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.

NEONATAL SEPSIS AND IDENTIFICATION OF RISK FACTORS: STUDY IN KMMC AND HOSPITAL MATHURA

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Dr. Amarjeet Singh ◽  
Dr. Ashok Kumar Garg
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.

NEONATAL SEPSIS AND RISK FACTORS, STUDY IN IN AVBRH TERTIARY CARE HOSPITAL

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Pramod P. Singhavi
Keyword(s):  
Risk Factors ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Late Onset ◽  
Signs And Symptoms ◽  
Maternal Risk Factors ◽  
Maternal Risk ◽  
Late Onset Sepsis ◽  
Early Onset Sepsis ◽  
Meconium Stained Amniotic Fluid

Introduction: Neonatal sepsis can be defined as a clinical condition which is characterized by signs and symptoms of infection in an infant 28 days of life or younger. This is manifested by systemic signs of infection and/ or isolation of a bacterial or other pathogen from the bloodstream. Sepsis is still one of the major causes of morbidity and mortality globally in neonates, despite of recent advances in healthcare units. The incidence of neonatal sepsis by bacteremia in asymptomatic infants is low. In neonatal sepsis we can include septicaemia, pneumonia, meningitis, osteomyelitis, and arthritis and urinary tract infections. The burden for neonatal sepsis was 2,202 (95% CI: 1,099–4,360) per 100,000 live births, with mortality between 11% and 19% and more than 40% of under-five deaths occur in the neonatal period, resulting in 3.1 million new-born deaths each year globally. Material and Methods: The total number neonates admitted in the hospital in given study period was 447, of which 198 were diagnosed for neonatal sepsis by the physician based on the signs and symptoms during admission. The data was collected in three parts: sociodemographic characteristics; maternal information; and part neonatal information for neonatal sepsis. Data was collected in the excel sheet and questionnaires were reviewed and organized by investigators. Results: Of the 198 neonates, 162 (81.8%) infants were in the age range of 0 to 7 days while 36 (18.2%) were aged between 8 and 28 days. Statistically significant difference was observed between early onset and late onset sepsis patients. Out of 198 cases 107 (54%) were male while 91(46%) were female. In early onset sepsis cases maternal UTI, Meconium stained amniotic fluid, Multipara and Premature rupture of membrane was seen in 24(14.8%), 21(13.0%), 19(11.7%) and 32 (19.8%) cases respectively. In late onset sepsis cases maternal UTI, Meconium stained amniotic fluid, Multipara and Premature rupture of membrane was seen in 1(2.8%), 2 (5.6%), 4(11.1%) and 2 (5.6%) cases respectively. Maternal risk factors were identified in 104(64.2%) of early onset sepsis cases while maternal risk factors in late onset sepsis cases were 10(27.8%). Culture positivity was observed in 28 (17.3%) cases of early neonatal sepsis while it was 4 (11.1%) in late onset sepsis. Conclusion: There was male preponderance in early as well as late onset neonatal sepsis. Maternal risk identification may help in the early identification and timely empirical antibiotic therapy. The prediction and/ or diagnosis of neonatal sepsis should be bases on culture-independent diagnostics and risk factor-based scoring systems.

scholarly journals Patient characteristics, Bacteriological profile & outcome of Neonatal Sepsis: A Hospital Based Study

2013 ◽  
Vol 2 (1) ◽  
pp. 49-54
Author(s):  
Nasim Jahan ◽  
Zabrul SM Haque ◽  
Md Abdul Mannan ◽  
Morsheda Akhter ◽  
Sabina Yasmin ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Late Onset ◽  
Female Ratio ◽  
Gram Negative ◽  
Common Pathogen ◽  
Late Onset Sepsis ◽  
Early Onset Sepsis

Neonatal sepsis is a major cause of mortality and morbidity in newborn. The spectrum of bacteria which causes neonatal sepsis varies in different parts of the world. The organisms responsible for early onset and late onset sepsis are different. The objective of the study was undertaken to determine the pattern of bacterial isolates responsible for early and late onset neonatal sepsis. A prospective descriptive study over the period of one year was conducted at the Department of Neonatal Intensive care unit of Ad-din Women’s Medical College and Hospital, Dhaka, Bangladesh.Organisms were isolated from 8.7% of collected blood samples. The male female ratio of culture proven sepsis was 1.7:1. More than half (52.8%) of the evaluated neonates were preterm. & 56.3% had low birth weight. The gram positive and gram negative bacteria accounted for 24.1% and 75.9% of the isolates respectively. Around three fourth of the neonates (75.8%) presented with early onset sepsis, while 24.2% presented with late onset sepsis. Acinetobacter was the most common pathogen both in early onset (70%) and late onset (30%) sepsis. Pseudomonas (89.4%) was the second most common pathogen in early onset sepsis. Total mortality rate was 5.7%. Pre term, low birth weight and gram negative sepsis contributes majority of mortality.Gram negative organism especially Acinetobacter found to be commonest cause of sepsis. Pseudomonas was second most common but contributed highest in late onset sepsis and neonatal death due to sepsis. DOI: http://dx.doi.org/10.3329/cbmj.v2i1.14184 Community Based Medical Journal Vol.2(1) 2013 49-54

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 Clinical, Bacteriological Profile & Outcome of Neonatal Sepsis in a Tertiary Care Hospital

2014 ◽  
Vol 26 (1) ◽  
pp. 18-21 ◽  
Author(s):  
Biplob Kumar Raha ◽  
Md Abdul Baki ◽  
Tahmina Begum ◽  
Nazmun Nahar ◽  
Nasim Jahan ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Klebsiella Pneumoniae ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Late Onset ◽  
Gram Negative ◽  
Common Pathogen ◽  
Late Onset Sepsis ◽  
Early Onset Sepsis

Neonatal sepsis is a major cause of mortality and morbidity in newborn, particularly in developing countries. The spectrum of bacteria which causes neonatal sepsis varies in different parts of the world. The organisms responsible for early onset and late onset sepsis are different. The objective of the study was undertaken to determine the pattern of bacterial isolates responsible for early and late onset neonatal sepsis based on the presence of one or more clinical signs, and its outcome. A cross- sectional prospective study was carried out in the special care baby unit (SCABU) from November 2008 to September 2009 under department of Paediatrics and Neonatology, BIRDEM General Hospital, Dhaka, Bangladesh. Organisms were isolated from 8.9% of collected blood samples. The male female ratio of culture proven sepsis was 1.7:1. Most of the culture proven septic neonates(71.88%) were preterm & 65.63% had low birth weight. The most frequent clinical presentations of patients with culture-proven sepsis were poor moro reflex (92.2%), feeding intolerance (90.6%), jaundice (87.5%), abdominal distention (76.6%), and lathergy (73.4%). The Gram positive and Gram negative bacteria accounted for 6 (9.4% ) and 58 (90.6%) of the isolates respectively. Around two third of the culture-proven septic neonates (70.3%) presented with early onset sepsis, while 29.7% presented with late onset sepsis. Klebsiella pneumoniae was the most common pathogen both in early onset (31.25%) and late onset (6.25%) sepsis. Serratia (18.75%) was the second most common pathogen in early onset sepsis. Total mortality rate was 9.38%. Preterm, low birth weight and Gram negative sepsis contributes majority of mortality. Gram negative organism especially Klebsiella pneumoniae contributed highest in early onset sepsis and neonatal death (6.25%) due to sepsis. DOI: http://dx.doi.org/10.3329/medtoday.v26i1.21306 Medicine Today 2014 Vol.26(1): 18-21

CLINICAL PREVALENCE AND CAUSATIVE MICROBES RESPONSIBLE FOR NEONATAL SEPSIS IN NEONATES ADMITTED IN NMCH

2018 ◽  
Author(s):  
Dr. Ramjee Prasad Gupta ◽  
Dr. Mohan Kejriwal ◽  
Dr. Alka Singh
Keyword(s):  
Neonatal Sepsis ◽  
Early Onset ◽  
Late Onset ◽  
Gram Negative ◽  
Medical College ◽  
Late Onset Sepsis ◽  
Adequate Care ◽  
Early Onset Sepsis ◽  
Low Birth Weight Babies ◽  
Third Generation Cephalosporins

Neonatal sepsis is of two types; early onset sepsis and late onset sepsis. Early onset sepsis (EOS) present within first 72 hours of life. In severe cases, the neonates may be symptomatic at birth. Infants with EOS usually present with respiratory distress and pneumonia. Hence based on above findings the present study was planned to evaluate the immediate clinical outcomes of culture proven neonatal sepsis in the NICU. The study was planned by enrolling the 320 neonates admitted in Neonatal unit of Department of Paediatrics in Nalanda Medical College and Hospital, Patna, from Dec 2017 to Jun 2018. The 40 neonates were diagnosed positive for septicemia was enrolled in the present study.  The approval of the institutional committee was taken prior conduct of study. All the patients were informed consents. The data from the present study revealed that adequate care of the low birth weight babies is of utmost importance to prevent infection by Klebsiella pneumoniae. Amikacin should be used along with third-generation cephalosporins for empirical treatment of gram-negative neonatal sepsis. This empirical regimen should be modified later based on the antibiogram of the isolates. Keywords: neonatal sepsis, epidemiology, microbiology, etc.

scholarly journals Bacteriological Profile of Neonatal Sepsis: A Hospital Based Study

1970 ◽  
Vol 31 (1) ◽  
pp. 1-5 ◽  
Author(s):  
NJ Shrestha ◽  
KU Subedi ◽  
GK Rai
Keyword(s):  
Escherichia Coli ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Late Onset ◽  
Female Ratio ◽  
Mortality And Morbidity ◽  
Common Organism ◽  
Bacteriological Profile ◽  
Late Onset Sepsis ◽  
Early Onset Sepsis

Introduction: Neonatal sepsis is a major cause of mortality and morbidity in newborn. There are many factors that contribute to neonatal sepsis. The organisms responsible for early onset and late onset sepsis are different. Objective: This study was conducted to analyze the organisms responsible for early onset and late onset neonatal sepsis. Materials and Methods: A prospective hospital based study over the period of one year was conducted at neonatal intermediate care unit of Kanti Children's Hospital, Maharajgunj, Kathmandu, Nepal. Results: Organisms were isolated in 6.1% of the collected blood samples. The male female ratio of culture proven sepsis was 1.9:1. Escherichia coli were found to be the most common organism in both early onset and late onset sepsis. Staphylococcus aureus was more common in late onset sepsis than early onset sepsis.Conclusion: Escherichia coli were the most common organism in both early onset and late onset sepsis. Staphylococcal aureus was significantly more common in late onset sepsis than early onset sepsis. Key words: Bacteriological profile; early onset sepsis; late onset sepsis; neonate DOI: 10.3126/jnps.v31i1.4158J Nep Paedtr Soc 2010;31(1):1-5

scholarly journals Brief comments on three existing approaches for managing neonates at risk of early-onset sepsis

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
E. Vaccina ◽  
A. Luglio ◽  
M. Ceccoli ◽  
M. Lecis ◽  
F. Leone ◽  
...  
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Clinical Observation ◽  
Main Body ◽  
Close Monitoring ◽  
Maternal Risk ◽  
Early Onset Sepsis ◽  
Sepsis Calculator

Abstract Background Growing concerns regarding the adverse effects of antibiotics during the first days of life and the marked reduction in the incidence of early-onset sepsis (EOS) are changing the clinical practice for managing neonates at risk of EOS. Strategies avoiding unnecessary antibiotics while promoting mother-infant bonding and breastfeeding deserve to be considered. Main body We compare strategies for managing newborns at risk of EOS recommended by the American Academy of Pediatrics, which are among the most followed recommendations worldwide. Currently three different approaches are suggested in asymptomatic full-term or late preterm neonates: i) the conventional management, based on standard perinatal risk factors for EOS alone, ii) the neonatal sepsis calculator, a multivariate risk assessment based on individualized, quantitative risk estimates (relying on maternal risk factors for EOS) combined with physical examination findings at birth and in the following hours and iii) an approach entirely based on newborn clinical condition (serial clinical observation) during the first 48 h of life. We discuss advantages and limitations of these approaches, by analyzing studies supporting each strategy. Approximately 40% of infants who develop EOS cannot be identified on the basis of maternal RFs or laboratory tests, therefore close monitoring of the asymptomatic but at-risk infant remains crucial. A key question is to know what proportion of babies with mild, unspecific symptoms at birth can be managed safely without giving antibiotics. Conclusions Both neonatal sepsis calculator and serial clinical observation may miss cases of EOS, and clinical vigilance for all neonates is essential There is a need to assess which symptoms at birth are more predictive of EOS, and therefore require immediate interventions, or symptoms that can be carefully reevaluated without necessarily treat immediately the neonate with antibiotics. Studies comparing strategies for managing neonates are recommended.

scholarly journals Clinical Profile of Neonatal Sepsis With Reference to Antibiotic Resistance

2018 ◽  
Vol 5 (1) ◽  
pp. 3460-3464
Author(s):  
Dr. Gargi Pathak ◽  
Dr. Anuya Chauhan ◽  
Dr. Sruthi Nair
Keyword(s):  
Antibiotic Resistance ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Late Onset ◽  
Abdominal Distension ◽  
Preterm Neonates ◽  
Total Blood ◽  
Civil Hospital ◽  
Late Onset Sepsis ◽  
Early Onset Sepsis

Introduction : Neonatal sepsis continues to be a major cause of morbidity and mortality in neonates. It is 30 per 1000 live births in India. The prevalence is more in preterm neonates. Objectives To describe the clinical and bacteriological spectrum in early onset sepsis and late onset sepsis. To describe the antibiotic resistance profile of bacteria causing early and late onset sepsis. To compare the risk factors and bacteriological spectrum in early onset and late onset sepsis. Setting:  NICU of civil hospital Ahmedabad Study period: June 2016 to December 2016 Design: retrospective cohort study Methods:  all neonate admitted in NICU of civil hospital Ahmedabad during the abovementioned period were assessed. Inclusion criteria: presence of one or more of established clinical features like , (fever/hypothermia, poor feeding, poor activity, respiratory distress/apneic spells, hepatospleenomegaly, vomitting, abdominal distension, seizures, signs of either respiratory or circulatory dysfunction evidenced by tachycardia/bradycardia, capillary refill time>3 seconds,, respiratory rate>60/minute, chest indrawing and/or grunting)along with >_2 of the following laboratory criteria(total blood leukocyte count<5000 or>15000, absolute neutrophil count(ANC)<500 cells/mm3or >1500 cells/mm3,C reactive protein (CRP)>0.6microgram/ml, positive blood culture). Information assessed in a proforma. Cases were divided into early onset sepsis(EOS) (presenting in the first 72 hours) and late onset sepsis(LOS) (presenting after 72 hours). All cases were started on antibiotics and upgraded or stopped based on culture and sensitivity. Cases were followed to discharge/death.

scholarly journals Clinical profile and outcome of early onset sepsis in high risk very low birth weight neonates

2018 ◽  
Vol 5 (2) ◽  
pp. 389 ◽  
Author(s):  
Omprakash S. Shukla ◽  
Aditi Rawat
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Blood Culture ◽  
Low Birth Weight ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Very Low Birth Weight ◽  
Gram Negative ◽  
Early Onset Sepsis ◽  
Culture Positive

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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