scholarly journals Analisis Penggunaan Antibiotik pada Pasien Sepsis Neonatorum di Neonatal Intensive Care Unit RSUP Prof. Dr. R. D. Kandou Manado

e-CliniC ◽  
2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Tesalonika Kereh ◽  
Rocky Wilar ◽  
Suryadi N. N. Tatura
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Coming Out ◽  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Clinical Syndrome ◽  
Cross Sectional ◽  
Third Line ◽  
Combination Antibiotics

Abstract: Neonatal sepsis is defined as a clinical syndrome with systemic manifestations and bacteremia that occurs in the first month of life. Admnistration of antibiotics had to follow the pattern of the most common causal germs in a hospital. This study was aimed to determine the antibiotics of neonatal sepsis patients at the Neonatal Intensive Care Unit (NICU) of Prof. Dr. R. D. Kandou Hospital Manado, in this case types of antibiotics, duration of the used antibiotics, as well as the use of the first, second, and third-line antibiotics. This was a descriptive analytical study with a cross sectional design. Samples were neonatal sepsis patients who were treated with first, second, and third line antibiotic therapy at the NICU from September to November 2019. The results obtained a total of 40 patients, consisting of 22 males (55%) and 18 females (45%). The condition of the patients when coming out of the ward were 12 recovered (30%) and 28 died (70%). Combination antibiotics were the most common used as many as 37 cases (58%). The length of time using antibiotics based on lines, obtained that the first-line antibiotics were given at a duration of ≤5 days, while the second and third line antibiotics were more often given at a duration of >5 days. In conclusion, most neonatal sepsis patients were given antibiotics in combination. There were differences among the durations of the first, second and third line antibiotics used in patients with neonatal sepsis.Keywords: neonatal sepsis, antibiotics Abstrak: Sepsis neonatorum didefinisikan sebagai sindrom klinis dengan manifestasi sistemik dan bakterimia yang terjadi pada satu bulan pertama kehidupan. Pemberian antibiotik harus memperhatikan pola kuman penyebab tersering yang ada di suatu rumah sakit. Penelitian ini bertujuan untuk mengetahui penggunaan antibiotik pada pasien sepsis neonatorum di Neonatal Intensive Care Unit (NICU) RSUP Prof. Dr. R. D. Kandou Manado dalam hal ini jenis-jenis antibiotik yang digunakan, durasi penggunaan antibiotik yang diberikan, serta penggunaan antibiotik lini pertama, kedua, dan ketiga. Jenis penelitian ialah deskriptif analitik dengan desain potong lintang. Sampel penelitian ialah pasien sepsis neonatorum yang menggunakan terapi antibiotik lini pertama, kedua, dan ketiga yang dirawat di ruangan NICU periode September - November 2019. Hasil penelitian memperoleh total 40 pasien, terdiri dari 22 bayi laki-laki (55%) dan 18 bayi perempuan (45%). Keadaan pasien saat keluar dari ruang rawat 12 sembuh (30%) dan 28 meninggal (70%). Penggunaan antibiotik kombinasi paling banyak digunakan yaitu sebanyak 37 kasus (58%). Lama waktu penggunaan antibiotik berdasarkan lini, didapatkan antibiotik lini pertama paling banyak diberikan pada durasi ≤5 hari, sedangkan lini kedua dan ketiga lebih sering diberikan pada durasi >5 hari. Simpulan penelitian ini ialah sebagian besar pasien sepsis neonatorum diberikan antibiotik secara kombinasi. Terdapat perbedaan pada lama waktu penggunaan antibiotik pasien sepsis neonatorum baik lini pertama, kedua dan ketiga.Kata kunci: sepsis neonatorum, antibiotik

scholarly journals Analisis Penggunaan Antibiotik pada Pasien Sepsis Neonatorum di Neonatal Intensive Care Unit RSUP Prof. Dr. R. D. Kandou Manado

e-CliniC ◽  
2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Tesalonika Kereh ◽  
Rocky Wilar ◽  
Suryadi N. N. Tatura
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Coming Out ◽  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Clinical Syndrome ◽  
Cross Sectional ◽  
Third Line ◽  
Combination Antibiotics

Abstract: Neonatal sepsis is defined as a clinical syndrome with systemic manifestations and bacteremia that occurs in the first month of life. Admnistration of antibiotics had to follow the pattern of the most common causal germs in a hospital. This study was aimed to determine the antibiotics of neonatal sepsis patients at the Neonatal Intensive Care Unit (NICU) of Prof. Dr. R. D. Kandou Hospital Manado, in this case types of antibiotics, duration of the used antibiotics, as well as the use of the first, second, and third-line antibiotics. This was a descriptive analytical study with a cross sectional design. Samples were neonatal sepsis patients who were treated with first, second, and third line antibiotic therapy at the NICU from September to November 2019. The results obtained a total of 40 patients, consisting of 22 males (55%) and 18 females (45%). The condition of the patients when coming out of the ward were 12 recovered (30%) and 28 died (70%). Combination antibiotics were the most common used as many as 37 cases (58%). The length of time using antibiotics based on lines, obtained that the first-line antibiotics were given at a duration of ≤5 days, while the second and third line antibiotics were more often given at a duration of >5 days. In conclusion, most neonatal sepsis patients were given antibiotics in combination. There were differences among the durations of the first, second and third line antibiotics used in patients with neonatal sepsis.Keywords: neonatal sepsis, antibiotics Abstrak: Sepsis neonatorum didefinisikan sebagai sindrom klinis dengan manifestasi sistemik dan bakterimia yang terjadi pada satu bulan pertama kehidupan. Pemberian antibiotik harus memperhatikan pola kuman penyebab tersering yang ada di suatu rumah sakit. Penelitian ini bertujuan untuk mengetahui penggunaan antibiotik pada pasien sepsis neonatorum di Neonatal Intensive Care Unit (NICU) RSUP Prof. Dr. R. D. Kandou Manado dalam hal ini jenis-jenis antibiotik yang digunakan, durasi penggunaan antibiotik yang diberikan, serta penggunaan antibiotik lini pertama, kedua, dan ketiga. Jenis penelitian ialah deskriptif analitik dengan desain potong lintang. Sampel penelitian ialah pasien sepsis neonatorum yang menggunakan terapi antibiotik lini pertama, kedua, dan ketiga yang dirawat di ruangan NICU periode September - November 2019. Hasil penelitian memperoleh total 40 pasien, terdiri dari 22 bayi laki-laki (55%) dan 18 bayi perempuan (45%). Keadaan pasien saat keluar dari ruang rawat 12 sembuh (30%) dan 28 meninggal (70%). Penggunaan antibiotik kombinasi paling banyak digunakan yaitu sebanyak 37 kasus (58%). Lama waktu penggunaan antibiotik berdasarkan lini, didapatkan antibiotik lini pertama paling banyak diberikan pada durasi ≤5 hari, sedangkan lini kedua dan ketiga lebih sering diberikan pada durasi >5 hari. Simpulan penelitian ini ialah sebagian besar pasien sepsis neonatorum diberikan antibiotik secara kombinasi. Terdapat perbedaan pada lama waktu penggunaan antibiotik pasien sepsis neonatorum baik lini pertama, kedua dan ketiga.Kata kunci: sepsis neonatorum, antibiotik

scholarly journals Study of Antibiotic Susceptibility among Bacterial Isolates in Neonatal Intensive Care Unit of a Tertiary Care Hospital: A Descriptive Cross-sectional Study

2020 ◽  
Vol 58 (231) ◽  
Author(s):  
Brajesh Raj Chaudhary ◽  
Kalpana Karmacharya Malla ◽  
Sajan Poudel ◽  
Brajesh Kumar Jha
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Sepsis ◽  
Antibiotic Susceptibility ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Care Hospital ◽  
Cross Sectional ◽  
Gram Negative

Introduction: Neonatal sepsis is a major cause of neonatal morbidity and mortality worldwide, especially in developing countries like Nepal. Antibiotic resistance among microorganisms poses new challenges in the treatment of neonatal sepsis. The present study is conducted with the objectives of determining clinico-bacteriological profile and antibiotic susceptibility among isolated bacteria in a neonatal intensive care unit. Methods: A descriptive cross-sectional study was conducted from January 1, 2017, to December 31, 2019, in the neonatal intensive care unit of a tertiary care hospital after obtaining ethical clearance from Institutional Review Committee (Reference Number: 2020-064). The sample size was calculated and 77 neonates with culture-proven sepsis were included in the study. The antibiotic susceptibility tests of the isolates were done by Kirby-Bauer disc diffusion method. Data entry was done in Statistical Packages for the Social Sciences version 20. Results: Of the 841 specimens (blood, cerebrospinal fluid, urine, tracheal aspirate and pus) processed for culture, bacteria were isolated in 84 (10.0%) specimens. Among the 84, gram-negative bacilli were the predominant isolates 76 (90.5%); of which Acinetobacter baumannii was the most common 27 (32.1%). Both the Gram-negative and the Gram-positive bacteria showed high resistance to Penicillin and Cephalosporins. Gram-negative bacteria showed maximum sensitivity to Colistin, Carbapenems, Tigecycline and Fluoroquinolones. Gram-positive bacteria showed maximum susceptibility to Amikacin, Vancomycin and Carbapenems. Conclusions: Judicious use of antibiotics based on the updated knowledge of prevalent organisms in the local hospital setting and their antibiotic sensitivity pattern is of utmost importance for the effective treatment of neonatal sepsis.

Presepsin - New Marker of Sepsis Romanian Neonatal Intensive Care Unit Experience

2019 ◽  
Vol 70 (8) ◽  
pp. 3008-3013
Author(s):  
Silvia Maria Stoicescu ◽  
Ramona Mohora ◽  
Monica Luminos ◽  
Madalina Maria Merisescu ◽  
Gheorghita Jugulete ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Sepsis ◽  
Predictive Value ◽  
Neonatal Intensive Care ◽  
Complete Blood Count ◽  
Clinical Manifestations ◽  
Receiver Operating Curve ◽  
Predictive Values

Difficulties in establishing the onset of neonatal sepsis has directed the medical research in recent years to the possibility of identifying early biological markers of diagnosis. Overdiagnosing neonatal sepsis leads to a higher rate and duration in the usage of antibiotics in the Neonatal Intensive Care Unit (NICU), which in term leads to a rise in bacterial resistance, antibiotherapy complications, duration of hospitalization and costs.Concomitant analysis of CRP (C Reactive Protein), procalcitonin, complete blood count, presepsin in newborn babies with suspicion of early or late neonatal sepsis. Presepsin sensibility and specificity in diagnosing neonatal sepsis. The study group consists of newborns admitted to Polizu Neonatology Clinic between 15th February- 15th July 2017, with suspected neonatal sepsis. We analyzed: clinical manifestations and biochemical markers values used for diagnosis of sepsis, namely the value of CRP, presepsin and procalcitonin on the onset day of the disease and later, according to evolution. CRP values may be influenced by clinical pathology. Procalcitonin values were mainly influenced by the presence of jaundice. Presepsin is the biochemical marker with the fastest predictive values of positive infection. Presepsin can be a useful tool for early diagnosis of neonatal sepsis and can guide the antibiotic treatment. Presepsin value is significantly higher in neonatal sepsis compared to healthy newborns (939 vs 368 ng/mL, p [ 0.0001); area under receiver operating curve (AUC) for presepsine was 0.931 (95% confidence interval 0.86-1.0). PSP has a greater sensibility and specificity compared to classical sepsis markers, CRP and PCT respectively (AUC 0.931 vs 0.857 vs 0.819, p [ 0.001). The cut off value for presepsin was established at 538 ng/mLwith a sensibility of 79.5% and a specificity of 87.2 %. The positive predictive value (PPV) is 83.8 % and negative predictive value (NPV) is 83.3%.

scholarly journals Level and Noise Sources in the Neonatal Intensive Care Unit of a Reference Hospital

2020 ◽  
Vol 38 (3) ◽  
Author(s):  
Alma Damaris Hernández-Salazar ◽  
Josefina Gallegos-Martínez ◽  
Jaime Reyes-Hernández
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Environmental Noise ◽  
Sound Level ◽  
Noise Sources ◽  
Cross Sectional ◽  
Reference Hospital ◽  
And Shifts

Objective. Determine the level of environmental and periauricular noise in preterm babies and identify the sources generating noise in the Neonatal Intensive Care Unit -NICU- of a reference hospital in San Luis Potosí, Mexico. Methods. Cross-sectional and analytic study of the measurement of the level of environmental noise in five critical areas of the NICU, according with the method of measurement of noise from fixed sources by the Mexican Official Norm and periauricular at 20 cm from the preterm patient’s pinna. The measurements were carried out during three representative days of a week,morning, evening and nocturnal shifts. A STEREN 400 sound level meter was used with 30 to 130 dB range of measurement and a rate of 0.5 s. Results. The average level of periauricular noise (64.5±1.91dB) was higher than the environmental noise (63.3±1.74 dB) during the days and shifts evaluated. The principal noise sources were activities carried out by the staff, like the nursing change of shift and conversations by the staff, which raised the level continuously or intermittently, operation of vital support equipment (alarms) and incidences (clashing of baby bottles and moving furnishings) producedsudden rises of noise. Conclusions. Environmental and periauricular noise in NICU exceeds by two and almost three times the 45 dB during the day and 35 dB at night from the norm in hospitals. It is necessary to implement permanent noise reduction programs to prevent sequelae in the preterm infant and professional burnout in the nursing staff.

scholarly journals Invasive candidiasis in a Brazilian neonatal intensive care unit

2021 ◽  
Vol 21 (2) ◽  
pp. 547-552
Author(s):  
Henrique Yuji Watanabe Silva ◽  
Felipe Teixeira de Mello Freitas
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Neonatal Intensive Care Unit ◽  
Invasive Candidiasis ◽  
Neonatal Intensive Care ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Antibiotics Use ◽  
Elbw Neonates

Abstract Objectives: to describe the epidemiology of invasive candidiasis in a neonatal intensive care unit. Methods: cross-sectional study that included all neonates with invasive candidiasis confirmed by blood culture from April 2015 to June 2018. Demographic, clinical and microbiological data were analyzed, comparing neonates with extreme low birth weight (ELBW) with neonates ≥ 1000g birth weight, considering a p <0.05 as statistically significant. Results: there were 38 cases of invasive candidiasis, resulting in an overall incidence of 2.5%. Twelve (32%) were ELBW neonates and 26 (68%) neonates ≥ 1000g birth weight, an incidence of 4.4% and 2.0%, respectively. Abdominal surgery was more frequent among neonates with birth weight ≥ 1000g compared to ELBW neonates (85% vs. 17%; p <0.01), as well as the median in days of antibiotics use (18 vs. 10.5; p = 0.04). The median in days of mechanical ventilation was more frequent among ELBW neonates (10 vs. 5.5; p = 0.04). The majority of Candida species were non-albicans (64%). Fatality rate was 32%. Conclusions: the incidence of invasive candidiasis among neonates with birth weight ≥ 1000g was higher than that found in the literature. This group has a higher proportion of gastrointestinal malformations that require surgery. Thus, fluconazole prophylaxis may be necessary for a broader group of neonates.

scholarly journals Neonatal admission from emergency department

2020 ◽  
Vol 7 (1) ◽  
pp. 117-120
Author(s):  
Sitaram Shrestha
Keyword(s):  
Intensive Care Unit ◽  
Emergency Department ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Neonatal Period ◽  
Birth Asphyxia ◽  
Vulnerable Period ◽  
Common Causes

Neonatal period is a vulnerable period of life. In Nepal, most common causes of newborn admission in the neonatal intensive care unit (NICU) are birth asphyxia, neonatal sepsis. This study explores the diseases with which 131 neonates were admitted from emergency department. Sepsis was the main cause of admission, followed by pneumonia.

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