scholarly journals Incidence of meningitis in term neonates with sepsis and antibiotic sensitivity pattern: an observational study

2019 ◽  
Vol 7 (1) ◽  
pp. 99
Author(s):  
Lakshmi Aparna Devi V. V. ◽  
Chapay Soren ◽  
M. Umadevi ◽  
R. Pradeep
Keyword(s):  
Blood Culture ◽  
Late Onset ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Antibiotic Sensitivity ◽  
P Value ◽  
Coagulase Negative Staphylococcus ◽  
Care Hospital ◽  
Early Onset Sepsis ◽  
Sensitivity Pattern

Background: To find out the incidence of meningitis in neonatal sepsis and antibiotic sensitivity pattern in term neonates.Methods: This prospective observational cohort study was done in a tertiary care hospital located in rural South India for a period of 2 years. Blood culture and lumbar puncture were performed for all term babies with clinically suspected sepsis. Growth, if detected was followed by antibiotic sensitivity testing.Results: Of a total of 50 neonates investigated with blood culture, 32(64%) were found to be culture positive for neonatal septicemia, 16 were diagnosed to have meningitis. Meningitis was present in 4(25%) early onset sepsis cases and in 12(75%) late onset sepsis cases (p-value: 0.008). Blood culture showed growth in all of the 16 cases of meningitis, but Cerebro Spinal Fluid (CSF) culture was positive in 5 cases. The most common presenting features are lethargy, seizures, decreased acceptance of feeds, instability of temperature regulation, vomiting, respiratory distress, and apnea. The most common organism in blood culture was Coagulase Negative Staphylococcus (CONS) (20%) followed by Klebsiella spp. (16%). CONS was most sensitive to Linezolid (100%), Vancomycin (90%). Of the 8 cases of Klebsiella, 62.5% cases were sensitive to Colistin and Tigecycline, 50% to Cotrimoxazole. CSF culture was positive in 5(31.25%) cases. CONS and Enterococci spp. were the most common organisms isolated in CSF.Conclusions: Clinical manifestations of meningitis overlap with those of sepsis and are nonspecific. Significant number of neonates with sepsis have meningitis. Hence, it is necessary to rule out meningitis in neonates presented with clinical features of sepsis. CONS was the most common agent isolated in both blood and CSF culture. Routine bacterial surveillance and study of their resistance patterns must be an essential component of neonatal care which helps in implementation of a rational empirical treatment strategy.

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

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

scholarly journals Clinical Profile and Role of Septic Screen in Early Onset Sepsis in a Tertiary Care Hospital of Western Nepal - A Prospective Observational Study

2020 ◽  
Vol 8 (1) ◽  
pp. 14-18
Author(s):  
Binod Kumar Gupta ◽  
Raju Kaphle ◽  
Buby Philip Kurian ◽  
Badri Kumar Gupta
Keyword(s):  
Respiratory Distress ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Coagulase Negative Staphylococcus ◽  
Care Hospital ◽  
Early Onset Sepsis ◽  
Wide Range

INTRODUCTION: Neonatal sepsis is an important cause of neonatal mortality and morbidity with wide range of clinical manifestations. This study was aimed to study the clinical characteristics of sepsis along with the role of septic screen for early diagnosis of septicemia. MATERIAL AND METHODS: A prospective observational hospital based cross-sectional study was conducted in 113 screen positive newborns over a 12-month period at Universal College of Medical Sciences, Teaching Hospital Bhairahawa, Nepal. RESULTS: Out of 489 cases admitted to the NICU during the study period, 113 babies with screen positive sepsis were included in the study. Poor feeding (46%, n=52), respiratory distress (38.9%, n=44) and lethargy (30.1%, n=34) were top three clinical presentations in neonates with sepsis followed by seizures, jaundice, vomiting, fever and hypothermia respectively. 57.5% (n=65) of clinical sepsis cases enrolled had culture positivity with staphylococcus aureus in 41.5% (n=27) and Coagulase negative Staphylococcus (CONS) in 27.7% (n=18).  Klebsiella was the third common organism isolated in blood culture (23.1%, n=15). The sensitivities and specificities of two-test and three-test combinations in proven sepsis was calculated. Two-test combinations showed sensitivities between 33-100% and specificities between 30-90% whereas three-test combinations showed the sensitivities and specificities between 60-100% and 20-90% respectively. CONCLUSION: Poor feeding, respiratory distress and lethargy were common presentations in early onset neonatal sepsis. Three-test combination of septic screen had no overall advantage over two-test combination in the present study.

scholarly journals Pattern of Antibiotic Sensitivity in Enteric Fever: A Tertiary Care Hospital Experience

2014 ◽  
Vol 15 (2) ◽  
pp. 122-124 ◽  
Author(s):  
Samira Rahat Afroze ◽  
Muhammad Abdur Rahim ◽  
Md. Mehedi Hasan ◽  
Farhana Afroz ◽  
Hasna Fahmima Haque ◽  
...  
Keyword(s):  
Blood Culture ◽  
Nalidixic Acid ◽  
Enteric Fever ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Sensitivity Pattern ◽  
Drug Resistant Strains

Objectives: To describe the antibiotic sensitivity pattern ofSalmonella typhi and Salmonella paratyphi from blood culture specimens. Methods: This cross-sectional study was done in the Department of Medicine, BIRDEM from July 2009 to June 2012. Standard laboratory and microbiological procedures were followed for blood culture and antibiotic sensitivity tests. Results: Among the 97 blood culture positive samples, S. typhi was 71 (73.2%) and S. paratyphi was 26 (26.8%). Multi-drug resistant strains of S. typhi and S. paratyphi were 23 (32.4%) and 3 (11.5%) cases respectively. Azithromycin, nalidixic acid, ciprofloxacin, levofloxacin and amoxicillin resistance was also found in a good number of cases (S. typhi and S. paratyphi: 71.8% and 57.7%, 42.3% and 30.8%, 38% and 34.6%, 38% and 26.9% and 38% and 26.9% cases respectively). Nineteen (31.1%) of the 61ciprofloxacin sensitive organisms were resistant to nalidixic acid. Ceftriaxone was sensitive in 100% of S. typhi and S. paratyphi. Cefixim, ciprofloxacin, levofloxacin, imipenem were among the most common sensitive antibiotics (S. typhi and S. paratyphi: 83.1% and 73.1%, 62% and 65.4%, 53.5% and 65.4%, 76.1% and 65.4% cases respectively). Conclusion: Ceftriaxone was the most sensitive antibiotic for treating enteric fever followed by cefixim, imipenem and ciprofloxacin. However, in suspected cases of enteric fever, blood culture should be requested before prescribing antibiotic.DOI: http://dx.doi.org/10.3329/jom.v15i2.20684 J MEDICINE 2014; 15 : 122-124

scholarly journals Bacterial etiology and antimicrobial susceptibility pattern of neonatal sepsis at a tertiary care hospital in Nepal

2021 ◽  
Vol 8 (5) ◽  
pp. 830
Author(s):  
Kiran Sharma ◽  
Love Kumar Sah ◽  
Prince Pareek ◽  
Sanjay Shah ◽  
Reema Garegrat
Keyword(s):  
Staphylococcus Aureus ◽  
Neonatal Sepsis ◽  
Late Onset ◽  
Antibiotic Sensitivity ◽  
Care Hospital ◽  
Gram Negative ◽  
Common Organism ◽  
Early Onset Sepsis ◽  
Sensitivity Pattern ◽  
Gram Negative Organisms

Background: Sepsis is the second major cause of mortality among neonates. Present study was done to identify the common organisms which cause early and late onset neonatal sepsis in neonates admitted in our department and their antibiotic sensitivity patterns.Methods: All neonates weighing more than 1500 gms and born to mothers with pre-existing infection, admitted to neonatal intensive care unit for suspected neonatal sepsis were included in the present study. They underwent blood culture and antibiotic sensitivity profiling.Results: 210 newborns were admitted to the NICU of our department for suspected neonatal sepsis. Longer duration of rupture of membranes was found to be significantly associated with growth of organisms. Amongst the cases with gram positive organisms, most were due to Coagulase-negative staphylococci (CoNS) (n=25), followed by Staphylococcus aureus (n=14), and, Enterococcus (n=4). Gram negative organisms isolated constituted 17 organisms. Amongst the cases with gram negative organisms, mostly were due to Klebsiella (n=10), followed by Pseudomonas (n=5) and E. coli (n=2). The most common organism causing early onset sepsis was CoNS, while Staphylococcus aureus was the most common organism causing late onset sepsis. CoNS was fully sensitive to Vancomycin and Amikacin. Staphylococcus aureus was fully sensitive to Amikacin, α-hemolytic. Streptococcus were sensitive to Amikacin, Vancomycin and Piperacillin and Tazobactum and Enterococcus was sensitive to Amikacin and Vancomycin.Conclusions: Antimicrobial surveillance of neonatal septicaemia is required to know the antibiotic sensitivity pattern and thus to formulate policies on use of antibiotics and to know the changing spectrum of antimicrobial sensitivity patterns.

scholarly journals Clinical and Bacteriological Profiles of Blood Culture Positive Sepsis in Newborns

1970 ◽  
Vol 27 (2) ◽  
pp. 64-67 ◽  
Author(s):  
P Shrestha ◽  
BK Das ◽  
NK Bhatta ◽  
DK Jha ◽  
B Das ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Blood Culture ◽  
Neonatal Sepsis ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Coagulase Negative Staphylococcus ◽  
Care Hospital ◽  
Klebsiella Species ◽  
First Choice ◽  
Gram Negative Organisms

Neonatal infections currently cause about 1.6 million deaths annually in developing countries. Sepsis and meningitis is responsible for most of these deaths. This study was undertaken to determine the clinical presentations, bacteriological profiles and antibiotic sensitivity patterns of isolates from blood cultures of neonates admitted in a tertiary care hospital in Eastern Nepal. All blood culture reports (n=103) during January 2006 - February 2007 from newborns admitted in neonatal division at BP Koirala Institute of Health Sciences, Nepal were analyzed and antibiotic sensitivity patterns were studied. The positive blood culture was 20% (103/513). Most (97.1%) of the sepsis was caused by single organism, while polymicrobial aetiology was observed in 2.9% cases. Meningitis was documented in 9(8.7%) cases. Staphylococcus aureus (38.8%) and coagulase negative staphylococcus (CONS) (21.3%) are the commonest isolates in blood culture. Among gram-negative organisms, Klebsiella species (11.6%) and Enterobacter species (9.7%) were the leading cause of neonatal sepsis. Majority of newborns with neonatal sepsis presented with refusal to feeds (42.7%), fever (41.7%) and jaundice (41.7%). Most of the organisms showed sensitivity with amino glycosides (gentamicin and amikacin) and third generation cephalosporins. It is concluded that Staphylococcus aureus, CONS, and Klebsiella species remain the principal organisms causing neonatal sepsis and first line antibiotics like amino glycosides should be first choice of drugs. Key words: Blood culture, neonatal sepsis, antibiotic sensitivity. doi:10.3126/jnps.v27i2.1411   J. Nepal Paediatr. Soc. Vol.27(2) p.64-67

scholarly journals Association of Admission Temperature and Outcome among Neonates with Sepsis in a Tertiary Care Hospital

2020 ◽  
Vol 35 (2) ◽  
pp. 150-155
Author(s):  
Mahfuza Shirin ◽  
M Monir Hossain ◽  
Manifa Afrin
Keyword(s):  
Early Onset ◽  
Age Of Onset ◽  
Late Onset ◽  
Mild Hypothermia ◽  
Tertiary Care ◽  
P Value ◽  
Moderate Hypothermia ◽  
Care Hospital ◽  
Late Onset Sepsis ◽  
Early Onset Sepsis

Background: Neonatal sepsis is one of the major causes of mortality in neonates. Hypothermia is also an important contributing factor of neonatal mortality. Neonates with sepsis can present with normal temperature, hypo or hyperthermia. Objectives: This study was design to find out the pattern of temperature on admission and its association with mortality among neonates admitted with sepsis. Methods: This cross-sectional study was conducted from September 2017 to April 2018 in the Department of Neonatal Medicine and NICU, Dhaka Shishu (Children) Hospital. Neonates up to thirty days of age, diagnosed as probable sepsis were enrolled. On admission, axillary temperature was recorded for 3 minutes and neonates were categorized according to the recorded temperature. Neonates were classified as early onset sepsis (EOS) and late onset sepsis (LOS) according to the age of onset of the sepsis. Outcome was also recorded. Statistical analysis was done by SPSS program version 25. Chi-square (X2) test was done to determine the association and p value, <0.05 was taken as significant. Results: Among 493 enrolled neonates, 41.2% neonates were with early onset sepsis (EOS) and 58.8% were with late onset sepsis (LOS). Out of 493 neonates, 89(18.1%) died. Among the enrolled neonates, 54.4% had normal temperature, 16.6% had mild hypothermia, 14.6% had moderate hypothermia and 14.4% had hyperthermia. It was found that mild and moderate hypothermia were significantly more in EOS(p<0.05). Mortality was significantly high in neonates with mild and moderate hypothermia (p<0.05). Conclusion: This study found that mortality was associated with mild and moderate hypothermia in neonates admitted with sepsis. DS (Child) H J 2019; 35(2) : 150-155

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