scholarly journals Neonatal sepsis-blood culture, antibiotic stewardship and clinico-bacteriological study

2020 ◽  
Vol 7 (12) ◽  
pp. 2376
Author(s):  
Purva Shah ◽  
Ketan Gadhvi ◽  
Bharat Muliya ◽  
Khushi Shah
Keyword(s):  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Late Onset ◽  
Newborn Infants ◽  
Tertiary Hospital ◽  
Resistance Pattern ◽  
Bacteriological Study ◽  
Mortality And Morbidity ◽  
Early Onset Sepsis ◽  
Septic Focus

Background: Neonatal sepsis refers to an infection involving bloodstream in newborn infants less than 28 days old. It continues to remain a leading cause of morbidity and mortality among infants, especially in middle and lower-income countries. Neonatal sepsis is divided into 2 groups based on the time of presentation after birth: early-onset sepsis and late-onset sepsis.Methods: This study was done in the neonatal intensive care unit of tertiary hospital, Surendranagar. Study design being observational, data collected from clinical examination and records of the neonates admitted with positive septic screen, neonates admitted with suspected clinical sepsis (temperature >990F or <950F, respiratory rate more than 60 per minute, change in behavior, abnormal cry, not accepting feed, drowsy or unconscious, septic focus on skin or umbilicus, diarrhea and seizures) and neonates admitted with culture positive sepsis.Results: As per this research, neonatal sepsis has more male preponderance, with more commonly occurring in low birth weights and preterm. Klebsiella, Staphylococcus aureus and Pseudomonas being the most isolated organisms. Their resistance pattern, antibiotic profile and newer trends also came across.Conclusions: Neonatal sepsis comes as one of the major causes of mortality and morbidity of the newborns admitted. By this research, analyzing the sex, age, gestational weeks, organism isolated and the antibiotic profile, emerging new resistance and newer useful antibiotics can thus be studied and can be taken as a base for further study as well as evaluation of the same, along with also guiding to manage and treat neonatal sepsis better.

scholarly journals Bacteriological Profile and Antibiotic Sensitivity of Neonatal Septicemia Admitted in Neonatal Intensive Care Unit (NICU) of Dhaka Shishu Hospital

2020 ◽  
Vol 35 (2) ◽  
pp. 130-134
Author(s):  
Md Mosharaf Hossain ◽  
Mir Mohammad Yusuf ◽  
Md Kamrunzzaman ◽  
Maksudur Rahman ◽  
Md Jahangir Alam
Keyword(s):  
Blood Culture ◽  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Late Onset ◽  
Antibiotic Sensitivity ◽  
Gram Negative ◽  
Mortality And Morbidity ◽  
Late Onset Sepsis ◽  
Early Onset Sepsis ◽  
Gram Negative Organisms

Background: Septicemia in neonates refers to bacterial infection documented by positive blood culture in the first four weeks of life and is one of the leading causes of neonatal mortality and morbidity. Objective: To isolate and identify the bacterial etiologic agents responsible for neonatal sepsis and to determine the susceptibility pattern of isolates in A NICU of Dhaka Shishu (Children) Hospital. Methods: This is a prospective observational study conducted in the NICU from July 2018 to December 2018. Two hundred ninty blood samples were collected and processed from patients in accordance with standard protocols. Antibiotic susceptibility of the isolates was done. Results: Blood culture reports were positive in 9.31% cases. Among the culture positive cases, there were 65.5% males and 34.5% females. Early onset sepsis was present in 74.8% and late onset sepsis was observed in 25.2% of the cases. Best overall sensitivity among Gram negative (Acinetobacter, Klebsiella, Pseudomonas) isolates was to netilmycin (61%), followed by ceftazidim (57%) and amikacin (56%).Gram positive (Staphylococci, streptococci) isolates had sensitivity of 50% to levofloxacin, 50% to ceftriaxon. Conclusion: Gram negative organisms are the leading cause of neonatal sepsis in this study and most of them are resistant to multiple antibiotics. Therefore the results of this study suggest that, surveillance of antimicrobial resistance in our hospital is necessary. DS (Child) H J 2019; 35(2) : 130-134

Role of N-Terminal Pro-brain Natriuretic Peptide in the Early Diagnosis of Neonatal Sepsis

2019 ◽  
Vol 14 (05) ◽  
pp. 228-234
Author(s):  
Nilufer Okur ◽  
Mehmet Buyuktiryaki ◽  
Nurdan Uras ◽  
Mehmet Yekta Oncel ◽  
Halid Halil ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Neonatal Intensive Care ◽  
Late Onset ◽  
Newborn Infants ◽  
Diagnostic Biomarker ◽  
Predictive Values ◽  
Mortality And Morbidity ◽  
Late Onset Sepsis

Objective Sepsis is one of the most significant contributors to mortality and morbidity in the neonatal population. The need to find specific biomarkers that provide meaningful information about the diagnosis of sepsis is still ongoing. This study aimed to investigate the utility of N-terminal pro-brain natriuretic peptide (NT-proBNP) as a diagnostic biomarker in newborn infants with late-onset sepsis. Methods A prospective, observational study was conducted in the neonatal intensive care unit between July 2016 and January 2017. The patients suspected of having late-onset sepsis and meeting the selection criteria were included in the study, and serial measurements of white blood cell count, serum C-reactive protein (CRP), plasma interleukin (IL) 6, and whole blood NT-proBNP levels were performed. Results The study included 87 patients diagnosed with sepsis and 35 control patients. The median NT-proBNP levels were higher in septic patients (58 [22–169] vs. 14 [7–21]; p < 0.001), showing a significant correlation with CRP and IL-6 levels (r = 0.327, p < 0.01 and r = 0.216, p < 0.05, respectively). The optimal diagnostic cutoff value for differentiating sepsis was 27.5 pg/mL. Predictive parameters of NT-proBNP, such as sensitivity (72%) and specificity (86%), were comparable to those of CRP and IL-6 for the early diagnosis of sepsis in neonates. Conclusion Plasma NT-proBNP levels were higher in septic neonates, and the predictive values were comparable to those of CRP and IL-6. However, these values were not high enough to make it a reliable diagnostic biomarker for identifying neonates in the early stages of sepsis.

scholarly journals Sepsis profile and outcome of preterm neonates admitted to neonatal intensive care unit of Cairo University Hospital

2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Khaled Salama ◽  
Amira Gad ◽  
Sarah El Tatawy
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Sepsis ◽  
Scoring System ◽  
Neonatal Intensive Care ◽  
Late Onset ◽  
University Hospital ◽  
Preterm Neonates ◽  
Early Onset Sepsis

Abstract Background This study demonstrates the experience of the neonatal intensive care unit (NICU) of a tertiary referral center in Egypt in management of prematures with neonatal sepsis. This retrospective study included preterm neonates admitted to NICU with clinical and/or laboratory diagnosis of sepsis. Blood culture was done followed by antimicrobial susceptibility testing for positive cases. Neonates with sepsis were classified into early onset sepsis (EOS) and late onset sepsis (LOS). Hematological scoring system (HSS) for detection of sepsis was calculated. Results The study included 153 cases of neonatal sepsis; 63 (41.2%) EOS and 90 (58.8%) LOS. The majority of the neonates had very low or moderately low birth weight (90.9%). All neonates received first-line antibiotics in the form of ampicillin-sulbactam, and gentamicin. Second-line antibiotics were administered to 133 neonates (86.9%) as vancomycin and imipenem-cilastatin. Mortalities were more common among EOS group (p < 0.017). Positive blood cultures were detected in 61 neonates (39.8%) with a total number of 66 cultures. The most commonly encountered organisms were Klebsiella MDR and CoNS (31.8% each). Klebsiella MDR was the most predominant organism in EOS (28.9%), while CoNS was the most predominant in LOS (39.2%) The detected organisms were divided into 3 families; Enterobacteriaceae, non-fermenters, and Gram-positive family. There 3 families were 100% resistant to ampicillin. The highest sensitivity in Enterobacteriaceae and Non-fermenters was for colistin and polymyxin-B. An HSS of 3–8 had a sensitivity and specificity of 62.3% and 57.6%, respectively for diagnosis of culture-proven sepsis. Conclusion Neonatal sepsis was encountered in 21.5% of admitted preterm neonates; LOS was more common (58.8%). Mortality was 51.6%. Klebsiella MDR and CoNS were the most commonly encountered organisms in both EOS and LOS. The isolated families were 100% resistant to ampicillin. The hematological scoring system (HSS) showed limited sensitivity for detection of sepsis.

scholarly journals Study on Bacteriological Profile and Sensitivity Pattern of the Organisms in Neonatal Sepsis

2021 ◽  
Vol 44 (3) ◽  
pp. 133-138
Author(s):  
Subir Dey ◽  
MA Mannan ◽  
Sanjoy Kumar Dey ◽  
Yasmin Sabina ◽  
Ferdous Navila
Keyword(s):  
Neonatal Intensive Care ◽  
Late Onset ◽  
Causative Organism ◽  
Gram Positive ◽  
College Hospital ◽  
Gram Negative ◽  
Mortality And Morbidity ◽  
Antimicrobial Sensitivity ◽  
Early Onset Sepsis ◽  
Sensitivity Pattern

Background: Sepsis in neonates by resistant strains remains a significant cause of mortality and morbidity in developing countries. This study attempted to find out the organisms responsible for early onset sepsis (EOS) and late onset sepsis (LOS) and determine their antimicrobial sensitivity pattern. Materials & Methods: This prospective observational single centre study was conducted on 1000 neonates during January to September 2018, that were investigated for rule out sepsis, at the Neonatal Intensive Care Unit of Ad-din Medical College Hospital, Dhaka. Results: Fifty-four neonates were found with culture proven sepsis.Coagulase-negative Staphylococci (CONS) (68.42%)was the commonest and followed by Acinetobacter (18.42%) were found on culture isolates in EOS. In LOS, CONS (75%) is the most predominant organism. Among the gram negative Acinetobacter (50%) was the most prevalent bacteria followed by E.coli (28.57%). None of the gram positive isolates were sensitive to Amikacin. Majority of the gram positive showed susceptibilities to Vancomycin (83%) and Linezolid (78%). Among gram negative isolates 93% were sensitive to Colistin, 63% to Gentamicin & 54% to Levofloxacin. Conclusion: Present study indicated that gram positive species especially CONS continue to be the predominant causative organism in both EOS and LOS and followed by Acinetobacter and E. coli in gram negative species. Bangladesh J Child Health 2020; VOL 44 (3) :133-138

scholarly journals Epidemiology of Neonatal Sepsis and Implicated Pathogens: A Study from Egypt

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Eman M. Rabie Shehab El-Din ◽  
Mohamed M. Adel El-Sokkary ◽  
Mohamed Reda Bassiouny ◽  
Ramadan Hassan
Keyword(s):  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Late Onset ◽  
Laboratory Data ◽  
Total Mortality ◽  
Coagulase Negative Staphylococci ◽  
Suspected Sepsis ◽  
Late Onset Sepsis ◽  
Early Onset Sepsis ◽  
Low Sensitivity

Prospective analytic study was conducted in NICUs of three Egyptian Neonatal Network (EGNN) participants in Mansoura Hospitals in Egypt over a period of 18 months from March 2011 to August 2012. By using EGNN 28-day discharge form, all demographic, clinical, and laboratory data were recorded and studied. During the study period, 357 neonates were diagnosed as suspected sepsis with an incidence of 45.9% (357/778) among the admitted neonates at the three neonatal intensive care units. 344 neonates (sex ratio = 1.3:1) were enrolled in the study in which 152 (44.2%) were classified as early onset sepsis EOS (≤72 hr) and 192 (55.8%) as late onset sepsis LOS (>72 hr). Among the LOS cases, 33.9% (65/192) were caused by nosocomial infections. In 40.7% (140/344), sepsis was confirmed by positive blood culture. The total mortality rate for the proven neonatal sepsis was 51% (25/49) and 42.9% (39/91) for EOS and LOS, respectively. Coagulase negative staphylococci were predominant isolates in both EOS and LOS, followed byKlebsiella pneumoniae. Most of the bacterial isolates had low sensitivity to the commonly used empiric antibiotics. However, 70.1% (89/127) exhibited multidrug resistance. Best sensitivities among Gram-positive isolates were found against imipenem, ciprofloxacin, vancomycin, and amikacin.

scholarly journals A study on bacteriological profile, drug sensitivity and resistance pattern of isolated organism in neonatal septicaemia in neonatal intensive care unit

2017 ◽  
Vol 4 (4) ◽  
pp. 1430
Author(s):  
Himanshu A. Joshi ◽  
Seema S. Shah
Keyword(s):  
Blood Culture ◽  
Klebsiella Pneumoniae ◽  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Bacterial Pathogen ◽  
Empirical Therapy ◽  
Resistance Pattern ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Bacteriological Profile

Background: Neonatal Sepsis is one of the major cause of mortality and morbidity in Neonates. Bacterial pathogens and drug resistance varies from different hospitals areas, regions and countries. Advances in early diagnosis and treatment have led to better prognosis of newborns in NICU. This study will provide the bacterial pathogen causing neonatal sepsis along with their antibiogram. The pattern of susceptibility to antibiotics in NICU at GMERS Medical College centre, was very helpful to start the empirical therapy.Methods: This retrospective study was carried out in GMERS Medical College, Gandhinagar from February 2015 to January 2016. Period in 228 neonates. Out of which 131 cases were positive for blood culture. The positive blood culture was detected by Bactec blood culture system.Results: In present study 131 out of 228 cases were culture positive (57.48%). In gram negative organism Klebsiella pneumoniae was the commonest followed by E. coli (3.05%) and Pseudomonas (2.3%) CONS was the most common isolates in from the group. Klebsiella pneumoniae was sensitive to levofloxacin (9816), imipenem (88.15%) and piperacillin+tazobactam (88.15%). This organism was having less sensitivity to routine 1st line antibiotics like ampicillin (9.2%), gentamycin (27.4%), amikeine (35.5%) amoxy+clavulinic (21%) acid, cefotaxime (25%), gram positive CONS having sensitivity to vanceomycin (8.8%), amkacine, ampicillin, levofloxacin, cefotaxime were having limited effect on CONS organism.Conclusions: There is an increasing trend of antibiotic resistance to the commonly used first line drugs. The pattern of sensitivity is changing hence continuous survelliance for antibiotic susceptibility is needed to ensure correct empirical therapy before blood culture reports are available. 

scholarly journals Etiology and antimicrobial susceptibility of neonatal sepsis in the Neonatal Intensive Care Unit in Can Tho Children’s Hospital

2021 ◽  
Vol 141 (5) ◽  
pp. 19-28
Author(s):  
Nguyen Ngoc Rang ◽  
Nguyen Vi Thu Ngoc
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Late Onset ◽  
Substantial Impact ◽  
Children's Hospital ◽  
Early Onset Sepsis ◽  
Children’S Hospital

This study aimed to determine the causative organisms in neonatal sepsis and their antimicrobial resistance patterns in the Neonatal Intensive Care Unit (NICU) of Can Tho Children’s Hospital in Vietnam. A retrospective descriptive study of neonatal sepsis was conducted from January 2018 to December 2019. A total of 139 neonates with positive blood culture was analyzed. Gram - positive bacteria (n = 84, 60.4%) were more common than Gram - negative bacteria (n = 49, 35.3%) and fungi (n = 6, 4.3%). Coagulase - negative Staphylococci (CONS) (28.3%) and Klebsiella pneumoniae (13.2%) were the most common cause of Early - onset sepsis, while CONS (39.5%) and Staphylococcus aureus (22.1%) were predominant isolates of Late - onset sepsis. Almost CONS and S. aureus were resistant to ampicillin and oxacillin, but susceptible to vancomycin (92 - 94%) and lizenolid (100%). K. pneumonia was resistant to cefotaxime (67%) and gentamicin (30%), but susceptible to imipenem (92%). Conclusion: CONS, S. aureus and K. pneumoniae were the most frequent pathogens in neonatal sepsis in our settings. Almost these strains were resistant to commonly used antibiotics. Change of first - line drugs should be based on the identification of isolated organisms and appropriate implementation of likely susceptible antibiotics would have a substantial impact on the outcomes.

scholarly journals Bacteriological Profile of Neonatal Sepsis: A Hospital Based Study

1970 ◽  
Vol 31 (1) ◽  
pp. 1-5 ◽  
Author(s):  
NJ Shrestha ◽  
KU Subedi ◽  
GK Rai
Keyword(s):  
Escherichia Coli ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Late Onset ◽  
Female Ratio ◽  
Mortality And Morbidity ◽  
Common Organism ◽  
Bacteriological Profile ◽  
Late Onset Sepsis ◽  
Early Onset Sepsis

Introduction: Neonatal sepsis is a major cause of mortality and morbidity in newborn. There are many factors that contribute to neonatal sepsis. The organisms responsible for early onset and late onset sepsis are different. Objective: This study was conducted to analyze the organisms responsible for early onset and late onset neonatal sepsis. Materials and Methods: A prospective hospital based study over the period of one year was conducted at neonatal intermediate care unit of Kanti Children's Hospital, Maharajgunj, Kathmandu, Nepal. Results: Organisms were isolated in 6.1% of the collected blood samples. The male female ratio of culture proven sepsis was 1.9:1. Escherichia coli were found to be the most common organism in both early onset and late onset sepsis. Staphylococcus aureus was more common in late onset sepsis than early onset sepsis.Conclusion: Escherichia coli were the most common organism in both early onset and late onset sepsis. Staphylococcal aureus was significantly more common in late onset sepsis than early onset sepsis. Key words: Bacteriological profile; early onset sepsis; late onset sepsis; neonate DOI: 10.3126/jnps.v31i1.4158J Nep Paedtr Soc 2010;31(1):1-5

scholarly journals Distribution of Microorganisms in Neonatal Sepsis and Possible Outbreak of Enterobacter spp. in Neonatal Intensive Care Unit

KYAMC Journal ◽  
2020 ◽  
Vol 11 (1) ◽  
pp. 14-20
Author(s):  
Tania Rahman ◽  
Md Anisur Rahman ◽  
Kamrunnahar Alo ◽  
Momtaz Begum ◽  
Sharmin Sarwar ◽  
...  
Keyword(s):  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Late Onset ◽  
Candida Spp ◽  
Isolation And Identification ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Leading Role ◽  
Frequent Monitoring ◽  
Gram Negative Organisms

Background: Neonatal sepsis is one of the leading causes of neonatal mortality and morbidity globally, more in developing countries. Frequent monitoring of changing pattern of pathogens causing neonatal sepsis is mandatory for effective treatment. Objectives: This study was done to isolate and identify different organisms of sepsis and to compare different types of organisms between early-onset neonatal sepsis (EONS) and late-onset neonatal sepsis (LONS). Materials and Methods: This cross sectional descriptive study was conducted in Department of Microbiology in collaboration with Department of Neonatology, (DMCH) Dhaka. Blood sample was collected from 106 clinically suspected septicemic neonates and isolation and identification of organism was done by automated blood culture and standard microbiological protocol. Data was collected from attendants by filling a predesigned questionnaire. Results: Among 106 samples, 76 (71.69%) were bloodculture positive. Prevalence of (LONS) was higher 42 (55.26%) in comparison to (EONS) 34 (44.74%). Male neonates were affected more 42 (55.26%) than female 34 (44.74%). Among the isolated organisms, Enterobacter spp. was the predominant organism 20 (26.31%) followed by Klebsiella pneumoniae 18 (23.68%) and Candida spp. 12 (15.79%). Conclusion: Gram-negative organisms play the leading role for causing neonatal sepsis and Enterobacter outbreak should be concerned. Therefore, regular surveillance of organism profile causing neonatal sepsis is of utmost necessity. KYAMC Journal Vol. 11, No.-1, April 2020, Page 14-20

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.

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