Does E-Coli play an important role in neonatal sepsis in preterm prelabour rupture of membrane?

2020 ◽  
Vol 10 (2) ◽  
pp. 121-126
Author(s):  
Ameer Elsherief ◽  
Adel Ahmed
Keyword(s):  
Neonatal Sepsis ◽  
E Coli

scholarly journals Development and Optimization of a Neonatal Rat Model of Sepsis

2018 ◽  
Vol 3 (1) ◽  
Keyword(s):  
Blood Culture ◽  
Rat Model ◽  
Neonatal Sepsis ◽  
Neonatal Rat ◽  
Neonatal Rats ◽  
Minimum Effective Dose ◽  
Biochemical Tests ◽  
E Coli ◽  
Common Causes ◽  
Neonatal Rat Model

Neonatal sepsis is the most common cause of mortality in newborns. Currently antibiotics and supportive care are the mainstay of treatment. Blood culture is considered as the gold standard for confirmation of diagnosis of neonatal sepsis. Here we have tried to develop a neonatal rat model of sepsis in order to better understand its progression. Lipopolysaccharide (LPS) is one of the common agents used to induce sepsis in rats. Here we found that LPS was ineffective in inducing sepsis in neonatal rats. We found that induction of live dose of Escherichia coli, one of the most common causes of neonatal sepsis was more effective than LPS injection. The rats were continuously monitored for the visual indications of sepsis development. Body weight, body temperature and the activity of rats were monitored continuously. Blood culture was done to check for the confirmation of diagnosis of sepsis. Further biochemical tests such as citrate, urease, indole and kliger-ion tests were done to confirm for E coli in the colonies of blood culture. The minimum effective dose of E coli needed to induce sepsis in neonatal rats was found to be 5*106 CFU of E coli.

scholarly journals Investigations on the Aetiology and Antibiotic Management of Neonatal Septicemia

2019 ◽  
Vol 28 (5-6) ◽  
pp. 105-15
Author(s):  
Hans Eldih Monintja
Keyword(s):  
Prospective Study ◽  
Neonatal Sepsis ◽  
Standard Treatment ◽  
Case Fatality ◽  
Third Generation ◽  
Neonatal Septicemia ◽  
E Coli ◽  
The Third ◽  
Antibiotic Management ◽  
A Prospective Study

This is a prospective study aimed in identifying the latest aetiological factors of neonatal sepsis in Dr. Cipto General Hospital, Jakarta, and investigating the efficacy of antibiotics treatment especially with ceftriaxone. This study revealed that the present main causative microorganisms are as follows: Pseudomonas, Klebsiella and E. coli. The case fatality rates being: (1) Standard treatment with ampicillin and gentamycin: 80.9%, (2) S(andard treatment with consomittant ceftriaxone: 20%, (3) Ceftriaxone: 9,52%. It seems that in facing neonatal septicemia, the initial antibiotic should be the third generation cephalosporine. The second choice is chloramphenicol. However, the causative agent and the sensitivity test should be monitored regularly.

scholarly journals Trend Analysis of Multidrug-Resistant Bacterial Pathogens Causing Neonatal Sepsis at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: A Retrospective Study

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Mohabaw Jemal ◽  
Fetene Tinshku ◽  
Yeshwas Nigussie ◽  
Birhanetinsae Kefyalew ◽  
Chalie Alemu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Infection Rate ◽  
Neonatal Sepsis ◽  
Bacterial Pathogens ◽  
Laboratory Data ◽  
Current Status ◽  
Outcome Variable ◽  
Bacterial Isolates ◽  
E Coli ◽  
Age Range

Background. Neonatal sepsis is the most common cause of mortality and morbidity. It is a major global public health challenge, particularly in developing countries. Therefore, knowing the current status of bacterial isolates and their antimicrobial resistance profile is essential to physicians and health workers to implement appropriate intervention. The aims of this study was to assess a ten-year trend of bacterial prevalence isolates from blood culture among neonates (<1 month of age). Method. A hospital-based retrospective study was conducted on 1854 neonatal patients who were admitted at University of Gondar Specialized Comprehensive Hospital between 2010 and 2020. Sociodemographical and laboratory data were collected from medical records. Quality of the data was assured through standard operational procedures. Data were entered and analysed using SPSS version 20. Bivariate analysis was employed to determine strings of association between the outcome variable and sociodemographic variables. A P value less than 0.05 will be considered to be statically significant. Results. In a total of 1854 patients, 538 (29%) were culture positive. The overall neonatal sepsis infection rate was 287 (53.5%) for male and 249 (46.5%) for female. The highest proportion of neonatal sepsis infection rate was observed among the patients in the age range between 3 and 28 days and gestational at birth <37 weeks, 461(86%) and 278 (52%), respectively. Gestational at birth ( P  ≤ 0.001, AOR = 5.81, CI: 4.63–7.29) is significantly associated with bacterial isolates. The predominant pathogens were Staphylococcus aureus, 18 (76.6%), Klebsiella pneumoniae, 146 (38%), and E. coli, 45 (11.7%) among the age range less than one weak. Klebsiella spp, S. aureus, and E. coli showed a high level of resistance to most tested antimicrobials. Amikacin, ciprofloxacin and norfloxacin, and erythromycin were the most effective antibiotics whereas ampicillin, amoxicillin, and cotrimoxazole were the least effective antibiotics for isolates. Conclusion. Neonatal sepsis infection is common in the 3–28 days of age range. S. aureus, E. coli, and K. pneumonia were the most common isolates. Most the bacterial pathogens were resistant to commonly prescribed antibiotics. Therefore, an antimicrobial sensitivity test for bacterial isolates is recommended to provide updated data for the physician in choosing the appropriate antibiotic for better patient treatment outcome.

scholarly journals Early Onset Neonatal Sepsis: The Burden of Group B Streptococcal and E. coli Disease Continues

PEDIATRICS ◽  
2011 ◽  
Vol 127 (5) ◽  
pp. 817-826 ◽  
Author(s):  
B. J. Stoll ◽  
N. I. Hansen ◽  
P. J. Sanchez ◽  
R. G. Faix ◽  
B. B. Poindexter ◽  
...  
Keyword(s):  
Neonatal Sepsis ◽  
Early Onset ◽  
E Coli ◽  
Group B

scholarly journals Bacterial Isolates of Early Onset Neonatal Sepsis and Their Antibiotic Susceptibility Pattern

2018 ◽  
Vol 17 (1) ◽  
pp. 3-8 ◽  
Author(s):  
Md Abdul Mannan ◽  
Shahed Iqbal ◽  
SM Rezaul Karim ◽  
Talim Uddin Ahmed ◽  
Md Hakimul Haque Khan ◽  
...  
Keyword(s):  
Neonatal Sepsis ◽  
Early Onset ◽  
Late Onset ◽  
Gram Positive ◽  
Gram Negative ◽  
E Coli ◽  
Late Onset Sepsis ◽  
Early Onset Sepsis ◽  
Sensitivity Pattern ◽  
Rule Out

Background: Neonatal infections are the commonest cause of neonatal mortality along with perinatal asphyxia and consequence of Prematurity and Low Birth Weight (LBW) in Bangladesh. Early Onset Neonatal Sepsis (EONS) is neonatal sepsis occurring within the first 72 hours of birth and it is much more fulminant and has a higher mortality than Late Onset Sepsis (LOS). Sepsis in neonate remains a significant cause of mortality and morbidity in developing countries. Changing bacterial flora and emergence of resistant strains adds to the problem. Thus, neonatal sepsis requires accurate and timely clinical and laboratory diagnosis and proper management for better outcome. The organisms responsible for Early Onset Sepsis (EOS) are different than Late Onset Sepsis (LOS). In this study an attempt has been made to know the positivity rate of EOS and profile of bacteria responsible for EOS and determine the antimicrobial sensitivity pattern that were investigated for rule out sepsis. Methods: This was a prospective observation single centre study over a period of nine months (January to September, 2017) conducted on neonates born at Ad-din Medical College Hospital (AMCH), Dhaka and subsequently admitted in Neonatal Intensive Care Unit (NICU) within 72 hours of birth that were investigated for rule out sepsis. Dual blood sample for cultures from separate area along with essential investigations were sent by collecting samples under aseptic precautions. Empirical antimicrobial therapy was started according to antimicrobial guidelines in the NICU. The blood cultures test were carried out by BD BACTEC automated blood culture system and susceptibility testing was done for all blood culture isolates according to the criteria of the National Committee for Clinical Laboratory Standards by disk diffusion method. Results: A total of 700 neonates were investigated to rule out sepsis and 5.43% neonates were found with culture proven sepsis in the study. The gram positive bacteria accounted for 71% and gram negative 29% of the total isolates. Out of total 38 isolates, Coagulase-Negative Staphylococci (CONS) (68.4%) was the commonest followed by Acinetobacter (18.4%) and E. coli (7.9%) was common culture isolates. Among the gram positive, CONS (96.3%) was commonest isolate and in gram negative Acinetobacter (63.6%) was the most prevalent bacteria followed by E.coli (27.3%). Gram positive isolate, especially CONS (68.4%) was the major culprit for the early onset sepsis. Among the commonly used antibiotics, the susceptibilities were remarkably low to Amikacin (16%) in comparison to Ampicillin (42%) Cefotaxime (45%) and moderately high to Gentamicin (58%) for both gram positive & gram negative isolates. All (100%) gram positive isolates were resistant to Amikacin. Majority of the gram positive showed low susceptibilities to Meropenem (22%) Ciprofloxacin (41%) Ampicillin (48%) & Oxacillin (48%) in comparison to Cefotaxime (52%) Levofloxacin (55%) Gentamicin (70%), Linezolid (70%) and Vancomycin (74%). 50% of Coagulase Negative Staphylococcus (CONS) were resistant to Methicillin/Oxacillin. The sensitivity pattern of majority of gram negative isolates showed high level of resistance to Piperacillin+Tazobacterm (9%) and Ampicillin (27%) Gentamicin (27%) Cefotaxime (27%) less sensitive to Ciprofloxacin (45%); moderately high to Levofloxacin (54%) & Amikacin (54%) and highly sensitive to Imipenem/Meropenem (73%) & Colistin (91%). Gentamicin (58%) and Levofloxacin (55%) were showed marginal superiority compared to Ampicillin (42%) and Cefotaxime (45%) for effective coverage of both. Conclusion: Present study indicated that gram positive species especially CONS continue to be the predominant causative organism followed by Acinetobacter and E. coli in gram negative species. The antibiotic susceptibility profile suggested that for a given cohort empiric (initial) choice of Ampicillin and Gentamicin in EOS. Routine bacterial surveillance and their sensitivity patterns must be an essential component of neonatal care Chatt Maa Shi Hosp Med Coll J; Vol.17 (1); Jan 2018; Page 3-8

scholarly journals Evaluation of Cefotaxime and Desacetylcefotaxime Concentrations in Cord Blood after Intrapartum Prophylaxis with Cefotaxime

2009 ◽  
Vol 53 (6) ◽  
pp. 2342-2345 ◽  
Author(s):  
Jacques Lepercq ◽  
Jean Marc Treluyer ◽  
Christelle Auger ◽  
Josette Raymond ◽  
Elisabeth Rey ◽  
...  
Keyword(s):  
Cord Blood ◽  
Neonatal Sepsis ◽  
Premature Rupture ◽  
Group B Streptococci ◽  
E Coli ◽  
Preterm Premature Rupture ◽  
The Family ◽  
Early Neonatal Sepsis ◽  
Blood Specimens ◽  
Group B

ABSTRACT Preterm premature rupture of the membranes is associated with a high risk of neonatal sepsis. An increase in the incidence of early-onset neonatal sepsis due to ampicillin-resistant Escherichia coli in premature infants has been observed in the past few years. Intrapartum prophylaxis with ampicillin has proven to be efficient for the prevention of early neonatal sepsis due to group B streptococci. To date, there is no strategy for the prevention of early neonatal sepsis due to ampicillin-resistant E. coli. Our aim was to investigate whether a standardized dosage regimen of intrapartum cefotaxime could provide concentrations in the cord blood greater than the cefotaxime MIC90 for E. coli. Seven pregnant women hospitalized with preterm premature rupture of the membranes and colonized with ampicillin-resistant isolates of the family Enterobacteriaceae were included. Cefotaxime was given intravenously during delivery, as follows: 2 g at the onset of labor and then 1 g every 4 h until delivery. Blood specimens were collected from the mother 30 min after the first injection and just before the second injection, and at birth, blood specimens were simultaneously collected from the mother and the umbilical cord. The concentrations of cefotaxime in the cord blood ranged from 0.5 to 8.5 mg/liter. The MIC90 of cefotaxime for E. coli strains (0.125 mg/liter) was achieved in all cases. This preliminary study supports the use of cefotaxime for intrapartum prophylaxis in women colonized with ampicillin-resistant isolates of Enterobacteriaceae. The effectiveness of this regimen for the prevention of neonatal sepsis needs to be evaluated with a larger population.

scholarly journals Initial antibiotic therapy of neonatal sepsis

2004 ◽  
Vol 132 (suppl. 1) ◽  
pp. 49-53
Author(s):  
Milos Jesic ◽  
Maja Jesic ◽  
Svjetlana Maglajlic ◽  
Marija Lukac ◽  
Sanja Sindjic ◽  
...  
Keyword(s):  
Neonatal Sepsis ◽  
Methicillin Resistance ◽  
Initial Therapy ◽  
Coagulase Negative Staphylococci ◽  
Streptococcus Group ◽  
E Coli ◽  
Group B ◽  
High Level ◽  
The University ◽  
Initial Combination

It is certain that in the past the types of bacterial agents responsible for neonatal sepsis and their sensitivity to antibiotics were not the same in all historical periods. However, the reports confirming the conclusion have been published only in the last three years. According to these facts, the bacterial causes of neonatal sepsis were analyzed in patients treated at the University children?s hospital in Belgrade (S&M) as well as their sensitivity to antibiotics to determine the most effective initial therapy. Between January 2001 and June 2004, 35 neonates, aged from 1-30 days, with positive blood culture were treated. Gram-negative bacteria were the cause of sepsis in 57% of patients (Pseudomonas - 20%, Klebsiella - 20%, E. coli - 8,5%, Acinetobacter - 8.5%), gram-positive in 43% (coagulase-negative Staphylococci - 14%, Staphylococcus epidermidis - 14%, Staphylococcus aureus - 9%, Streptococcus group B - 3%, Listeria monocytogenes - 3%). The bacteria were the most sensitive to carbapenems (85-89%), amikacin (68%), third-generation cephalosporins (47-50%), while the sensitivity to gentamicin was less than expected (48.5%). Sensitivity to ampicillin (8%) confirmed a high level of resistance to this antibiotic. All isolated Staphylococci were sensitive to vancomycin, and the overall methicillin resistance was 46%. Combined cefotaxime and amikacin therapy was the most effective of all suggested initial combinations of antibiotics (74%). The sensitivity to all other combinations of antibiotics was 51-71%. The most adequate initial combination of antibiotics for the treatment of neonatal sepsis is cefotaxime plus amikacin. The most adequate antibiotic for the treatment of nosocomial neonatal sepsis is carbapenem.

scholarly journals Epidemiological and clinicobacteriological study of neonatal sepsis

2018 ◽  
Vol 5 (4) ◽  
pp. 1360
Author(s):  
Dhivyanarayani M. ◽  
Raju V. ◽  
Vindyarani W. K.
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Neonatal Sepsis ◽  
Tracheal Aspirate ◽  
Extremely Low Birth Weight ◽  
Indwelling Catheters ◽  
E Coli ◽  
Sepsis Diagnosis ◽  
Culture Sensitivity ◽  
Prolonged Hospital

Background: Neonatal mortality is still high in developing countries like India, which is mostly contributed by sepsis. Early diagnosis and appropriate management can improve the outcome of neonatal sepsis. Diagnosis of neonatal sepsis can be difficult at times as the symptoms and signs are nonspecific. To study the incidence of sepsis in different gestational age and birth weight categories.Methods: The study conducted prospectively in1169 babies admitted to NICU from first May 2011 to 30th April 2012. Data was collected using performance. Investigations including CBC, CXR, Blood culture sensitivity and CRP were done on the same day (IT ratio and micro ESR were not done). CSF study and cultures of urine, surface swab, tracheal aspirate etc done only in selected cases.Results: There were 238 episodes of sepsis and the incidence of sepsis in this study was 20.01% among the babies admitted during the study period. The incidence was more in extreme preterm and extremely low birth weight categories. Among babies with sepsis culture positive sepsis was seen in 18.45%. E. coli was the commonest organism in EOS and Klebsiella in LOS.Conclusions: In this study incidence of neonatal sepsis was 20.35%. Lower the birth weight and gestational age, higher was the incidence of sepsis. PROM >18 hours, MSAF and prematurity were found to be associated with EOS while extreme prematurity, prolonged ventilation, indwelling catheters and prolonged hospital stay were found to be statistically significant in causing LOS.

scholarly journals NEONATAL SEPSIS

2018 ◽  
Vol 25 (11) ◽  
pp. 1683-1688
Author(s):  
Muhammad Hussain ◽  
Ahmad Ali Aurakzai ◽  
Mohammad Irshad ◽  
Ihsan Ullah
Keyword(s):  
Staphylococcus Aureus ◽  
Neonatal Sepsis ◽  
Control Program ◽  
Cross Sectional Study ◽  
Resistance Pattern ◽  
Cross Sectional ◽  
E Coli ◽  
Different Types ◽  
Hospital Study ◽  
Klebsiella Spp

Objectives: To study the frequency of different types of bacteria causing sepsisin neonates, their sensitivity and resistance to various antibiotics in common practice at a tertiarycare hospital. Study Design: Prospective cross-sectional study. Stetting and Duration of study:The study was conducted in Neonatal unit, Lady Reading Hospital, Peshawar, Pakistan fromJanuary to October 2017 (10 months duration). Material and Methods: Blood culture positiveneonatal sepsis patients admitted to the Nursery C, LRH during 10 months were analyzed forbacteria and their sensitivity/ resistance pattern. Results: During study period total 115 bloodculture proven neonatal sepsis causes were found. Only 3 pathogens were isolated, where E.Coli was the most frequent organism found in 85 cases. Staphylococcus aureus (25Cases) wasthe second frequently occurring organism while Klebsiella spp. was the third pathogen causingsepsis in my study (7 cases). Amikacin (88% sensitive against E. Coli), vancomycin (100%sensitive against Staphylococcus aureus) were found most sensitive than commonly usedantibiotics. As the organisms were mostly resistant to ampicillin (76.23%) Amoxicillin (82.48%),Cefotaxime (93.75%) and Ceftriaxone (66.29%), Ceftazidime was comparatively less resistant(55.80%). Conclusion: E. Coli was found to be the major cause for neonatal sepsis followed byStaphylococcus aureus in admitted neonates at Lady Reading Hospital. An alarming increasein the resistance pattern of empirically used antibiotics was observed. So, there is dire needfor continuous monitoring/ surveillance of this alarming resistance of commonly used drugs.Moreover, an effective infections control program is needed to limit the spread of resistantstrains of these pathogens.

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