours during hospitalization (OR 7.32), and prolonged rupture of membrane for ≥ 48 hours until birth (OR 5.77). The risk of neonatal sepsis was higher in preterm pregnancy with gestational age of <37 weeks (OR 18.59). Conclusion. Risk of neonatal sepsis is higher in longer duration of prolonged rupture of membrane as well as preterm pregnancy.

scholarly journals Etiological patterns of bacterial meningitis in neonatal sepsis

2016 ◽  
Vol 46 (1) ◽  
pp. 32
Author(s):  
Andy Setiawan ◽  
Idham Amir ◽  
Alan R. Tumbelaka
Keyword(s):  
Bacterial Meningitis ◽  
Neonatal Sepsis ◽  
Cross Sectional Study ◽  
Causative Organism ◽  
Sectional Study ◽  
Inclusion Criteria ◽  
First Line ◽  
Cross Sectional ◽  
Live Births ◽  
Very High

Background Sepsis and meningitis are major causes of mortalityand morbidity in neonates. The prevalence of sepsis is around 1-4out of every 1000 live births, and one-fourth is accompanied bymeningitis. These numbers are higher in prematures.Objective To find out the prevalence and etiological patterns ofbacterial meningitis in neonatal sepsis, and the pattern of antibi-otic susceptibility for organisms causing bacterial meningitis.Methods This was a cross sectional study, conducted in the neo-natal ward and emergency room at Cipto Mangunkusumo Hospi-tal from October 2003 to October 2004.Results Seventy two neonates fulfilled the inclusion criteria andwere examined for blood and cerebrospinal fluid (CSF) cultures.Sixty out of 72 neonates were proven for sepsis. Bacterial menin-gitis was found in 18 neonates, and all cases were accompaniedby sepsis. Positive CSF cultures were found in 12 neonates. Theother six were diagnosed based on CSF cell count >32/μl.Acinetobacter calcoaceticus was the major causative organismsin this study. The organisms were highly resistant to first line anti-biotics, except for chloramphenicol. They were also sensitive toceftazidime (second line), meropenem, and imipenem.Conclusions The prevalence of bacterial meningitis in neonatalsepsis at Cipto Mangunkusumo Hospital was 18/60 in 2003-2004.The major causative organism was Acinetobacter calcoaceticus.Antibiotic resistance was very high and only chloramphenicol,ceftazidime, meropenem, and imipenem remain effective

Procalcitonin and Neonatal Sepsis: Is This the Biomarker We Are Looking For?

2017 ◽  
Vol 36 (6) ◽  
pp. 380-384 ◽  
Author(s):  
Susan Givens Bell
Keyword(s):  
Neonatal Sepsis ◽  
Early Onset ◽  
Diagnostic Marker ◽  
C Reactive Protein ◽  
Neonatal Deaths ◽  
Live Births ◽  
Neonatal Disease ◽  
Protein Levels ◽  
Reactive Protein ◽  
Early Onset Sepsis

AbstractResearchers estimate the incidence of early onset sepsis as 0.77–1/1,000 live births. It remains as one of the leading causes of neonatal deaths. Clinicians and researchers continue to search for biomarkers for specific neonatal disease processes. Clinicians frequently trend C-reactive protein levels during evaluation for neonatal sepsis. Recently, researchers have begun to explore procalcitonin as a potentially useful diagnostic marker for neonatal sepsis.

scholarly journals Immature to total neutrophil ratio as an early indicator of early neonatal sepsis

2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Erum Saboohi ◽  
Farhan Saeed ◽  
Rashid Naseem Khan ◽  
Muhammad Athar Khan
Keyword(s):  
Negative Predictive Value ◽  
Neutrophil Count ◽  
Neonatal Sepsis ◽  
Predictive Value ◽  
Early Onset ◽  
Hematological Parameter ◽  
Early Indicator ◽  
Early Onset Sepsis ◽  
The Mean ◽  
Early Neonatal Sepsis

Background & Objectives: Neonatal septicemia is responsible for 1.5 to 2.0 million deaths/year in the under developed countries of the world. Pakistan is number three among these countries and accounts for 7% of global neonatal deaths. The objective of the study was to determine the role of simple hematological parameter, immature to total neutrophil ratio (I/T ratio) in diagnosing early onset neonatal bacterial infection. Methods: A descriptive cross-sectional study was conducted in Neonatal Intensive Care Unit of Liaquat College of Medicine & Dentistry (LCMD) Hospital from January 2016 to January 2017. A total 85 neonates were admitted with clinical suspicion of presumed early onset sepsis or who had potential risk factors for sepsis like prematurity, prolonged rupture of membranes was carried out. After taking informed consent from parents of admitted neonates, data was collected in a structured questionnaire. Laboratory workup included White blood cell count, CRP, absolute neutrophil count, immature neutrophil count while blood C/S was kept as gold standard. Empirical antibiotics started after sample collection for workup. Manual differential count and immature neutrophil count of the peripheral blood smear was performed by a senior technician masked to clinical information. I/T ratio was calculated from WBC, neutrophils and immature neutrophil count by a simple formula. Results: Out of 85 neonates, 13 had positive blood cultures (15.29%). The mean white blood count was 18761.18 ± 8570.75 and mean I/T ratio was 0.1622 ± 0.0419.About 50% of proven sepsis cases had WBC higher than 26000 as compared to 50% of cases for negative diagnoses that had WBC <15500 . The mean I/T in positive CRP 0.204 ± 0.04 was non-significantly higher as compared to negative CRP 0.151 ± 0.034 (p =0.084). Point biserial correlation revealed that I/T ratio was significant strong correlation (rpb = 0.721, p < 0.001) and overall I/T ratio was a good indicator of a positive and negative blood culture result. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of I/T ratio were 76.47%, 83.82%, 54.16% and 93.44% respectively. Similarly majority of neonates having high I/T ratio also depicts positive C-reactive protein (CRP) (NPV 91.23%). Therefore, both I/T and CRP showed a high negative predictive value (I/T = 93.44% and CRP = 91.23%) in this study. Conclusion: I/T ratio is a useful tool for early onset sepsis (EOS) with reasonable specificity but cannot be relied upon as sole indicator. Combination of normal immature to total neutrophil Ratio with negative CRP values in neonates with presumed sepsis is an indicator of non-infected neonate which comprised 78.8% of our study population. How to cite this:Saboohi E, Saeed F, Khan RN, Khan MA. Immature to total neutrophil ratio as an early indicator of early neonatal sepsis. Pak J Med Sci. 2019;35(1):241-246. doi: https://doi.org/10.12669/pjms.35.1.99 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals FREQUENCY OF PRE-GESTATIONAL DIABETES MELLITUS AMONG PREGNANT WOMEN WITH MISCARRIAGE

2019 ◽  
Vol 17 (1) ◽  
pp. 15-18
Author(s):  
Maria Ghafoor ◽  
Najma Farhat ◽  
Firdous Khatoon ◽  
Asifa Ghazi ◽  
Fauzia Anbreen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Gestational Age ◽  
Descriptive Analysis ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Gynecology And Obstetrics

Background: In developing countries, miscarriage is one of the common and increasing problems of pregnancy. The objectives of this study were to determine the frequency of pre-gestational diabetes mellitus among pregnant women with miscarriage in our population. Materials & Methods: This descriptive, cross-sectional study was conducted in the Department of Gynecology and Obstetrics, Khyber Teaching Hospital, Peshawar, Pakistan from 3rd November 2015 to 2nd May 2016. Sample size was 268 pregnant women with miscarriage selected through consecutive sampling technique. Inclusion criteria were all pregnant women with miscarriage. Exclusion criteria were molar pregnancy, ectopic pregnancy and diabetics. HbA1c levels of ≤6% was taken as normal, whereas a level >6 was taken as raised level or pre-gestational diabetes. Variables were age, pre-gestational diabetes mellitus, number of pregnancies and duration of pregnancy (≤24, >24). Mean and SD were calculated for quantitative while frequency and percentages for qualitative variables. Descriptive analysis was performed by using SPSS version 16. Results: Mean age of the patients was 27.66 ±4.93 years. Out of 268 participants, 81(30.22%) were having pre-gestational diabetes mellitus and 187(69.78) were normal, 234(87.31%) were having first pregnancy whereas 34 were having >1 pregnancies, the pre-gestational age ≤ 24 weeks were 130(48.51%) and >24 weeks were 138(51.49%). Conclusion: One third of the patients with miscarriage were having pre-gestational diabetes mellitus. Almost half of the patients were having gestational age of

Sign in / Sign up

Export Citation Format

Share Document