NEONATAL SEPSIS;

Introduction: Neonatal sepsis is a systemic condition characterized bybacteremia that occurs in the first month of life. It is a fatal condition and need to be treatedpromptly. Bacterial isolates include both gram positive and negative bacteria and the cureof condition is highly dependent on antimicrobial drug sensitivity and resistant patterns. It isthere for utmost important to known commonly occurring bacteria in neonatal septic statesand their drug sensitivity patterns. Objectives: To determine the frequency of the bacterialisolates in blood and their sensitivity patterns to commonly used antibiotics in neonatal sepsis.Setting: Neonatal intensive care unit(NICU), Department of Shifa International Hospital. (SIH),Islamabad. Study Design: Cross sectional. Duration: This study was conducted between 6 1stJune 2013 to 30th November 2013. Subject and Methods: A total of 180 neonates, admittedin NICU with evidence of clinical sepsis i.e. with signs and symptoms suggestive of septicemia(fever, lethargy, reluctance to feed, seizures, and irritability) were included in this study. Thesamples for blood cultures were taken. Identification of bacterial isolates was carried out by thestandard bacteriological techniques, which include gram staining and bacterial cultures andantimicrobial sensitivity patterns which was performed by modified Kirby and Bauer disc diffusemethod as per CLSI (Clinical and Laboratory StandardsInstitute)guidelines.A predesignedPerforma was filled. Results: Culture revealed bacterial growth in 7.2% samples. Gram negativeorganisms were observed in 6.67% and only 1 were gram positive. In this study, 50% and 100%of E-coli were sensitive to ampicillin, meropenem and amikacin, gentamycin respectively. Sixtyto 100% of pseudomonas was sensitive to ceftazidime, tazobactum, meropenem and 100%of enterococcus was sensitive to ampicillin and vancomycin. Conclusion: Antimicrobial drugresistance and constantly changing resistance patterns is emerging issues in various groupsof infections and septic states, especially for routinely used antibiotics as found in our study.Thus by prescribing rational use of antimicrobial as per bactriogram, It‘ll be easier totreat sepsiseffectively and economically and reduce the mortality and morbidity related to neonatal sepsis.

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Bacterial etiology and antibiotic resistance pattern of neonatal sepsis: a study in a tertiary care hospital, in Bangladesh

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20193098 ◽

2019 ◽

Vol 6 (5) ◽

pp. 1839

Author(s):

Mahfuza Shirin ◽

M. Monir Hossain ◽

Manifa Afrin ◽

Mohammad Abdullah Al Mamun

Keyword(s):

Neonatal Sepsis ◽

Tertiary Care ◽

Resistance Pattern ◽

Gram Negative Bacteria ◽

Care Hospital ◽

Gram Positive ◽

Cross Sectional ◽

Gram Negative ◽

Mortality And Morbidity ◽

Gram Positive Bacteria

Background: Neonatal sepsis is a leading cause of neonatal mortality and morbidity. The objective of the study was to detect causative microorganisms of neonatal sepsis and their antimicrobial resistance patterns.Methods: This prospective cross-sectional study was conducted from July 2017 to June 2018 in the Department of Neonatal Medicine and NICU of Dhaka Shishu (Children) Hospital (DSH). Neonates diagnosed with probable sepsis were studied. After enrollment, 1 mL blood was taken and sent to Microbiology department of DSH for culture and sensitivity. With baseline characteristics, clinical examination findings and outcome, were also recorded.Results: Rate of isolation of single organism was 9.2% (84/913). Out of 84 isolates, gram negative bacteria were 77.4% with Klebsiella pneumonae being the commonest (35, 41.7%), gram positive bacteria were 11.9% with Staphylococcus aureus and Streptococcus were equal (5, 5.95% each) and the remaining (9, 10.7%) isolated organism was Candida. Most of the isolated gram-negative bacteria were resistant to ampicillin, gentamicin, and ceftazidime; but gram-positive bacteria preserved 20-80% sensitivity. Klebsiella was more resistant than Acinetobacter to amikacin, netilmicin, ciprofloxacin and levofloxacin. Around 45-65% of gram-negative bacteria were resistant to imipenem and meropenem but gram-positive bacteria showed lesser resistance. Among the gram-negative bacteria, Klebsiella and Acinetobacter were resistant to piperacillin as same as carbapenem group, but gram-positive bacteria were 100% sensitive to piperacillin. All the gram-negative bacteria showed more resistance to 4th generation cephalosporin, cefepime than carbapenem. Out of culture positive 84 neonates, 63 (75.0%) were cured but 21 (25.0%) died. Among the 21 expired neonates, 47.6% (10/21) were infected with Klebsiella.Conclusion: This study observed that gram-negative bacteria causing neonatal sepsis predominantly, with emergence of Candida. All the isolated gram-positive and gram-negative organisms were mostly resistant to available antibiotics

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

Archives of Clinical Infectious Diseases ◽

10.5812/archcid.84710 ◽

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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Distribution of Microorganisms in Neonatal Sepsis and Possible Outbreak of Enterobacter spp. in Neonatal Intensive Care Unit

KYAMC Journal ◽

10.3329/kyamcj.v11i1.47145 ◽

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

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Bacterial Isolates and its Antibiotic Susceptibility Pattern in NICU

Kathmandu University Medical Journal ◽

10.3126/kumj.v11i1.11030 ◽

2014 ◽

Vol 11 (1) ◽

pp. 66-70 ◽

Cited By ~ 13

Author(s):

S Shrestha ◽

NC Shrestha ◽

S Dongol Singh ◽

RPB Shrestha ◽

S Kayestha ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Bacterial Isolates ◽

Susceptibility Pattern ◽

Gram Positive ◽

Antibiotic Susceptibility Pattern ◽

Gram Negative ◽

Nosocomial Sepsis

Background Neonatal sepsis is one of the major causes of morbidity and mortality among the newborns in the developing world. Objectives To determine the common bacterial isolates causing sepsis in neonatal intensive care unit and its antibiotic susceptibility pattern. Methods A one year discriptive prospective study was conducted in neonatal intensive care unit to analyse the results of blood culture and to look into the sensitivity of the commonly used antibiotics. Results The blood culture yield by conventional method was 44.13% with nosocomial sepsis accounting for 10.79%. 84.08% were culture proven early onset sepsis and 15.95% were late onset sepsis. Klebsiella infection was the commonest organism isolated in early, late and nosocomial sepsis but statistically not significant. Gram positive organisms were 39.36% in which Staphylococcus aureus was the leading microorganism followed by coagulase negative staphylococcus areus. Gram negative organisms were 60.64% amongst them Klebsiella was the most often encountered followed by Pseudomonas. The most common organism Klebsiella was 87.5% and 78.3% resistance to ampicillin and gentamycin respectively. Among gram negative isolates 87.5% and 77.2% were resistance to ampicillin and gentamycin respectively. Among gram positive isolates 58.5% and 31.5% resistance were noted to ampicillin and gentamycin respectively. Resistance to cefotaxim to gram negative and gram positive isolates were 87.34% and 59.35% respectively. Conclusion Klebsiella is most common organism which is almost resistance to first line antibiotics. Resistance to both gram negative and gram positive isolates among firstline antibiotics and even with cefotaxim is emerging and is a major concern in neonatal intensive care unit. DOI: http://dx.doi.org/10.3126/kumj.v11i1.11030 Kathmandu University Medical Journal Vol.11(1) 2013: 66-70

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Clinical Profile and Outcome of Neonates Admitted to Neonatal Intensive Care Unit of NGMC

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v15i1.23533 ◽

2017 ◽

Vol 15 (1) ◽

pp. 20-22

Author(s):

Roma KM ◽

Manita Pyakurel ◽

Veena Gupta ◽

Piush Kanodia

Keyword(s):

Neonatal Sepsis ◽

Neonatal Intensive Care ◽

Neonatal Period ◽

Study Data ◽

Clinical Profile ◽

Mortality And Morbidity ◽

Medical Practitioners ◽

Common Causes ◽

Causes Of Mortality ◽

The Common

Background: Neonatal period is a period from birth to under 28 days of life. The common causes of mortality and morbidity in our region are preventable, among which neonatal sepsis is the commonest one. Most of the deaths occur within 7 days of life. Objectives: To study the clinical profile, pattern of diseases, causes of morbidity and mortality amongst newborns. Materials and methods: A hospital based descriptive study was done among total 967 newborns including both inborn and out born admitted in NICU, NGMC from January 2016 to December 2016. Age, sex, gestational age, diagnosis at admission, outcome of admitted th newborns were the main variables under study. Data was entered in Excel and analyzed using SPSS 20th version. Data were presented through pie, bar graph and table with frequency and percentage. Results: Male were predominant in the study (65%). One third of the admitted newborns were preterms. Half of the admitted newborns were admitted on their first day of life. Neonatal sepsis was the most common cause of admission. Deaths occured in 7.4%of total babies. Seventy-six percent got improved after treatment. Only 2.8% were referred to higher center. Conclusions: Most of the neonates got admitted in first day of life with commonest cause being neonatal sepsis. Recovery rate was satisfactory. To reduce the mortality and morbidity of neonates, we need to increase awareness level in general population and proper aseptic practices in medical practitioners.

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Bacteriological profile and antibiogram of cancer patients admitted in intensive care unit of a tertiary care cancer hospital in central Kerala

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20205323 ◽

2020 ◽

Vol 8 (12) ◽

pp. 4450

Author(s):

Sanjana Ramakrishnan ◽

Sourabh Radhakrishnan ◽

Sonu Lazar Cyriac

Keyword(s):

Cancer Patients ◽

Bacterial Infections ◽

Tertiary Care ◽

Gram Positive ◽

Cross Sectional ◽

Gram Negative ◽

Mortality And Morbidity ◽

E Coli ◽

Resistance To Penicillin ◽

Study Laboratory

Background: Opportunistic bacterial infections remain a serious morbidity among cancer patients. This study was aimed to determine the bacteriological and antibiotic profile of cancer patients admitted to the ICU of a tertiary care centre.Methods: Cross sectional study was done among cancer patients admitted in the Oncology neutropenic ICU during the period from August 2017 to July 2019. All patients admitted with a proven diagnosis of cancer for whom at least one bacterial culture was sent from any site were included in the study. Laboratory on culture reports were obtained from patient files and analysed.Results: A total of 278 samples from 256 patients (60±11.6 years) were analysed. Among the 111/278 positive cultures, 29 were blood samples and 1 was a pleural fluid sample. Gram negative organisms were 62.1% with Escherichia coli (25, 36.2%) as prevalent. Among the 37.8% gram positives, Staphylococcus aureus (18. 42.8%) was prevalent. Most of the E. coli strains showed highest resistance to ceftazidime (96%) and highest sensitivity to amikacin. The commonest gram-positive organism, Staphylococcus species were 100 % sensitive to vancomycin and linezolid and 100 % resistance to penicillin. Conclusions: E. coli (gram negative) showed highest resistance to ceftazidime and sensitivity to amikacin. S. aureus (gram positive) was sensitive to vancomycin and linezolid and resistance to penicillin. An antibiogram for cancer patients helps the clinician to initiate an appropriate empirical antibiotic therapy to reduce mortality and morbidity.

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

10.36106/ijsr/5926619 ◽

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.

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Role of Lumbar Puncture in Late Onset Neonatal Sepsis

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v39i3.28459 ◽

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.

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Bacteriological Profile and their Susceptibility Pattern in Neonatal Intensive Care Unit at Tertiary Care Hospital in Wah

Journal of Rawalpindi Medical College ◽

10.37939/jrmc.v24i3.1310 ◽

2020 ◽

Vol 24 (3) ◽

pp. 219-224

Author(s):

Saba Mushtaq ◽

Sohail Ashraf ◽

Lubna Ghazal ◽

Rida Zahid ◽

Basharat Hussain ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Neonatal Sepsis ◽

Neonatal Intensive Care ◽

Gram Negative Bacteria ◽

Gram Positive ◽

Blood Samples ◽

Gram Negative ◽

Gram Positive Cocci

Introduction: Neonatal sepsis is a clinical syndrome characterized by multiple symptoms and signs of infection during the first month of life. The objective of this study is to determine the frequency of commonly isolated bacteria from patients of neonatal sepsis and their susceptibility patterns in POF hospital at Wah. Methods: This cross-sectional study was carried out in POF Hospital Neonatal intensive care unit and Microbiology laboratory from January 2018 to December 2019. The blood samples of patients suspected with neonatal sepsis were processed as per standard methodology. Results: Out of ninety blood samples, fifty-one (56.7%) yielded the growth of Gram-negative rods and thirty-nine (43.3%) yielded Gram-positive cocci. Among Gram-positive bacteria, coagulase-negative staphylococci were the most common pathogen isolated from 53.8% cases followed by methicillin-resistant Staphylococcus aureus (15.3%). Among Gram-negative bacteria, Klebsiella pneumoniae (54.90%) was the most frequently identified bacteria followed by Serratia marcescens (27.45%). The Gram-positive cocci were the most susceptible to linezolid (100%) followed by vancomycin (87.2%). The Gram-negative rods depict remarkable resistance to ciprofloxacin (92.2%), gentamicin (100%), and meropenem (54.9%). Conclusions: The study concluded a predominance of Gram-negative bacteria as a causative agent of neonatal sepsis in our setup. The bacterial isolates are highly resistant to commonly prescribed oral as well as injectable antibiotics. Implementation of infection control policies is a dire need to combat the grave situation of increasing antibiotic resistance.

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Bacteriological Profile of Neonatal Sepsis and Antibiogram of the Isolates

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v37i1.16303 ◽

2017 ◽

Vol 37 (1) ◽

pp. 5-9

Author(s):

Roshan Parajuli ◽

Narayan Dutt Pant ◽

Raju Bhandari ◽

Anil Giri ◽

Suman Rai ◽

...

Keyword(s):

Staphylococcus Epidermidis ◽

Neonatal Sepsis ◽

Diffusion Method ◽

Preliminary Treatment ◽

Biochemical Tests ◽

Gram Positive ◽

Cross Sectional ◽

Gram Negative ◽

Bacteriological Profile ◽

Gram Positive Cocci

Introduction: Neonatal sepsis is a serious problem in developing countries like Nepal. The main objectives of this study were to determine the bacteriological profile of neonatal sepsis, to determine the antimicrobial susceptibility patterns of the causative agents and to evaluate the association between the neonatal sepsis and the different characteristics of the neonates.Methods: A hospital based cross-sectional study was conducted among a total of 450 neonates suspected of suffering from sepsis. Blood culture was performed using statdard microbiological techniques. The colonies grown were identified on the basis of colony morphology, Gram’s stain and biochemical tests. The antimicrobial susceptiblility testing was performed by Kirby Bauer disc diffusion method. Results: Out of total 450 blood samples, 92 (20.4%) were culture positive. Of which, 16 (17.4%) samples contained gram negative bacteria and 76 (82.6%) samples contained gram positive cocci. The most common bacterial pathogens isolated were Staphylococcus epidermidis (67.4%) followed by Escherichia coli (13%). All gram positive cocci were susceptible to vancomycin, while all gram negative bacilli were sensitive to amikacin. There was statistically significant relationship between neonatal sepsis and gestation age of neonates.Conclusions: Neonatal sepsis is still present as a serious problem in Nepal. Staphylococcus epidermidis was the most common cause of the neonatal sepsis. Prematurely delivered neonates should be given more care, as they are more prone to suffering from neonatal sepsis. Vancomycin and amikacin can be used as the drugs of choice for preliminary treatment of neonatal sepsis in our settings.

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