Antibiotic Susceptibility Patterns in the NICU of Ghaem Hospital of Mashhad

2021 ◽  
Author(s):  
Hassan Boskabadi ◽  
Elahe Heidari ◽  
Fatemeh Bagheri ◽  
Maryam Zakerihamidi
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Neonatal Sepsis ◽  
Antibiotic Susceptibility ◽  
Clinical Signs ◽  
High Sensitivity ◽  
Signs And Symptoms ◽  
Clinical Syndrome ◽  
Cross Sectional ◽  
E Coli

Background and Aims: Neonatal sepsis is considered a clinical syndrome characterized by signs and symptoms of infection associated with positive blood culture. The present study investigates the rate of sensitivity and resistance to antibiotics in neonates with definite sepsis. Materials and Methods: This cross-sectional study was conducted on 268 neonates with definitive sepsis (positive blood culture with clinical signs of infection) hospitalized in the NICU of Ghaem Hospital of Mashhad, from 2008 to 2018. To investigate the antibiotic susceptibility pattern, identifying microorganism and antibiogram tests was performed according to the standard microbiological method. The data were collected through a questionnaire designed by the researchers. It included neonates’ characteristics, types of microorganisms in neonatal unite, and sensitivity and resistance to neonatal sepsis’s common microorganism. Results: Based on the results, Klebsiella showed sensitivity to norfloxacin (100%), ciprofloxacin (100%), meropenem (100%), imipenem (94%), cotrimoxazole (73%), and vancomycin (67%). Similarly, Enterobacter showed 100% sensitivity to ciprofloxacin, meropenem, norfloxacin, and high sensitivity to imipenem (94%) and co-trimoxazole (83%). Acinetobacter turned out to be sensitive to co-trimoxazole and norfloxacin (both of them were 67%) and to amikacin in 33% of the cases. E. coli was sensitive to imipenem (83.33%), ciprofloxacin (80%), and ceftazidime (71.43%). Finally, staphylococcus coagulase negative was sensitive to piperacillin in 100%, vancomycin in 96.67%, and imipenem in 71.43% of the cases. Conclusions: The findings of the present study suggest that high-sensitivity drugs for the treatment of definite neonatal sepsis are Meropenem(Klebsiella and E. coli), Enterobacter(Ampicilin), Acinetobacter(Imipenem) and Staphylococcus coagulase negative (vancomycin).

STUDY OF ABSOLUTE, IMMATURE NEUTROPHIL COUNT AND CRP AS DIAGNOSTIC MARKERS FOR EARLY ONSET NEONATAL SEPSIS.

2021 ◽  
pp. 25-26
Author(s):  
Pooja Poswal ◽  
Manisha Rohilla ◽  
Sunil Arora ◽  
Irbinder Kour Bali
Keyword(s):  
Blood Culture ◽  
Neutrophil Count ◽  
Neonatal Sepsis ◽  
Hematological Parameters ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Clinical Signs And Symptoms

Introduction: Neonatal Sepsis is difcult to differentiate from other conditions due to non- specic clinical signs and symptoms. Inammation in neonates shows variations in hematological parameters. Our study is to evaluate the hematological parameters and C-reactive protein estimation in neonatal sepsis for early diagnosis. Material And Methods: It was a cross-sectional study including 80 neonates admitted in the neonatal care unit, 40 (proven sepsis) and 40 probable cases); blood culture being the gold standard. Hematological parameters, immature to total neutrophil ratio (I/T ratio), Absolute neutrophil count (ANC), CRP and Blood culture were done as per standard protocols. Results: ANC had highest sensitivity of 90% followed by I/T ratio (87.5%) and CRP (77.5%). The sensitivity and specicity for the combination of ANC and I/T ratio was 78.3% and 83.6% respectively. Conclusion: ANC, I/T Ratio and CRP are quick, simple and cost-effective routine laboratory tests which help in neonatal sepsis prediction and to start proper and timely antibiotic therapy.

scholarly journals Study to correlate sepsis markers and blood culture in neonatal sepsis

2020 ◽  
Vol 7 (2) ◽  
pp. 294
Author(s):  
Harshitha M. Swamy ◽  
Lakshmi . ◽  
Mallesh K. ◽  
Asima Banu
Keyword(s):  
Blood Culture ◽  
Neonatal Sepsis ◽  
High Sensitivity ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Neonatal Deaths ◽  
E Coli ◽  
Culture Positivity ◽  
Blood Culture Positivity

Background: Neonatal sepsis forms the second most common cause of neonatal mortality resulting in more than one million neonatal deaths per year. Neonatal sepsis, pneumonia and meningitis together result in one- fourth of all newborn deaths. Objectives of the study was to correlate sepsis markers with blood culture in neonatal sepsis.Methods: A cross sectional study was carried out in the NICU unit under department of Pediatrics, between November 2017 and May 2019. Sample size was 50. Babies admitted to NICU with clinical suspicion of sepsis were included in the study. Blood samples from these babies were collected under aseptic precautions and subjected to rapid diagnostic tests- sepsis markers and blood culture.Results: Male were predominant (64%). Important risk factors were preterm and low birth weight. Blood culture positivity was 20% (E. coli being most commonly isolated organism). CRP had a high sensitivity of 90% and low specificity of 47%. Procalcitonin had highest sensitivity of 100% and low specificity of 47.5%.Conclusions: CRP and PCT were found to be statistically significant (p=0.036 and 0.01), can be used as a diagnostic tool in neonatal sepsis.

scholarly journals Clinical and Bacteriological Profile of Early Onset Neonatal Sepsis Admitted in NICU of Tertiary Hospital in Biratnagar

2018 ◽  
Vol 3 (1) ◽  
pp. 370-376
Author(s):  
Arun Giri ◽  
Vijay Kumar Sah ◽  
Bikash Sharma Poudel ◽  
Niraj Niraula ◽  
Raju Sedai
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Blood Culture ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Coagulase Negative Staphylococcus ◽  
Sensitivity Pattern ◽  
Clinical Signs And Symptoms

Introduction: Neonatal sepsis is one of the major causes of neonatal morbidity and mortality especially in developing countries. The clinical signs and symptoms of neonatal sepsis are non specific and blood culture report is considered gold standard for confirmation of neonatal sepsis. Organisms and their sensitivity pattern vary from place to place. The confirmation of diagnosis and management of neonatal sepsis is challenging and time consuming.Objective: The aim of this study was to find incidence of blood culture proven sepsis in suspected early onset neonatal sepsis, find out sensitivity pattern of isolated organism and to find association of risk factors and clinical signs and symptoms with blood culture proven sepsis.Methodology: Prospective study was conducted in Nobel Medical College, Biratnagar from November 2016 to November 2017. Sample size was calculated to be 300 and blood culture was sent of each neonates admitted with suspected early onset neonatal sepsis before giving neonates with first dose of antibiotics and report of 72 hours was taken into consideration.Results: Out of 300 cases of suspected early onset neonatal sepsis 70.3% presented with lethargy, followed by other symptoms like poor feeding, respiratory distress, fever, hypothermia, feeding intolerance, abnormal body movement and abdominal distension. Low birth weight neonates, preterm neonates, prolonged duration of per vaginal leaking and low platelets count were significantly associated with blood culture proven sepsis in this study. Incidence of blood culture positive sepsis in suspected early onset neonatal sepsis was 27%. Coagulase negative Staphylococcus aureus(21%) was predominant organism isolated followed by Klebsiella Pneumonia, Pseudomonas, Escherichia coli. All of the isolated Klebsiella and Pseudomonas and 86% of Escherichia coli were found to be resistant to ampicillin. All isolated Coagulase negative Staphylococcus aureus were sensitive to vancomycin.Conclusion: Coagulase negative Staphyloccus aureus was predominant organism detected but majority of organisms were gram negative organisms. High resistance to ampicillin was found and cefotaxime was also less sensitive to isolated organism. Vancomycin was found to be sensitive to all isolated Staphylococcus aureus and coagulase negative Staphylococcus aureus. Amikacin was highly sensitive among causative organisms isolated. BJHS 2018;3(1)5 : 370-376

scholarly journals Role of Lumbar Puncture in Late Onset Neonatal Sepsis

2019 ◽  
Vol 39 (3) ◽  
pp. 155-161
Author(s):  
Amit Kumar Das ◽  
Deepak Mishra ◽  
Nitu Kumari Jha ◽  
Rakesh Mishra ◽  
Soniya Jha
Keyword(s):  
Blood Culture ◽  
Lumbar Puncture ◽  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Late Onset ◽  
Signs And Symptoms ◽  
Clinical Syndrome ◽  
Neonatal Deaths ◽  
Late Onset Sepsis

Introduction: Neonatal sepsis is a clinical syndrome characterized by signs and symptoms of infection with or without accompanying bacteremia in the first month of life.  It is responsible for about 30-50% of the total neonatal deaths in developing countries.  Neonatal sepsis can be divided into two sub-types depending upon whether the onset of symptoms within the first 72 hours of life (Early Onset Neonatal Sepsis) or after 72 hours of life (Late Onset Neonatal Sepsis ).  Meningitis is an important complication of late onset neonatal sepsis. Method: This was hospital based prospective observational study conducted among the neonates admitted with diagnosis of late onset neonatal sepsis in Neonatal Intermediate Care Unit (NIMCU) and Neonatal Intensive Care Unit (NICU) of Kanti Children’s Hospital from July 2016 to June 2017. The objective of this study was to evaluate the importance of performing LP in neonates with LONS. Results: 16.8% neonates with late onset neonatal sepsis were found to have meningitis. Among the neonates with meningitis CRP was positive 57.2% and negative in 42.8 %.  Among the cases with abnormal CSF findings, blood culture was sterile in 85% cases and organism was isolated 15% cases. In 88.8% cases with positive blood culture, no meningitis was detected. Lumbar puncture was traumatic in 1 neonate (0.8%) in first attempt. Apart from this no other complication of performing lumbar puncture was noted. Conclusion: Lumbar puncture and CSF examination is mandatory in all cases with late-onset sepsis.

scholarly journals Study of procalcitonin in neonatal sepsis with blood culture in suspected sepsis in North India

2021 ◽  
Vol 8 (7) ◽  
pp. 1241
Author(s):  
Munna Lal Jaipal ◽  
Ajit Kumar Shrivastava ◽  
Prema Ram Choudhary
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Tertiary Care ◽  
Clinical Signs ◽  
North India ◽  
Care Hospital ◽  
Negative Blood Culture ◽  
Suspected Sepsis ◽  
Cross Sectional ◽  
Number Of Patients

Background: Sepsis can occasionally be difficult to demonstrate, and its difference from non-infectious conditions in critically ill patients is often a challenge. Serum procalcitonin (PCT) assay is one of the biomarkers of sepsis. The aim of the study was to investigate the value of procalcitonin, in the early diagnosis of neonatal sepsis.Methods: A cross-sectional study was conducted at tertiary care hospital in New Delhi. It included all neonates with clinical signs of sepsis. The neonates were divided into two groups as sepsis, and healthy neonates. The PCT level was measured by using ELISA technique and compared between the two groups. Statistical analysis was performed using SPSS windows version 20.0 software.Results: In this study total number of patients included 350, out of which 175 were clinically suspected sepsis cases and 175 were healthy controls. 68 (39%) neonates were show positive blood culture and 107 (61%) neonates were representing negative blood culture report in study group. The mean serum value of PCT was significantly (p<0.001) higher in sepsis neonates. The serum PCT value was significantly increased in neonate’s sepsis with positive blood culture (p<0.001) and negative blood culture (p<0.001) as compared to healthy neonates.Conclusions: It is concluded from this study that the PCT assay was established to be a valuable biomarker of sepsis in this study. The assay might be performed and reported quickly and gave precious information before availability of culture results. This might assist in avoiding unnecessary antibiotic therapy.

scholarly journals Prospective study to evaluate the risk factors associated with mortality in neonatal septicemia

2017 ◽  
Vol 4 (5) ◽  
pp. 1687
Author(s):  
Mandeep Singh Khurana ◽  
Supriya Malik ◽  
Gursharan Singh Narang ◽  
Ritish Saini
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Blood Culture ◽  
Low Birth Weight ◽  
Positive Blood Culture ◽  
Neonatal Sepsis ◽  
Clinical Syndrome ◽  
Preterm Baby ◽  
Neonatal Septicemia ◽  
Factors Associated

Background: Neonatal sepsis is a clinical syndrome of bacteremia characterized by systemic signs and symptoms of infection in the first month of life. Neonatal sepsis refers to infection occuring within the neonatal period i.e. first 28 days of life for a term baby and up to 4 weeks beyond the expected date of delivery in a preterm baby. Neonatal sepsis is one of the major cause of neonatal morbidity and mortality.Methods: The present study is a prospective observational study conducted in the neonatal intensive care unit (NICU) of Sri Guru Ram Das Institute of Medical Sciences and Research (SGRDIMSAR), Sri Amritsar over a period of one year from January 2015 to January 2016. Aim of the study is to know the incidence of neonatal sepsis, to study bacteriology of neonatal septicemia and to evaluate the risk factors associated with mortality in neonatal sepsis in our hospital.Results: During the study period (January 2015 to January 2016), 727 neonates were admitted in NICU of SGRDIMSAR, Sri Amritsar. Out of them, 109 neonates were diagnosed as having septicemia. Incidence of neonatal sepsis in our hospital in this study is 149.9/1000 neonatal admissions. 59 (54.1%) neonates had positive blood culture. Out of 109 septic neonates, 50 died and 59 survived. Mortality observed in the present study is 45.9%.Conclusions: It is concluded from present study that the main factors associated with neonatal mortality are low birth weight, prematurity, positive blood culture, neutropenia and prolonged prothrombin time. Some of the risk factors like low birth weight and prematurity are preventable by proper antenatal check ups and measures can be taken for safe and hygienic delivery. Babies with risk factors should be monitored closely for early detection of sepsis and the neonates with sepsis having abnormal laboratory parameters should be subjected to appropriate therapeutic intervention in order to decrease the mortality. 

scholarly journals Role of Sepsis Screening in early diagnosis of Neonatal Sepsis

2017 ◽  
Vol 7 (1) ◽  
pp. 1103-1110 ◽  
Author(s):  
A Lakhey ◽  
H Shakya
Keyword(s):  
Blood Culture ◽  
Early Diagnosis ◽  
Neonatal Sepsis ◽  
Signs And Symptoms ◽  
Statistical Correlation ◽  
Clinical Syndrome ◽  
Total Leukocyte Count ◽  
Invaluable Tool ◽  
Sepsis Screen ◽  
Sepsis Screening

Background: Neonatal sepsis, a clinical syndrome of bacteremia with systemic signs and symptoms of infection in the first 4 weeks of life is a major cause of morbidity and mortality in newborn inborn. Early diagnosis is critical, as sepsis can progress more rapidly in neonates than in adults. An attempt was made to establish correlation between early neonatal sepsis screening & blood culture in neonates presenting with features of sepsis. The aim of this study is to assess the usefulness of sepsis screen in early diagnosis of neonatal septicemia.Materials and Methods: The study was done in Kist medical college and hospital, Nepal from October 2015 to October 2016.  Statistical correlation between early indicators of sepsis screen & blood culture (considered as gold standard) was established in clinically suspicious cases of neonatal sepsis. Results: Out of 150 cases studied, 72 were culture positive. CRP (77.8%) and immature: total neutrophils ratio (73%) showed highest sensitivity. CRP (66.7%), I/T ratio (61.5%) and micro ESR (60.2%) showed highest specificity. Positive predictive value was highest for CRP (68.2%) followed by I/T ratio (63.8%) and corrected total leukocyte count (56.2%)Conclusion: Serum CRP is the most sensitive marker of sepsis. Use of peripheral smear study and CRP can be implicated effectively as a sepsis screen for early diagnosis of neonatal sepsis. The combination of parameters yielded better results than single tests and proved to be an invaluable tool for early diagnosis of neonatal sepsis. 

scholarly journals Bacterial DNA detection in very preterm infants assessed for risk of early onset sepsis

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Zbyněk Straňák ◽  
Ivan Berka ◽  
Peter Korček ◽  
Jan Urbánek ◽  
Táňa Lázničková ◽  
...  
Keyword(s):  
Blood Culture ◽  
Real Time ◽  
Preterm Infants ◽  
Positive Blood Culture ◽  
Clinical Signs ◽  
Bacterial Dna ◽  
Very Preterm Infants ◽  
E Coli ◽  
Very Preterm ◽  
Neonatal Blood

Abstract Objectives The aim of this study is to evaluate the diagnostic ability of multiplex real-time polymerase chain reaction (PCR) in very preterm infants assessed for risk of early onset neonatal sepsis (EOS). Methods Prospective observational cohort study. Blood samples of preterm neonates ≤32 weeks of gestation were evaluated by commercial multiplex real-time PCR within 2 h after delivery. The definition of EOS was based on positive blood culture and clinical signs of infection or negative blood culture, clinical signs of infection and abnormal neonatal blood count and serum biomarkers. Results Among 82 subjects analyzed in the study, 15 had clinical or confirmed EOS. PCR was positive in four of these infants (including the only one with a positive blood culture), as well as in 15 of the 67 infants without sepsis (sensitivity 27%, specificity 78%). Out of 19 PCR positive subjects, Escherichia coli was detected in 12 infants (63%). Statistically significant association was found between vaginal E. coli colonization of the mother and E. coli PCR positivity of the neonate (p=0.001). No relationship was found between neonatal E. coli swab results and assessment findings of bacterial DNA in neonatal blood stream. Conclusions Multiplex real-time PCR had insufficient diagnostic capability for EOS in high risk very preterm infants. The study revealed no significant association between PCR results and the diagnosis of clinical EOS. Correlation between maternal vaginal swab results and positive PCR in the newborn needs further investigation to fully understand the role of bacterial DNA analysis in preterm infants.

scholarly journals Sensitivity and Resistant of the Microorganisms Responsible for Neonatal Sepsis to Antibiotics

2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Hassan Boskabadi ◽  
Ali Moradi ◽  
Asal Ramazani ◽  
Maryam Zakerihamidi
Keyword(s):  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Clinical Signs ◽  
High Sensitivity ◽  
Cross Sectional Study ◽  
Definitive Treatment ◽  
Gram Positive ◽  
Cross Sectional ◽  
Microdilution Method ◽  
Antibiotics Susceptibility

Background: Sepsis is a major neonatal disease that requires appropriate early treatment. Objectives: The current study aimed to determine the resistance and sensitivity to antibiotics in neonates admitted to the neonatal intensive care unit (NICU) due to sepsis. Methods: In this cross-sectional study, 268 neonates with definitive sepsis (positive blood culture with clinical signs of infection) hospitalized during 2009-2019 are investigated. Identification of microorganism and antibiogram test were performed according to the standard microbiological method. Antibiotics susceptibility testing was performed by disk diffusion and microdilution method according to Clinical and Laboratory Standards Institute (CLSI) (2013). A researcher-made questionnaire, including characteristics of neonates and types of microorganisms (gram-positive or negative) in the neonatal ward, as well as sensitivity and resistance to common microorganisms in neonatal sepsis, was used to collect data. Results: According to the antibiogram results, the microorganism found in NICU showed sensitivity to vancomycin (97%), imipenem (71%), and co-trimoxazole (56%), as well as Norfloxacin, Cephalotin, and Cefazolin (50%). Gram-negative bacteria showed complete sensitivity (100%) to Piperacillin, Clavulanic acid, Colistin, Tazobactam, and Meropenem and high sensitivity (> 86%) to Imipenem, Norfloxacin, and Ciprofloxacin. There was high resistance to Amoxicillin, Ampicillin, Amikacin, Gentamicin, Cephalotin, Cefotaxime, Ceftriaxone, Ceftizoxime, Cephalexin, and Clindamycin. Gram-positive bacteria showed full sensitivity (100%) to Doxycycline, Piperacillin, and Tobramycin and reasonable sensitivity (> 75%) to Vancomycin, imipenem, and tetracycline. Azithromycin, Ampicillin, Gentamicin, Cefepime, Meropenem, Penicillin, Erythromycin, Oxacillin, and Amoxicillin showed resistance in 100% of cases. Conclusions: This study demonstrated high-sensitivity drugs for definitive treatment of neonatal sepsis (i.e., Vancomycin, Piperacillin, Tazobactam, and Meropenem for gram-negatives, and Piperacillin, and Tobramycin for gram-positive microorganisms).

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