scholarly journals Isolation and Identification of Serratia marcescens from Suspected Late Neonatal Sepsis in Intensive Care Unit

2018 ◽  
Vol 9 (01) ◽  
Author(s):  
Jabbar S. Hassan ◽  
Ahmed E. Salman ◽  
Ahmed S. Obeid ◽  
Thana R. Abdul Rhman
Keyword(s):  
Serratia Marcescens ◽  
Neonatal Sepsis ◽  
Late Onset ◽  
Venous Blood ◽  
Cross Sectional Study ◽  
Molecular Technique ◽  
Luxs Gene ◽  
Isolation And Identification ◽  
Cross Sectional ◽  
Late Onset Sepsis

Background: Neonatal sepsis stays one of the main sources of morbidity and mortality both among infant in ICU, in light of the planning of the disease neonatal sepsis has been categorized into early and late-onset sepsis, where the latter occurs after one week of life and is often more insidious in onset than the former. Objective: To detect the rate of Serratia marcescens infection in neonatal sepsis in ICU by molecular technique. Methods: A total of 50 neonates with the age group 8 days to 30 days who were admitted to AL-Kadhumiya Teaching Hospital/ Baghdad during the period January to March ,2017 were recruited for this cross-sectional study. Approximately 3 ml of venous blood were obtained from each patients. These samples were examined for septicemia by blood culturing followed by API20 for quick identification of relevant bacteria. Furthermore, bacteria DNA was isolated directly from blood samples, and conventional PCR based on luxS gene, highly specific to S. marcescens, was achieved. Results: Blood culture were positive in 36(72 %) out of 50 samples; the most common bacterial causes were Staphylococcus aureus (18.7%), Pseudomonas aeruginosa (13.8%) and Serratia marcescens (11.1%), Molecular method revealed specific amplification of luxS gene in 12 samples (24%). Conclusion: Serratia marcescens has risen as a most widely recognized causative agent in late onset sepsis.

TLR2 and TLR4 expressions in late-onset neonatal sepsis: Is it a potential novel biomarker?

2020 ◽  
pp. 1-7
Author(s):  
R. Rohsiswatmo ◽  
M. Azharry ◽  
T.T. Sari ◽  
Y. Bahasoan ◽  
D. Wulandari
Keyword(s):  
Blood Culture ◽  
Neonatal Sepsis ◽  
Predictive Value ◽  
Complete Blood Count ◽  
Late Onset ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Tlr4 Expression ◽  
Cross Sectional ◽  
Reactive Protein

BACKGROUND: Late-onset neonatal sepsis (LONS) detection is problematic as no single examinations (blood culture, c-reactive protein (CRP), procalcitonin (PCT)) are reliable. Toll-like receptors (TLRs), which detect the presence of pathogen-associated molecular patterns is a promising novel biomarker, but less studied in LONS. This study aimed to determine neutrophils and monocytes TLR2 and TLR4 expression in LONS and their diagnostic value. METHODS: A cross-sectional study conducted in May and June 2017 involving 52 neonates with clinical late-onset (>72 hours of age) sepsis. We examine complete blood count, I/T ratio, CRP, PCT, as well as TLR2 and TLR4 expression to compared with blood culture as the gold standard. We classified cases into proven or unproven sepsis. RESULT: The incidence of LONS was 32.6% in the subjects. The expression of TLR2 was low in LONS, while TLR4 was high. TLR4 neutrophil expression has 88.2% sensitivity, 20% specificity, 34.9% positive predictive value (PPV), 77.8% negative predictive value (NPV), and an AUC of 0.541. TLR4 monocyte expression has 92.1% sensitivity, 11.4% specificity, 34% PPV, 80% NPV, and an AUC of 0.528. The AUC of CRP is increased from 0.608 to 0.843 after combination with TLR4, comparable with CRP + PCT (AUC 0.829). CONCLUSION: The increase in TLR4 expression has good sensitivity but low specificity. TLR4 expression, in combination with CRP, could become a reliable biomarker for the diagnosis of LONS.

scholarly journals Urinary tract infection among neonatal sepsis of late-onset in Cipto Mangunkusumo Hospital

2016 ◽  
Vol 45 (5) ◽  
pp. 217 ◽  
Author(s):  
Novie Amelia ◽  
Idham Amir ◽  
Partini P Trihono
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Neonatal Sepsis ◽  
Urine Culture ◽  
Late Onset ◽  
Preterm Neonates ◽  
Cross Sectional ◽  
Female Ratio ◽  
Late Onset Sepsis

Background Urine culture, as part of a full septic work-up forlate-onset neonatal sepsis, was not routinely done in the Neona-tal Ward at Cipto Mangunkusumo Hospital, and as of today, theprevalence of urinary tract infection (UTI) among neonates withlate-onset sepsis remains unknown.Objectives To determine the prevalence and microbiological pat-terns of UTI among late-onset neonatal sepsis in CiptoMangunkusumo Hospital.Methods We conducted a cross-sectional study on all neonatesdiagnosed as suspected late-onset sepsis who underwent sep-sis evaluation between 20 October 2003 – 30 April 2004. Urinespecimens were collected by bladder catheterization for cultureand urinalysis.Results UTI was found in 14.9% (7/47) neonates who under-went urine culture (male: female ratio was 5:2). Six subjectswho had UTI were preterm neonates, Klebsiella pneumoniaewas found in both blood and urine cultures of 1 subject, while theothers showed different microorganisms. Forty-five out of 47subjects, who were suspected of late-onset sepsis, had posi-tive blood cultures. All subjects with UTI had positive bacteriuriafrom Gram-stained specimen.Conclusions The prevalence of UTI among neonates with late-onset sepsis in Cipto Mangunkusumo Hospital was 14.9%. Themicroorganisms most frequently found in urine cultures werePseudomonas sp., Staphylococcus epidermidis, and Klebsiellapneumoniae. Urine culture, urinalysis, and urinary Gram-stainshould be performed as part of sepsis evaluation for late-onsetneonatal sepsis, especially in male and preterm neonates

scholarly journals PATTERN OF ANTIBIOTICS UTILIZATION IN NEONATAL SEPTICEMIA: A CROSS-SECTIONAL STUDY FROM RURAL TERTIARY CARE HOSPITAL WESTERN MAHARASHTRA, INDIA

2017 ◽  
Vol 9 (3) ◽  
pp. 60 ◽  
Author(s):  
Shinde A. R. ◽  
Mohite R. V. ◽  
Shinde R. V.
Keyword(s):  
Neonatal Sepsis ◽  
Tertiary Care Hospital ◽  
Late Onset ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Antibiotic Regimen ◽  
Sectional Study ◽  
Cross Sectional ◽  
Empiric Antibiotic

Objective: To assess the quantification of use of antibiotics and to find out empiric antibiotic regimen practiced for neonatal sepsis in rural tertiary health care centre.Methods: A hospital, record based cross-sectional study was conducted in Neonatal Intensive Care Unit(NICU) at tertiary care hospital located in western Maharashtra, India. The study was planned during the year 2011-12 among 84 neonates with sepsis. Data were collected by using proforma includes demographic details, antibiotic prescriptions and relevant information.Results: Among the total 84 neonates, max, 60.71% had a history of term delivery. The proportion of early and late onset of sepsis was 47.61% and 52.38% for which total 18 antibiotics were used of which max, 88.88% were injectables. Amikacin was used in max, 78.57% neonates followed by cefotaxime, 45.23% and ampicillin, 35.71% in single or combination form respectively. Amikacin was used for max; 929 d followed by cefotaxime, 523 d and ampicillin 331 d respectively. Antibiotics used in single, double and multiple regimens were 19.04%, 46.42% and 34.52% respectively. Empiric antibiotic regimens practiced were cefotaxim+amikacin and cefotaxim+ampicillin, of which max, 80% patients were treated with the cefotaxim+amikacin antibiotic regimen. Out of 84 neonates max, 70% were improved at the time of discharge.Conclusion: Neonatal sepsis was well treated by cefotaxim+amikacin empirical injectable regimen with maximum survival.

scholarly journals ASSESSMENT OF SERUM PROCALCITONIN LEVELAS A MARKER TO DIAGNOSE LATE ONSET SEPSIS IN NEONATES

2020 ◽  
pp. 1-2
Author(s):  
Javeri Aarti Harish ◽  
Jagadeeswari Jagadeeswari
Keyword(s):  
Neonatal Intensive Care ◽  
Late Onset ◽  
Cross Sectional Study ◽  
Coagulase Negative Staphylococci ◽  
Efficient Tool ◽  
Cross Sectional ◽  
Medical College ◽  
Late Onset Sepsis ◽  
Detection And Diagnosis ◽  
Single Laboratory

Introduction: Sepsis constitutes one of the most prevalent cause of mortality in newborns, eminently in developing countries. There are several investigations available that may be used as indicators to identify sepsis, however, the inability of a single laboratory investigation for rapid detection and diagnosis of sepsis, calls for the need of a specific investigation. Lately, it has been proclaimed that procalcitonin can be used as a reliable predictor for diagnosis and to determine severity as well as outcome of neonatal sepsis. Objective: To assess levels of serum Procalcitonin level as a marker to diagnose late-onset sepsis in a neonatal intensive care unit (NICU). Methods and Materials: A cross-sectional study was performed between the June 2018 to November 2018 at Sree Balaji Medical College and Hospital. Serum procalcitonin levels were determined for 25 neonates of age between 3-30 days. Results: Distinct elevations of procalcitonin levels were observed in neonates with late-onset sepsis caused mainly by coagulase-negative staphylococci. Currently nosocomial infection due to coagulase-negative staphylococci is a frequent occurrence in NICUs. Conclusion: Serum procalcitonin is an efficient tool to diagnose Late Onset of Sepsis.

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.

Diagnostic value of assessment of Serum Cortisol, Hepcidin and Thyroid Hormone Levels in Neonates with Late Onset Sepsis

2020 ◽  
Vol 20 ◽  
Author(s):  
Adel Hagag ◽  
Mohamed S Elfarargy ◽  
Reham Lyonis ◽  
Ghada M Al-Ashmawy
Keyword(s):  
Thyroid Hormones ◽  
Antibiotic Therapy ◽  
Neonatal Sepsis ◽  
Late Onset ◽  
Serum Cortisol ◽  
Control Group ◽  
Serum Free ◽  
Group I ◽  
Late Onset Sepsis ◽  
Serum Hepcidin

Background: Neonatal sepsis is a clinical syndrome characterized by symptoms and signs of infection in the first twenty eight days of life. Serum thyroid, cortisol and hepcidin are affected by neonatal sepsis. Aim of the work: The aim of this study was to assess the predictive value of serum thyroid hormones including free triiodothyronine (free TT3) and free tetraiodothyronine (free TT4), serum cortisol and hepcidin levels through comparison of their concentrations between normal neonates and neonates with high probable late onset sepsis. Patients and Methods: This case control study was carried out on 40 neonates with suspected high probable late onset neonatal sepsis based on clinical and laboratory finding who were admitted to NICU of Pediatric Department, Tanta University, Egypt in the period from April 2017 to May 2019 (group I) and 40 healthy neonates matched in age and sex as a control group (group II). For patients and controls; blood culture, highly sensitive C‑reactive protein (H-s CRP), serum hepcidin, serum cortisol and thyroid hormones levels including free TT3 and free TT4 were assessed. Results: There were no significant differences between studied groups as regard weight, gestational age, sex and mode of delivery. H-s CRP, serum cortisol and hepcidin were significantly higher in group I than group II while serum free TT3 and free TT4 were significantly lower in group I compared with controls. There was significantly lower H-s CRP, serum hepcidin and cortisol and significantly higher serum free TT3 and free TT4 in group I after antibiotic therapy compared to the same group before treatment while there were no significant differences between group I after antibiotic therapy and control group as regard the same parameters. There were significant positive correlation between H-s CRP and serum hepcidin and cortisol in group I while there was significant negative correlation between H-s CRP and free TT3 and free TT4. ROC curve of specificity and sensitivity of H-s CRP, serum hepcidin, cortisol, free TT3 and free TT4 in prediction of neonatal sepsis shows that serum hepcidin had the highest sensitivity and specificity with 95% and 90% respectively followed by serum cortisol, H-s CRP, free TT3 and lastly free TT4. Conclusion and recommendations: Neonates with high probable sepsis had significantly higher serum cortisol and hepcidin and significantly lower free TT3 and free TT4 compared with healthy neonates. These findings may arouse our attention about the use of these markers in diagnosis of in neonatal sepsis which can lead to early treatment and subsequently better prognosis.

Can Cytokines be used as an Activation Marker in Rheumatoid Arthritis?

2020 ◽  
Vol 20 ◽  
Author(s):  
Fatih Öner Kaya ◽  
Yeşim Ceylaner ◽  
Belkız Öngen İpek ◽  
Zeynep Güneş Özünal ◽  
Gülbüz Sezgin ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Healthy Volunteers ◽  
Venous Blood ◽  
Cross Sectional Study ◽  
Joint Disease ◽  
Control Group ◽  
Cross Sectional ◽  
Positive Correlation ◽  
Das 28 ◽  
Tnf Α

Aims: The etiopathogenesis of Rheumatoid Arthritis (RA) is not clearly understood. However, the role of the cytokines takes an important part in this mechanism. We aimed to bring a new approach to the concept of 'remission' in patients with RA. Background: RA is a chronic, autoimmune, inflammatory disease that involves small joints in the form of symmetrical polyarthritis and progresses with exacerbations and remissions. Pain, swelling, tenderness and morning stiffness are typical of the joints involved. Although it is approached as a primary joint disease, a wide variety of extra-articular involvements may also occur. It is an interesting pathophysiological process, the exact cause of which is still unknown, with many environmental, genetic and potentially undiscovered possible factors in a chaotic manner. Objective: In this cross-sectional study, sedimentation rate (ESR), C- Reactive protein (CRP), Tumor necrosis factor (TNF)-α, soluble-TNF-α receptor (TNF-R), Interleukin (IL)-1B and IL-10 were measured in three groups which were healthy volunteers, patients with RA in the active period, and patients with RA in remission. Disease activity score-28 (DAS-28) was calculated in active RA and RA in remission. Methods: This study included 20 healthy volunteers, 20 remission patients with RA and 20 active RA patients. Venous blood samples were collected from patients in both healthy and RA groups. Results: RA group consisted 43 (71.6%) female and 17 (28.4%) male. Control group consisted 11 (55%) female and 9 (45%) male. TNF-R was significantly high only in the active group according to the healthy group (p=0.002). IL-10 was significantly high in active RA according to RA in remission (p=0.03). DAS-28 was significantly high in active RA according to RA in remission (p=0.001). In the active RA group, ESR and TNF-R had a positive correlation (r:0.442; p=0.048). In the active RA group, there was also a positive correlation between TNF-R and CRP (r:0.621; p=0,003). Both healthy and active RA group had significant positive correlation between ESR and CRP (r: 0.481; p=0.032 and r: 0,697; p=0,001 respectively). Conclusion: TNF-R can be the main pathophysiological factor and a marker showing activation. TNF-R can be very important in revealing the effect of TNF on the disease and the value of this effect in the treatment and ensuring the follow-up of the disease with CRP instead of ESR in activation.

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