Aetiology and frequency of risk factor for late onset neonatal sepsis in a IIIb level NICU

Background Neonatal sepsis is one of the major causes of morbidity and mortality at the community and hospital levels in India. There are several community practices associated with and contributing to Neonatal sepsis, especially late onset variety.Objective To analyze whether scalp shaving is an independent risk factor associated with community acquired late onset neonatal sepsis and the causative organism responsible.Methods This was a prospective, non-interventional, observational study. The study was conducted at two tertiary teaching hospitals in Eastern India from 1st May 2010 to 30th April 2011. A total of 382 babies were diagnosed as Late Onset Neonatal Sepsis and 410 , age and sex matched controls were taken from the Well Baby and Immunization clinics. The patients were clinically screened for sepsis and "septic screen" and blood, urine and CSF cultures sent, as needed.Results History of scalp shaving was present in 46(12.04%) out of 382 cases of Late Onset Neonatal Sepsis as compared to 20(4.87%) of 410 matched community controls, the difference was statistically significant (p<0.005). Positive blood cultures were obtained in 20(43.48%) out of 46 scalp shaven babies as compared to 118(35.11%) out of 336 non scalp shaven babies. The commonest organism in babies with scalp shaving was found to be methicillin resistant Staphylococcus aureus(MRSA), whereas the most common organism in non scalp shaven babies was Klebsiella pnuemoniae.Conclusion Scalp shaving appears to be an independent variable associated with community acquired Late Onset Neonatal Sepsis.Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-3, 35-44

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The Risk Factors of Bacterial Meningitis in Late-Onset Neonatal Sepsis

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.6706 ◽

2021 ◽

Vol 9 (B) ◽

pp. 1224-1228

Author(s):

Ni Made Reditya Noviyani ◽

I Made Kardana ◽

Dewi Sutriani Mahalini ◽

Ida Bagus Gede Suparyatha ◽

Ketut Ariawati ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Bacterial Meningitis ◽

Gestational Age ◽

Neonatal Sepsis ◽

Late Onset ◽

Invasive Procedure ◽

Neonatal Morbidity ◽

Chi Square ◽

Comprehensive Management

BACKGROUND: Neonatal bacterial meningitis has a significant contribution on neonatal morbidity and mortality. It is the most common complication of late-onset neonatal sepsis. An understanding of the risk factors for bacterial meningitis in late-onset neonatal sepsis is required to provide comprehensive management. AIM: To identify the risk factors of bacterial meningitis in late-onset neonatal sepsis. METHODS: This is an analytical study with a case–control design, conducted in May 2019-February 2021, involving neonates aged 4–28 days who suffered from late-onset neonatal sepsis in Level II and III Neonatal Care Unit, Sanglah General Hospital Denpasar. Statistical analysis was performed using Chi-square and logistic regression. RESULTS: A total of 54 patients were analyzed in this study. The mean age of subjects with neonatal bacterial meningitis was 13 days and the majority of them were male (51.9%). The risk factor of bacterial meningitis in late-onset neonatal sepsis was gestational age <37 weeks with odds ratio 4.22 (95% confidence interval 1.28–13.86, p = 0.01). There was no significant association of birth weight <2500 g, neonatal asphyxia, and invasive procedure on neonatal bacterial meningitis. CONCLUSION: Gestational age <37 weeks is a risk factor for bacterial meningitis in late-onset neonatal sepsis.

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NEONATAL SEPSIS AND IDENTIFICATION OF RISK FACTORS: STUDY IN AVBRH HOSPITAL SAWANGI

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i6.1215 ◽

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

Infectious Disorders - Drug Targets ◽

10.2174/1871526520666200327185244 ◽

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.

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Point of Care Neonatal Ultrasound in Late-Onset Neonatal Sepsis

Journal of Neonatology ◽

10.1177/09732179211007599 ◽

2021 ◽

pp. 097321792110075

Author(s):

Rameshwor Yengkhom ◽

Pradeep Suryawanshi ◽

Rahul Murugkar ◽

Bhavya Gupta ◽

Sujata Deshpande ◽

...

Keyword(s):

Neonatal Sepsis ◽

Late Onset ◽

Point Of Care ◽

Cardiac Contractility ◽

Free Fluid ◽

Ultrasound Screening ◽

Laboratory Findings ◽

Late Onset Sepsis ◽

Pulmonary Arterial ◽

Neonatal Care Unit

Background and Objectives: Point of care neonatal ultrasound is a useful tool in evaluation of heart, brain, lungs, and abdomen in neonatal sepsis. The objective of our study was to perform bedside ultrasound screening of heart, brain, lungs, and abdomen in neonates with late onset culture positive sepsis and study the patterns of abnormalities and also their role in change of patient management. Methods: This prospective observational study was conducted at a tertiary level neonatal care unit from March 2017 to May 2018. All neonates with suspected late onset sepsis on the basis of clinical and laboratory findings underwent point of care neonatal ultrasound of heart, brain, lungs, and abdomen. Results: Of 153 suspected and eligible late-onset neonatal sepsis (LONS) cases, 67 (44%) had positive blood culture and were analyzed. Of this 67 neonates, 30 (45%) had abnormal neurosonography, 38 (57%) had abnormal cardiac output, 14 (20%) had abnormal cardiac contractility, 17 (25%) had abnormal pulmonary pressure, 18 (27%) had pulmonary arterial hypertension, 19 (28%) had pneumonia, and 7 (10%) had free fluid in abdomen. Clinical management was changed in 26 (39%) neonates. Conclusion: Bedside point of care neonatal ultrasound is a useful tool in assessment of heart, brain, lungs, and abdomen in a LONS. It could help in making appropriate decisions in the management, and therefore potentially reduce morbidity and mortality.

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Acid‐suppressive medication as a possible risk factor for late‐onset asthma

Allergy ◽

10.1111/all.14099 ◽

2019 ◽

Vol 75 (5) ◽

pp. 1247-1250 ◽

Cited By ~ 1

Author(s):

Yasuhiro Tomita ◽

Yuma Fukutomi ◽

Mari Irie ◽

Kazuhiro Azekawa ◽

Hiroaki Hayashi ◽

...

Keyword(s):

Risk Factor ◽

Late Onset

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Poor Adherence to the Screening-Based Strategy of Group B Streptococcus Despite Colonization of Pregnant Women in Greece

Pathogens ◽

10.3390/pathogens10040418 ◽

2021 ◽

Vol 10 (4) ◽

pp. 418

Author(s):

Maria Maroudia Berikopoulou ◽

Aikaterini Pana ◽

Theodota Liakopoulou-Tsitsipi ◽

Nikos F. Vlahos ◽

Vasiliki Papaevangelou ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Pregnant Women ◽

Late Onset ◽

Group B Streptococcus ◽

Culture Collection ◽

Carrier Status ◽

Cross Sectional ◽

Screening Guidelines ◽

Group B

Group B streptococcus (GBS) is a leading cause of serious neonatal infections. Maternal GBS colonization is associated with early- and late-onset neonatal disease (EOD/LOD). In Greece, a screening-based strategy is recommended, in which concurrent vaginal-rectal cultures should be obtained between 36 0/7 and 37 6/7 weeks’ gestation. We sought to examine the level of adherence to the GBS screening guidelines and estimate the prevalence of GBS colonization among pregnant women. Although in Greece the screening-based strategy is followed, we also examined known EOD risk factors and linked them to GBS colonization. A cross-sectional study of 604 women postpartum in three hospitals and maternity clinics was conducted. Following written informed consent, data were collected via a short self-completed questionnaire and review of patients’ records. In 34.6% of the enrolled pregnant women, no culture had been taken. Of the remaining, 12.8% had proper vaginal-rectal sample collections. The overall maternal colonization rate was 9.6%. At least one risk factor for EOD was identified in 12.6% of participants. The presence of risk factors was associated with positive cultures (p = 0.014). The rate of culture collection did not differ between women with or without an EOD risk factor. Adherence to a universal screening of pregnant women with vaginal-rectal cultures was poor. Despite probable underestimation of GBS carrier status, almost 1 in 10 participants were GBS positive during pregnancy. Screening of women with risk factors for EOD should, at least, be prioritized to achieve prevention and prompt intervention of EOD.

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