Risk Factors Assessment and Clinical Profile of Neonatal Sepsis in Blood Culture Proven Neonates.

Background: Neonatal sepsis is one of the main causes of mortality and morbidity, especially in very low birth weight neonates (birth weight <1499 grams) despite the progress in hygiene, introduction of new and potent antimicrobial agents for treatment and advanced measures for diagnosis. The aim of the study was to find correlation of clinical features and risk factors of neonatal sepsis in culture positive cases.Methods: A cross- sectional study was carried out in one hundred neonates with risk factors of septicemia after obtaining informed consent. Blood culture was done using Bactec Peds Plus/F Culture as a gold standard to diagnose septicaemia. Correlation of risk factors, clinical features with laboratory findings was obtained by using chi-square test. p-value of less than 0.05 was considered as significant.Results: Out of 100 neonates with suspected sepsis, BACTEC culture proven sepsis was seen in 40% cases. Gram negative sepsis was seen in 62.5% cases. The most common bacteria for early onset sepsis were Klebsiella, Pseudomonas and MRSA contributing 17% each to the bacteriological profile. The most common predisposing factor and clinical feature in culture positive cases were Premature rupture of membrane >24 hours (67%) and bleeding/petechia/pupura (72%) respectively. The major cause of mortality was pulmonary hemorrhage.Conclusions: Gram negative organism were more common and associated with higher mortality. Blood culture positivity increases with increase in number of risk factors in neonatal septicemia. A detailed history and thorough clinical examination is vital for early recognition of sepsis.

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To Study the Clinical Profile of Neonatal Sepsis and the Sensitivity of Various Markers of Sepsis Screen

MVP Journal of Medical Sciences ◽

10.18311/mvpjms/2014/v1/i1/808 ◽

2014 ◽

Vol 1 (1) ◽

pp. 19

Author(s):

Sagar Sonawane ◽

Milind Suryawanshi ◽

Priyanka Patil ◽

Ravindra Sonawane ◽

M. K. Tolani

Keyword(s):

Blood Culture ◽

Positive Blood Culture ◽

Neonatal Sepsis ◽

Clinical Manifestations ◽

Clinical Profile ◽

Gastric Bleeding ◽

Automated Method ◽

Feed Intolerance ◽

Sepsis Screen ◽

A Prospective Study

Objective: To study the clinical profile of Neonatal Sepsis & the sensitivity of various markers of sepsis screen. Material & Methods: This was a prospective study of neonates admitted to our NICU from January 2010 to October 2011 with diagnosis of neonatal sepsis or those who developed sepsis later on during their stay in NICU. All newborns diagnosed as a case of neonatal sepsis, based on clinical features with positive sepsis screen and/or positive blood culture, were included in our study. Blood Culture & Sensitivity was done with conventional non–automated method using Herley’s Broth. Result: Common clinical manifestations of Neonatal Sepsis among the study group were Lethargy (96.36%), Tachypnea (92.73%), Refusal to suck/feeding difficulty (76.36%), Delayed CRT, Poor Pulses (74.55%), Sclerema (61.82%), Gastric Bleeding (45.45%) & Feed Intolerance (45.45%). 46 babies had positive sepsis screen (sensitivity 84%), while 27 babies had a positive blood culture (sensitivity 49.09%).

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Statistical validity of interleukin-6 as a biomarker for the diagnosis of early-onset neonatal sepsis

Microbiology Research ◽

10.4081/mr.2012.e5 ◽

2012 ◽

Vol 3 (1) ◽

pp. 5 ◽

Cited By ~ 2

Author(s):

Sriparna Basu ◽

Shashikant Dewangan ◽

Shampa Anupurva ◽

Ashok Kumar

Keyword(s):

Risk Factors ◽

Blood Culture ◽

Cord Blood ◽

Interleukin 6 ◽

Neonatal Sepsis ◽

Early Onset ◽

Diagnostic Marker ◽

Statistical Validity ◽

Sepsis Screening ◽

Early Diagnostic

Use of empirical antibiotics in neonates with risk factors of early-onset neonatal sepsis (EOS) is a common practice. A laboratory parameter is needed to help in the accurate diagnosis of EOS to avoid unnecessary use of antibiotics. The aim of this prospective observational cohort study was to compare the statistical validity of cord blood interleukin-6 (IL-6) with conventional sepsis screening as an early diagnostic marker for EOS. Eighty-seven neonates with antenatal risk factors for sepsis were followed up for 72 h for the development of EOS. Cord blood was collected for measurement of IL-6 concentrations. Blood culture and conventional sepsis screening (total leukocyte count, absolute neutrophil count, C-reactive protein and micro-erythrocyte sedimentation rate) were sent for analysis soon after delivery. The study group comprised of symptomatic neonates with positive blood culture (n=36). An equal number of gestational-age matched asymptomatic neonates without risk factor of sepsis served as controls. Statistical validity of IL-6 was compared with sepsis screening parameters as the diagnostic marker for EOS. Gram negative organisms were the predominant cause of EOS. The most commonly isolated organism was Acinetobacter baumanii. The sensitivity and specificity of IL-6 with a cut-off value of 40.5 pg/mL and area under curve of 0.959 were 92.3 and 90.48%, respectively. In contrast, the sensitivity and specificity of different parameters of sepsis screening ranged from 37.5-68.75% and 47.95-57.35%, respectively. In conclusion, cord blood IL-6 can be used as a highly sensitive and specific early diagnostic marker of EOS at a cut-off concentration of 40.5 pg/mL.

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Umbilical Cord Blood Culture in General in the Diagnosis of Sageis Newborns

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2020/v32i2930893 ◽

2020 ◽

pp. 126-131

Author(s):

Naredra P. Porval ◽

Kanvikar Reshmi ◽

D. B. Potdar ◽

S. B. Karanjkar

Keyword(s):

Risk Factors ◽

Birth Weight ◽

High Risk ◽

Blood Culture ◽

Cord Blood ◽

Umbilical Cord ◽

Umbilical Cord Blood ◽

Neonatal Sepsis ◽

Venous Blood ◽

Peripheral Venous Blood

Worldwide neonatal sepsis is among the most frequent causes of neonatal death. Various studies have tried to establish the relationship between prevalence of neonatal septicemia risk factors and bacteriological profiling, low birth weight, prematurity, etc. Current study was aimed to compare early onset of neonatal sepsis (EONS) among primigravida and multigravida mothers using umbilical cord blood (UCB) and peripheral venous blood (PVB) samples. It was also aimed to establish the utilization of umbilical cord blood culture (UCBC) in comparison to peripheral venous blood culture (PVBC) in identifying EONS. In present study the blood samples were collected from high risk neonates for the clinical blood culture and screening. Among the 75 neonates in the study, 24 (32.0%) were observed to have sepsis screen positive. Study of high risk neonates umbilical cord blood culture (UCBC) positivity was 17.3% while Peripheral Venous blood culture positivity was 5.3%. Moreover, in this study all risk factors like Prematurity, Low birth weights, Premature rupture of membrane, and birth asphyxia were significantly (p<0.05) associated with UCBC growth/positivity. Low birth weight (86%) was mostly reported in the high risk neonates with other associated sepsis factors. Similarly maternal fever and prolonged rupture of membrane was highly significantly (p<0.01) associated with UCBC positivity. Gram negative bacterias were more commonly found, such as Pseudomonas (5.3%), followed by E. coli (4%), and Klebsiella (2.7%) and gram positive Streptococcus sp. (2.7%), etc. From our analysis it can be said that the UCBC has strong diagnostic outcomes as compared to the PVBC for etiological evaluation of bacterial sepsis in neonates at high risk.

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

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20173767 ◽

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.

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Comparative Study of Diagnostic Markers in Neonatal Sepsis

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v34i2.9788 ◽

2014 ◽

Vol 34 (2) ◽

pp. 111-114 ◽

Cited By ~ 1

Author(s):

Vijay Baburao Sonawane ◽

Sonali U Gaikwad ◽

Nitin N Kadam ◽

Jitendra Gavhane

Keyword(s):

Risk Factors ◽

Blood Culture ◽

Comparative Study ◽

Neonatal Sepsis ◽

Signs And Symptoms ◽

Diagnostic Markers ◽

Control Group ◽

Specific Marker ◽

Study Group ◽

Mortality And Morbidity

Introduction: Neonatal septicemia is one of the commonest causes of neonatal mortality and morbidity. The objectives of this study were intended for qualitative and quantitative analysis of diagnostic markers in neonatal sepsis.Materials and Methods: This is a hospital based study conducted over three years (Aug 2005 – Aug 2008). Hundred and sixty neonates, delivered in the hospital, having risk factors for neonatal sepsis, along with those coming to hospital with signs and symptoms of sepsis up to 28 days of life (as study group ) along with normal newborns admitted to the postnatal ward without high risk factors (control group) were enrolled for this study. Comparative study on various diagnostics markers such blood culture, CBC,CRP, IT ratio and Micro-ESR was carried out to know their sensitivity and specificity.Results: E.Coli was the most common organism responsible for sepsis. CRP was reported to be highly sensitive (84.21%), and CBC was highly specific (75.00%), IT ratio has sensitivity of 62.5% and specificity of 56.25% while Micro-ESR has shown sensitivity of 50.0% and specificity of 62.5%,Out of 160 cases, blood culture (BacTalert) showed growth in48 cases in study group while two cases in control group. Thus blood culture positivity was 60%.Conclusion: Blood culture is the gold standard for the diagnosis of septicemia. CRP is most sensitive while CBC is most specific marker in neonatal sepsis.DOI: http://dx.doi.org/10.3126/jnps.v34i2.9788J Nepal Paediatr Soc 2014;34(2):111-114

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1378. Reservoirs of Transmission of Resistant Gram-negative Pathogens Responsible for Neonatal Sepsis among Hospitalized Neonates in Pune, India

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1560 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S698-S699

Author(s):

Julia Johnson ◽

Matthew Robinson ◽

Shilpa Nandkumar Naik ◽

Sunil Patil ◽

...

Keyword(s):

Risk Factors ◽

Blood Culture ◽

Neonatal Sepsis ◽

Tertiary Care ◽

Resistance Pattern ◽

Common Cause ◽

Gram Negative ◽

Rectal Swabs ◽

Neonatal Blood

Abstract Background Neonatal infections with resistant Gram-negative (GN) organisms are associated with high rates of mortality, with limited antibiotic treatment options. The role of maternal colonization and environmental GN organisms as reservoirs for transmission to neonates has not been well described. Methods We performed a prospective cohort study from October 12, 2018, until October 31, 2019, to describe the role of maternal and environmental GN colonization in BSI among neonates admitted to the neonatal intensive care unit (NICU) at a tertiary care center in Pune, India. Women admitted to Labor & Delivery with risk factors for neonatal sepsis who provided consent were enrolled and their neonates were followed until hospital discharge. For neonates who developed bloodstream infection (BSI), colonization with resistant GN organisms was assessed in their mothers from frozen vaginal and rectal swabs collected at enrollment and at delivery and in the neonates from frozen skin swabs and peri-rectal swabs collected at day of life (DOL) 0, 3, 7, and weekly until discharge. Environmental colonization was assessed with weekly sampling of unit sinks and the immediate neonatal care environment. Colonization samples were processed to identify organisms that matched neonatal blood culture isolates. Results 953 women were enrolled, of whom 741 (78%) received antepartum antibiotics. Among 987 live born neonates, 12 (1%) died in the delivery room and 257 (26%) required NICU admission. Among neonates admitted to the NICU, 143 (56%) had at least one blood culture, of which 28 (20%) were positive; 21 (75%) had a GN BSI. The most common cause of neonatal BSI was Klebsiella pneumoniae, and 8 (38%) GN BSI were due to a carbapenem-resistant organism. No organism isolated from maternal samples matched organism and resistance pattern from neonatal blood culture. Matching strains were found in unit sinks and neonatal rectal and skin samples (Figure 1). Organism recovery from swabs and match to bloodstream isolate by sample source and time of collection from birth Conclusion Among neonates born to mothers with risk factors for neonatal sepsis, GN organisms were the most common cause of neonatal BSI. Environmental and neonatal colonization may represent important reservoirs of transmission for these pathogens among neonates hospitalized in a tertiary care NICU in Pune, India. Disclosures All Authors: No reported disclosures

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Neonatal Sepsis-Culture Positive Sepsis Vs Clinical Sepsis

International Journal of Medical and Dental Sciences ◽

10.18311/ijmds/2017/18790 ◽

2017 ◽

Vol 6 (1) ◽

pp. 1362

Author(s):

Purbasha Ghosh ◽

Rabindra Nath Misra ◽

Retina Paul

Keyword(s):

Risk Factors ◽

Staphylococcus Aureus ◽

Blood Culture ◽

Neonatal Sepsis ◽

Gold Standard ◽

Methicillin Resistance ◽

High Morbidity ◽

Sepsis Screen ◽

Culture Positive ◽

Culture Negative

Background: The incidence of sepsis is increasing globally, with high morbidity and mortality. Diagnosis of neonatal sepsis is still a clinical and laboratory challenge. Though blood culture is gold standard, it sometimes gives false negative result. So, judgement of clinical condition along with various investigations is important.Objectives: To find out the risk factors associated with neonatal sepsis, to isolate&amp;identify the pathogens from various clinical specimens and to find out antimicrobial susceptibility of the pathogens.Material and methods: Blood culture, sepsis screen, haematological&amp;biochemical markers, cerebrospinal fluid (CSF) study, radiology, MRSA (methicillin resistance Staphylococcus aureus) surveillance were carried out in this study. Some samples were processed in BacT/ALERT-3D system (BioMerieux ) and identified by VITEK-2 (BioMerieux). Epi Info Software system was used to calculate statistics.Results: One seventy (65.9%) were culture positive and 88 (34.1%) were culture negative out of 258 clinically suspected cases. Methicillin sensitive Staphylococcus aureus (MSSA) 66 (38.82%) was the commonest organism. Among 88 culture negative cases, 38(43.2%) babies were two or more sepsis screen tests positive, 40(45.5%) culture negative babies were with risk factors and 5(5.7%) had radiological evidence of pneumonia.Conclusion: The clinical diagnosis of it remains difficult as the symptoms are nonspecific. So, blood culture is mandatory. Other diagnostic tests also help in this situation. Blood culture is still the "Gold standard" for the diagnosis of septicaemia in neonates, but culture negativity cannot exclude the sepsis as a whole.

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Risk Factors for Neonatal Sepsis and Method for Reduction of Blood Culture Contamination

Malawi Medical Journal ◽

10.4314/mmj.v27i1.6 ◽

2015 ◽

Vol 27 (1) ◽

pp. 20 ◽

Cited By ~ 5

Author(s):

A Doronjski ◽

N Barišić ◽

V Stojanović

Keyword(s):

Risk Factors ◽

Blood Culture ◽

Neonatal Sepsis

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Qualitative C-reactive protein as a marker of neonatal sepsis in a tertiary neonatal unit in Sudan

Healthcare in Low-resource Settings ◽

10.4081/hls.2013.e21 ◽

2013 ◽

Vol 1 (2) ◽

pp. 21

Author(s):

Abdelmoneim E. Kheir ◽

Ghada A. Jobara ◽

Kamal M. Elhag ◽

Mohamed Z. Karar

Keyword(s):

Risk Factors ◽

Blood Culture ◽

Neonatal Sepsis ◽

Neonatal Intensive Care ◽

University Hospital ◽

C Reactive Protein ◽

Chi Square ◽

Reactive Protein ◽

Chi Square Test ◽

A Prospective Study

Sepsis is one of the most common causes of morbidity and mortality in newborns. Diagnosis of neonatal sepsis may be difficult because clinical presentations are often non-specific. The aim of this study was to evaluate the role of qualitative C-reactive protein in the diagnosis of neonatal sepsis, and examine the correlation between C-reactive protein, blood culture and risk factors for sepsis. This was a prospective study, conducted in the Neonatal Intensive Care Unit at Soba University Hospital, Sudan. A total of seventy babies with a clinical diagnosis of sepsis were included. Chi square test was used to determine the association between C-reactive protein and risk factors for sepsis and also the association between C-reactive protein and blood culture. Blood culture was positive in 41.4% of babies, and C-reactive protein was positive in 58% of babies with positive blood culture. There was significant association between C-reactive protein results and blood culture (P=0.00). In conclusion, we can assume that Creactive protein is a reliable diagnostic marker of neonatal sepsis, especially in developing communities with poor resources.

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