scholarly journals Neonatal Sepsis in A Tertiary Care Hospital: Evaluation of Causative Agents and Antimicrobial Susceptibilities

2013 ◽  
Vol 37 (1) ◽  
pp. 14-17
Author(s):  
Begum Sharifun Nahar ◽  
Syeda Afroza ◽  
Sunirmol Roy ◽  
Nurun Nahar ◽  
Tarok Nath Kundu

Background: Neonatal sepsis is an important issue with a high morbidity and mortality rate in spite of new advances in antibiotic therapy. Identifying the causative agents and their antibiotic sensitivity in a neonatal care unit (NCU) helps the physician to choose the most appropriate antibiotic therapy. Objectives: This study was aimed to find out the etiological agent and antibiotic susceptibilities in newborn with culture positive sepsis. Methodology: This was a cross sectional study carried out in the neonatal care unit (NCU) of Sir Salimullah Medical College Mitford Hospital (SSMC) from June 2010 to May 2011. Seventy five neonates both preterm and term with culture proven sepsis were analyzed from admitted sick newborn to find out their etiology and antimicrobial sensitivity pattern. Blood culture was done in the department of Microbiology of the same medical college hospital. Results: In this study, out of 75 cases, early onset sepsis was observed in 55(73.33%) cases. Whereas late onset sepsis was in 20(26.66%) cases. Gram negative organisms were isolated in 59 (78%) of 75 cases. Pseudomonas aeroginosa 27 (46.55%), E Coli 15(25.86%) and Serratia 8 (13.79%) were the common microbes. Coagulase negative staphylococcus (CONS) was 10 (62%), followed by Staphylococcus aureus 6 (38%) were the major Gram positive isolates. Gram negative isolates were sensitive to Imipenem, Ceftazidime and Ciprofloxacin whereas 80 % gram positive isolates were sensitive to Amikacin. Conclusion : It was observed from this study that gram negative organisms like pseudomonas aeroginosa and E.coli were the common organisms for neonatal sepsis in hospitalized neonates and imipenem was the most sensitive drug against gram - ve septicaemia. DOI: http://dx.doi.org/10.3329/bjch.v37i1.15346 BANGLADESH J CHILD HEALTH 2013; VOL 37 (1) : 14-17

2019 ◽  
Vol 6 (2) ◽  
pp. 796 ◽  
Author(s):  
Rashmi P. ◽  
Praveen B. K.

Background: Neonatal sepsis is the commonest cause of neonatal mortality responsible for about 30-50% of total neonatal deaths in developing countries. Surveillance of causative organisms and their antibiotic sensitivity pattern promotes rational use of antibiotics and antibiotic stewardship.Methods: A retrospective study, relevant data regarding the neonates diagnosed with culture positive sepsis was obtained from the case records during the period from July 2014 to June 2017. Culture positive sepsis was defined as isolation of bacterial pathogen from blood in neonates with clinical suspicion of sepsis.Results: Of the 414 neonates with clinical suspicion of sepsis, 110 neonates had blood culture positive sepsis. Sepsis was predominant in males (64.5%). Low birth weight (47.2%) and prematurity (40.9 %) were important neonatal risk factors for sepsis. Early onset sepsis occurred in 58.1% of the cases and late onset sepsis in 41.9% of the neonates. Gram-positive cocci constituted 67.52% of all isolates and gram negative 30.76%. The most frequently isolated organism in blood was methicillin resistant coagulase negative staphylococcus(MRCONS) (32.47%). Gram positive organisms included MRCONS, methicillin resistant Staphylococci aureus (MRSA), group B Streptococci (GBS), Staphylococcus aureus and Enterococci. Among Gram-negative organisms, Acinetobacter was most frequently isolated followed by Klebsiella, Escherichia coli, Pseudomonas, Citrobacter and Burkholderia species. The mortality in the study group was 13.5%. Gram negative organisms were most resistant to ampicillin and cephalosporins. Gram positive isolates were least resistant to vancomycin and linezolid.Conclusions: Gram positive sepsis was the most common type of sepsis among the neonates, although mortality was more in gram negative sepsis.


2019 ◽  
Vol 6 (2) ◽  
pp. 487
Author(s):  
Soumini Rath ◽  
Santosh Kumar Panda ◽  
Manas Kumar Nayak ◽  
Deepti Damayanty Pradhan

Background: The objective of this study is to evaluate sensitive pattern of causative organisms of neonatal sepsis with its clinical outcome in a tertiary neonatal care unit of eastern India.Methods: This retrospective observational cohort study was done in a tertiary care hospital of Odisha. All the blood culture positive neonatal sepsis cases, excluding neonates with multiple congenital malformations, diagnosed during January 2017 to December 2018 were analysed using descriptive summary statistics.Results: A total of 73 neonatal sepsis cases were diagnosed by BacT/Alert and VITEK-2 blood culture method. Among them, 50 (68%) babies had gram negative sepsis,14 (19%) cases of gram-positive sepsis and nine (13%) cases of fungal sepsis. In present study 38 (52%) cases were early onset sepsis, 38(52 %) babies were term, 55(75%) were male and 44 (60%) babies were out born. Klebsiella pneumonia and Acinetobacter were the most common organism in early onset and late onset sepsis respectively. Among gram negative organism (GNB), 66% were multi drug resistant. A fifty percent of gram-negative organism were sensitive to meropenem and 28% were sensitive to piperacillin/tazobactam. The sensitivity of GNB to colistin, ciprofloxacin, amikacin was 76%, 64% and 56% respectively. The sensitivity of gram-positive organisms to linezolid, vancomycin, teicoplanin and penicillin were 92%, 85%,85% and 20% respectively. Survival rate among culture positive sepsis was 83%.Conclusions: Multi drug organisms are emerging in modern neonatal care practice. Practice of antibiotic stewardship may save the babies from multidrug resistance organism in future.


Author(s):  
Tapashi Ghosh ◽  
Sabyasachi Saha ◽  
Ananya Mandal ◽  
Nikhil Tudu ◽  
Jayanta Bikash De

Background: Antimicrobial sensitivity pattern from clinical isolates can reveal important information that can help in drafting the hospital antibiotic policy as well as help improve prescribing patterns and patient outcome in a particular region.Methods: Data from the results of the antimicrobial sensitivity pattern of clinical isolates of the patients between 1stJuly and 31st December 2018 were collected on a pre-designed and pre tested case study form and analysed with the help of descriptive statistics.Results: A total of 75 blood culture reports were obtained which showed 58 gram positive cultures. Further 46 of the gram positive samples were positive for Coagulase negative Staphylococcus. A total of 305 urine samples were obtained for culture which showed gram negative cultures. Paediatric and medicine wards were the common yielding sites. A total of 242 pus reports were obtained which showed 47 gram positive cultures. A total of 154 wound swab samples were obtained which showed 47 gram positive cultures. For pus and wound swab samples, surgery wards were the common yielding sites. Common gram negative organisms seen were Klebsiella sp., E. coli, Citrobacter sp., Pseudomonas, Proteus and Enterobacter. Gram positive organisms were commonly resistant to Erythromycin, orally active Penicillins, Vancomycin and Teicoplanin and gram negative organisms were commonly resistant to Cephalosporins, Aminoglycosides, Colistin, Fluroquinolones and Meropenem.Conclusions: This study showed that over six months samples of body pus, wound swab, blood culture and urine showed high levels of resistance to commonly used antibiotics. This would provide an outline for development of an effective hospital Infection Control Policy.


2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S116-S117
Author(s):  
Connor Deri ◽  
Whitney Nesbitt ◽  
George Nelson ◽  
Jessica Keefe

Abstract Background Bloodstream infections are a leading cause of mortality amongst hospitalized patients. Optimizing time to pathogen identification and receipt of appropriate antibiotic therapy significantly decreases mortality, morbidity, and length of hospitalization. Rapid diagnostic tests, such as Verigene, assist in the early identification of bacteria and resistance determinants from positive blood cultures; however, Verigene assays are limited to the detection of 13 gram-positive and 9 gram-negative bacteria. Methods The purpose of this study was to describe gram-negative and gram-positive aerobic bacteria identified from positive blood cultures with no Verigene target detected and to use the susceptibilities to create an antibiogram to assist in empiric antibiotic selection. A total of 2325 positive blood cultures resulted between January 2017 and October 2018 underwent Verigene testing. Results Of the 2325 isolates, 383 (16.5%), had no Verigene organism or resistance mechanism detected. Of these, there were 239 (62.4%) gram-positive isolates, 141 (36.8%) gram-negative isolates, and 3 yeast isolates with 96 unique organisms. Seventy-six (19.8%) of the organisms identified by standard culture, but not Verigene testing, are included on Verigene panel. We analyzed nine common antibiotics active against gram-negative organisms to determine percent susceptibilities against the isolated aerobic pathogens: amikacin (92.1%), cefepime (93.5%), ceftazidime (94.0%), ceftriaxone (79.7%), ciprofloxacin (88.5%), gentamicin (91.9%), levofloxacin (86.9%), piperacillin–tazobactam (83.8%), and tobramycin (85.5%). Additionally, four antibiotics active against gram-positive organisms were analyzed for gram-positive susceptibilities: cefotaxime (91.8%), ceftriaxone (98.1%), levofloxacin (82.5%), and vancomycin (91.8%). Conclusion The results of this study provide clinicians with antibiotic susceptibilities against organisms that were not identified through Verigene to better guide timely and appropriate antibiotic therapy against gram-negative and gram-positive aerobic bacteria. Disclosures All authors: No reported disclosures.


2018 ◽  
Vol 25 (12) ◽  
pp. 1945-1948
Author(s):  
Juveriya Shah ◽  
Ali Akbar Siyal ◽  
Tabinda Taqi

Objectives: The objective of this study was to take a look at main causes associated with highest neonatal morbidity and mortality in neonatal care unit of People’s medical college hospital Nawabshah. Study Design: Retrospective study. Period: January 2015 to December 2015. Setting: Paediatric medicine ward of People’s medical college hospital Nawabshah. Methods: The data collected included; sex, gestational age, postnatal age atadmission, weight at admission, main cause of admission, outcome, cause of death. Results: The number of neonates admitted in NICU was 2863 (14.4%) of the total admissions (19882) to the paediatric unit including neonatal unit during the study period. There were more males 1750 (61.9%) than females. Prematurity, neonatal sepsis and birth asphyxia were the most common morbidities (27.5%, 14.9% and 14.6%, respectively). The overall mortality was 21.93% (628 out of 2863 babies). The morbidities with the highest mortality were birth asphyxia 244(38.85%), neonatal sepsis and meningitis 77 (12.26%), and V.L.B.W (9.03%). Conclusion: Birth Asphyxia, neonatal sepsis and meningitis, and low birth weight were the major contributors in admission as well as mortality of newborns, depicting a lack of care and attention in antenatal duration and there is a major lack of training and retraining of birth attendants. 


2020 ◽  
Vol 8 (2) ◽  
Author(s):  
Alisha Akya ◽  
Mosayeb Rostamian ◽  
Shahab Rezaeian ◽  
Mahnaz Ahmadi ◽  
Maryam Janatolmakan ◽  
...  

Context: Sepsis is one of the most common causes of neonatal mortality, especially in developing countries. The purpose of this study was to systematically review the bacterial causative agents of neonatal sepsis and their antibiotic susceptibility in Iran. Material and Methods: We searched all previously published papers to gather related information on Iranian neonatal sepsis in international and national databases (in both Persian and English) from 2006 to 2018. The standard STROBE checklist was used for quality assessment. The data were analyzed by statistical methods with a random-effects model using Stata 14 software. Results: A total of 89,472 neonates with sepsis (presented in 17 studies) were included in this systematic review. The mortality rate of neonates was 28.0%. The proportions of neonatal sepsis caused by Gram-negative and Gram-positive bacteria were 66.0% and 33.0%, respectively. The most common bacteria causing neonatal sepsis were Klebsiella pneumoniae and Pseudomonas aeruginosa (Gram-negative) and coagulase-negative staphylococci and Staphylococcus aureus (Gram-positive). Conclusions: Gram-negative bacteria are the most common causes of neonatal sepsis in Iran. Imipenem is the most effective antibiotic against Gram-negative bacilli and vancomycin against Gram-positive cocci causing neonatal sepsis in Iran.


Author(s):  
Erum Malik ◽  
David A. Phoenix ◽  
Timothy J. Snape ◽  
Frederick Harris ◽  
Jaipaul Singh ◽  
...  

AbstractHere the hypothesis that linearized esculentin 2EM (E2EM-lin) from Glandirana emeljanovi possesses pH dependent activity is investigated. The peptide showed weak activity against Gram-negative bacteria (MLCs ≥ 75.0 μM) but potent efficacy towards Gram-positive bacteria (MLCs ≤ 6.25 μM). E2EM-lin adopted an α-helical structure in the presence of bacterial membranes that increased as pH was increased from 6 to 8 (↑ 15.5–26.9%), whilst similar increases in pH enhanced the ability of the peptide to penetrate (↑ 2.3–5.1 mN m−1) and lyse (↑ 15.1–32.5%) these membranes. Theoretical analysis predicted that this membranolytic mechanism involved a tilted segment, that increased along the α-helical long axis of E2EM-lin (1–23) in the N → C direction, with −  < µH > increasing overall from circa − 0.8 to − 0.3. In combination, these data showed that E2EM-lin killed bacteria via novel mechanisms that were enhanced by alkaline conditions and involved the formation of tilted and membranolytic, α-helical structure. The preference of E2EM-lin for Gram-positive bacteria over Gram-negative organisms was primarily driven by the superior ability of phosphatidylglycerol to induce α-helical structure in the peptide as compared to phosphatidylethanolamine. These data were used to generate a novel pore-forming model for the membranolytic activity of E2EM-lin, which would appear to be the first, major reported instance of pH dependent AMPs with alkaline optima using tilted structure to drive a pore-forming process. It is proposed that E2EM-lin has the potential for development to serve purposes ranging from therapeutic usage, such as chronic wound disinfection, to food preservation by killing food spoilage organisms.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S777-S778
Author(s):  
Arsheena Yassin ◽  
Christine Stavropoulos ◽  
Krystina L Woods ◽  
Jiashan Xu ◽  
Justin Carale ◽  
...  

Abstract Background Hand infections represent a major source of morbidity, which can result in hand stiffness and amputation. Early appropriate empiric antibiotic regimen may reduce the associated morbidity, hence the importance to examine local epidemiology. The aim of this study was to define the current epidemiology of adult hand infections at two urban hospitals in New York City. Methods We performed a double center, retrospective study of adult patients hospitalized from March 2018 to May 2020. Patients with positive cultures associated with the hand infections were included. Retrospectively, 100 patients were reviewed. Data on baseline demographic, clinical, surgical, microbiology, and treatment parameters were collected. Results Of the 100 patients, 76% were male, with median age of 47.5 years (35, 58.25) and average C-reactive protein (CRP) of 50.66 mg/L (± 64.64) on admission (see Table 1). Previous hospitalization within 1 year (38%), previous surgical procedures (39%) and recent IV medication use (26%) were common. 130 bacterial isolates were identified (see Table 2). The most frequent organisms were Gram-positive, with Methicillin susceptible Staphylococcus aureus (MSSA, 25.38%), Streptococcus species (20.08%), and Methicillin resistant Staphylococcus aureus (MRSA, 15.38%) being the most common. Gram-negative organisms were infrequent, with Haemophilus parainfluenzae (3.85%), Enterobacter cloacae (3.85) and Pseudomonas aeruginosa (3.08%) being the most prevalent. Of the 100 patients, 27% had polymicrobial infections, associated with trauma (6%), illicit IV use (6%) and unknown (7%) etiologies. Table 1: Baseline demographics and co-morbid conditions Table 2: Types and numbers of organisms in relation to etiologies Conclusion Within our population, the most common organisms associated with hand infections were Gram-positive, with Staphylococcus aureus and Streptococcus species being the most prevalent. Gram-negative pathogens were infrequently isolated. The results within this study can provide guidance to clinicians on assessing the appropriate empiric antibiotic regimen in patients with hand infections, and can serve as a basis for further studies identifying risk factors associated with isolation of organisms associated with hand infections. Disclosures All Authors: No reported disclosures


Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 349
Author(s):  
Sien Ombelet ◽  
Alessandra Natale ◽  
Jean-Baptiste Ronat ◽  
Olivier Vandenberg ◽  
Liselotte Hardy ◽  
...  

Bacterial identification is challenging in low-resource settings (LRS). We evaluated the MicroScan identification panels (Beckman Coulter, Brea, CA, USA) as part of Médecins Sans Frontières’ Mini-lab Project. The MicroScan Dried Overnight Positive ID Type 3 (PID3) panels for Gram-positive organisms and Dried Overnight Negative ID Type 2 (NID2) panels for Gram-negative organisms were assessed with 367 clinical isolates from LRS. Robustness was studied by inoculating Gram-negative species on the Gram-positive panel and vice versa. The ease of use of the panels and readability of the instructions for use (IFU) were evaluated. Of species represented in the MicroScan database, 94.6% (185/195) of Gram-negative and 85.9% (110/128) of Gram-positive isolates were correctly identified up to species level. Of species not represented in the database (e.g., Streptococcus suis and Bacillus spp.), 53.1% out of 49 isolates were incorrectly identified as non-related bacterial species. Testing of Gram-positive isolates on Gram-negative panels and vice versa (n = 144) resulted in incorrect identifications for 38.2% of tested isolates. The readability level of the IFU was considered too high for LRS. Inoculation of the panels was favorably evaluated, whereas the visual reading of the panels was considered error-prone. In conclusion, the accuracy of the MicroScan identification panels was excellent for Gram-negative species and good for Gram-positive species. Improvements in stability, robustness, and ease of use have been identified to assure adaptation to LRS constraints.


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