ASSESSMENT OF SERUM PROCALCITONIN LEVELAS A MARKER TO DIAGNOSE LATE ONSET SEPSIS IN NEONATES

Introduction: Sepsis constitutes one of the most prevalent cause of mortality in newborns, eminently in developing countries. There are several investigations available that may be used as indicators to identify sepsis, however, the inability of a single laboratory investigation for rapid detection and diagnosis of sepsis, calls for the need of a specific investigation. Lately, it has been proclaimed that procalcitonin can be used as a reliable predictor for diagnosis and to determine severity as well as outcome of neonatal sepsis. Objective: To assess levels of serum Procalcitonin level as a marker to diagnose late-onset sepsis in a neonatal intensive care unit (NICU). Methods and Materials: A cross-sectional study was performed between the June 2018 to November 2018 at Sree Balaji Medical College and Hospital. Serum procalcitonin levels were determined for 25 neonates of age between 3-30 days. Results: Distinct elevations of procalcitonin levels were observed in neonates with late-onset sepsis caused mainly by coagulase-negative staphylococci. Currently nosocomial infection due to coagulase-negative staphylococci is a frequent occurrence in NICUs. Conclusion: Serum procalcitonin is an efficient tool to diagnose Late Onset of Sepsis.

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Prevalence of Ventilator Associated Pneumonia in Neonates in A Tertiary Care Hospital in Western Nepal

Journal of Nepal Medical Association ◽

10.31729/jnma.4295 ◽

2019 ◽

Vol 57 (216) ◽

Author(s):

Anita Lamichhane ◽

Aparna Mishra

Keyword(s):

Sample Size ◽

Neonatal Intensive Care ◽

Tertiary Care Hospital ◽

Late Onset ◽

Tertiary Care ◽

Cross Sectional Study ◽

Point Estimate ◽

Ventilator Associated Pneumonia ◽

Care Hospital ◽

Cross Sectional

Introduction: Ventilator-associated pneumonia is a serious problem which needs to be addressed for a better outcome of the ventilated babies. The present study is undertaken to find out the prevalence of ventilator-associated pneumonia in neonates in a tertiary care hospital in western Nepal.Methods: A descriptive cross-sectional study was carried out in a tertiary care hospital in the western region of Nepal from March 2016 to February 2019 after approval from the Institutional review committee. Sample size was calculated and convenience sampling was done to reach the sample size. Data were collected from hospital records and entered in Statistical Package for the Social Sciences, point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data.Results: Out of 95 patients ventilated in neonatal intensive care unit in the last 3 years, 23 (24.01%) developed ventilator-associated pneumonia. Prevalence of ventilator-associated pneumonia is 23 (24.01%) at 95% (14%-34%). Late onset ventilator associated pneumonia was seen in 15 (15.78%) while early onset ventilator associated pneumonia was seen in 8 (8.42%). Conclusions: Prevalence of ventilator associated pneumonia in neonates in tertiary care hospital is high compared to other studies conducted in neonates.

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Prevalence of central venous catheter salvage in newborn with staphylococcal bloodstream infection

Revista Brasileira de Enfermagem ◽

10.1590/0034-7167-2020-1073 ◽

2021 ◽

Vol 74 (6) ◽

Author(s):

Izabela Linha Secco ◽

Mitzy Tannia Reichembach ◽

Higor Pacheco Pereira ◽

Regina Paula Guimarães Vieira Cavalcante da Silva

Keyword(s):

Blood Culture ◽

Central Venous Catheter ◽

Antibiotic Therapy ◽

Bloodstream Infection ◽

Neonatal Intensive Care ◽

Venous Catheter ◽

Cross Sectional Study ◽

Central Venous ◽

Coagulase Negative Staphylococci ◽

Cross Sectional

ABSTRACT Objectives: to establish the prevalence of salvage of central venous catheters in newborns with bloodstream infection caused by coagulase-negative staphylococci. Methods: retrospective cross-sectional study with 136 newborns admitted to the Neonatal Intensive Care Unit between 2011 and 2017. The total of 143 infection events undergoing antibiotic therapy were evaluated. Results: among the 143 infection events, 39 catheters in which antibiotic therapy was used were saved and in 69 cases, the device was removed. Positive central blood culture and single lumen catheter were factors associated with salvage failure. The probability of salvage decreased with infections diagnosed from 15 days of using the catheter. Negative blood culture raised the chance of salvage by fourfold. Conclusions: the use of antibiotic therapy in the treatment of infections resulted in a low prevalence of salvage of the central venous catheter. The probability of salvage was associated with variables of the device.

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PREVALENCE AND OUTCOME OF THROMBOCYTOPENIA AND ITS CORRELATION WITH CRP IN NEONATAL INTENSIVE CARE UNIT

10.36106/ijar/3007661 ◽

2021 ◽

pp. 45-46

Author(s):

Rama Rajyam ◽

V Thrishi Sagna

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Late Onset ◽

Cross Sectional Study ◽

Severe Thrombocytopenia ◽

Cross Sectional ◽

Reactive Protein ◽

King George Hospital

Introduction: Neonatal thrombocytopenia, one of the most common hematological abnormalities in neonates particularly in premature and sick neonates. The aim of this study to study the prevalence and outcome of Thrombocytopenia and its correlation with CRP in the neonatal intensive care unit. Objectives: 1. To nd the prevalence of Thrombocytopenia in the Neonatal intensive care unit in King George Hospital. 2. Factors that predisposing to Thrombocytopenia in neonates 3. Outcomes of thrombocytopenia in neonates. 4. Correlation of thrombocytopenia with the C-reactive protein (CRP) in neonates. Materials And Methods: It is a cross -sectional study in 80 Newborns less than or equal to 28 days admitted in NICU, king George hospital, Visakhapatnam from JANUARY 2019 to JUNE 2020 over period of 18 months. Data is collected from the medical records. Results: The prevalence of thrombocytopenia in this study is 40% with early-onset thrombocytopenia being 65% whereas, that of late-onset thrombocytopenia is 35% ,strong assosciation is found between thrombocytopenia and sepsis ,with mild to moderate variety being (86.4%) and (40%) of severe thrombocytopenia group. Of 80 newborns ,90% of severely thrombocytopenic group have positive CRP, whereas it is 40.9% in the mild to moderate group and 1.4% in normal group.40% of severe thrombocytopenic group had elevated PT, APTT, INR. There was higher proportion of bleeding (45.5%) in severe thrombocytopenia group. gastrointestinal bleeding constituted for 36.4% and intracranial bleeding 2.1% . Conclusion: Positive septic workup is signicantly association with thrombocytopenia, CRP was signicantly association with thrombocytopenia in this study

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Metabolic and Electrolyte profile in Birth Asphyxia

Pediatric Review International Journal of Pediatric Research ◽

10.17511/ijpr.2020.i07.03 ◽

2020 ◽

Vol 7 (7) ◽

pp. 331-336

Author(s):

Dr. Abhishek Kumar Singh ◽

◽

Dr. Bhoopendra Sharma ◽

Dr. Anita Mehta ◽

Dr. Karm Chand Gandhi ◽

...

Keyword(s):

Neonatal Intensive Care ◽

Birth Asphyxia ◽

Cross Sectional Study ◽

Metabolic Abnormalities ◽

Neonatal Seizures ◽

Inborn Errors ◽

Cross Sectional ◽

Medical College ◽

Definition Of ◽

Ischemic Encephalopathy

Introduction: The definition of birth asphyxia is given by the ACOG, AAP includes the existence of 3factors: Metabolic or mixed acidemia (pH<7) which is determined by umbilical cord arterial bloodsamples. The major causes of neonatal seizures are Hypoxic-ischemic encephalopathy (HIE), whichrepresents about 50% of the causes of neonatal seizures. Metabolic abnormalities, infection,intracranial hemorrhage, developmental anomalies, and other like inborn errors of metabolism areother causes of neonatal seizures. Material and Methods: A cross-sectional study. This is ahospital-based prospective study conducted at Nehru Hospital, BRD Medical College, Gorakhpur (UP)in the Neonatal Intensive Care Unit of the pediatric department. This study was conducted from July2018 to July 2019. Result: Prevalence of Hypocalcemia was 7.6%, Prevalence of hypernatremia was1.3%, Out of 315 patients 32 (10.2%) patients expired and 283 (89.8%) was successfullydischarged. Conclusion: No association between Hypocalcemia and Hypomagnesemia Prevalence ofhyponatremia was 6.3% and no association between hyponatremia and Hypomagnesemia. Theprevalence of hypernatremia was 1.3% and there was no association between hypernatremia andHypomagnesemia.

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Epidemiology of Neonatal Sepsis and Implicated Pathogens: A Study from Egypt

BioMed Research International ◽

10.1155/2015/509484 ◽

2015 ◽

Vol 2015 ◽

pp. 1-11 ◽

Cited By ~ 35

Author(s):

Eman M. Rabie Shehab El-Din ◽

Mohamed M. Adel El-Sokkary ◽

Mohamed Reda Bassiouny ◽

Ramadan Hassan

Keyword(s):

Neonatal Sepsis ◽

Neonatal Intensive Care ◽

Late Onset ◽

Laboratory Data ◽

Total Mortality ◽

Coagulase Negative Staphylococci ◽

Suspected Sepsis ◽

Late Onset Sepsis ◽

Early Onset Sepsis ◽

Low Sensitivity

Prospective analytic study was conducted in NICUs of three Egyptian Neonatal Network (EGNN) participants in Mansoura Hospitals in Egypt over a period of 18 months from March 2011 to August 2012. By using EGNN 28-day discharge form, all demographic, clinical, and laboratory data were recorded and studied. During the study period, 357 neonates were diagnosed as suspected sepsis with an incidence of 45.9% (357/778) among the admitted neonates at the three neonatal intensive care units. 344 neonates (sex ratio = 1.3:1) were enrolled in the study in which 152 (44.2%) were classified as early onset sepsis EOS (≤72 hr) and 192 (55.8%) as late onset sepsis LOS (>72 hr). Among the LOS cases, 33.9% (65/192) were caused by nosocomial infections. In 40.7% (140/344), sepsis was confirmed by positive blood culture. The total mortality rate for the proven neonatal sepsis was 51% (25/49) and 42.9% (39/91) for EOS and LOS, respectively. Coagulase negative staphylococci were predominant isolates in both EOS and LOS, followed byKlebsiella pneumoniae. Most of the bacterial isolates had low sensitivity to the commonly used empiric antibiotics. However, 70.1% (89/127) exhibited multidrug resistance. Best sensitivities among Gram-positive isolates were found against imipenem, ciprofloxacin, vancomycin, and amikacin.

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Phototherapy Induced Hypocalcaemia in Neonates with Jaundice

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v18i2.38829 ◽

2021 ◽

Vol 18 (2) ◽

pp. 1-3

Author(s):

Rajesh KC ◽

Piush Kanodia

Keyword(s):

Serum Calcium ◽

Neonatal Intensive Care ◽

Calcium Supplementation ◽

Cross Sectional Study ◽

P Value ◽

Cross Sectional ◽

Medical College ◽

Increased Risk ◽

Before And After ◽

Clinically Significant

Introduction: Neonatal hyperbilirubinemia is seen mainly in the first week of life and in many of the cases it is only in physiological range which requires no intervention. Approximately 5-10% of them have clinically significant jaundice that requires phototherapy and even exchange transfusion. Phototherapy can produce various adverse effects; hypocalcaemia is one of the lesser known effects. So, estimation of calcium levels before and after phototherapy should be done in neonates with jaundice. Aims: The aim of this study is to determine hypocalcaemia, in neonates receiving phototherapy, by measuring serum calcium levels. Methods: This cross sectional study was conducted, from February 2020 to August 2020, on 50 neonates admitted in Neonatal Intensive Care Unit of Nepalgunj Medical College, Kohalpur with unconjugated hyperbilirubinemia requiring phototherapy. Serum calcium levels were evaluated before and after phototherapy. Neonates were assessed for clinical features of hypocalcaemia i.e. jitteriness, irritability/ excitability and convulsions. Data were analyzed using SPSS version 25.P value <0.05 was taken as significant. Results: Frequency of hypocalcaemia after phototherapy was 26%. There was significant change in serum calcium levels before and after phototherapy (p<0.01). Among hypocalcaemic neonates, 56% were symptomatic; 38% developed jitteriness, 18% developed irritability / excitability and none of them developed convulsions. Conclusion: Neonates undergoing phototherapy are at increased risk for hypocalcaemia. Monitoring for hypocalcaemia and its complications should be considered. However, universal recommendation of calcium supplementation is yet to be established but seems reasonable.

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Late onset sepsis: comparison between coagulase-negative staphylococci and other bacteria in the neonatal intensive care unit

Infectious Diseases ◽

10.1080/23744235.2018.1487075 ◽

2018 ◽

Vol 50 (10) ◽

pp. 764-770 ◽

Cited By ~ 3

Author(s):

Neta Berlak ◽

Eilon Shany ◽

Shalom Ben-Shimol ◽

Ilana Azulay Chertok ◽

Gil Goldinger ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Late Onset ◽

Coagulase Negative Staphylococci ◽

Late Onset Sepsis

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Prevalence and Risk factors of Hypoglycaemia in Neonates at St. Paul’s Hospital Millennium Medical College Neonatal Intensive Care Unit, Ethiopia: A Cross Sectional Study

10.21203/rs.3.rs-37914/v1 ◽

2020 ◽

Author(s):

Bereket Yismaw Fantahun ◽

Ikram Nurussen

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Birth Weight ◽

Maternal Age ◽

Neonatal Intensive Care ◽

Cross Sectional Study ◽

Sectional Study ◽

Neonatal Hypoglycaemia ◽

Cross Sectional ◽

Medical College

Abstract Background Hypoglycaemia is a common metabolic abnormality seen in neonates that can cause preventable death. Its overall incidence has been estimated to be 1 to 5 per 1,000 live births, with higher incidence in at-risk populations. There is limited data regarding its prevalence and risk factors in developing countries like Ethiopia. Therefore, this study was aimed to determine the prevalence and risk factors of neonatal hypoglycaemia in neonatal intensive care unit (NICU) at Saint Paul’s Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia. Methodology A cross sectional study was conducted from June 17 to August 3, 2018 at SPHMMC, NICU. Neonates whose age was less than 48hrs and admitted to NICU were enrolled. Sociodemographic, maternal and neonatal factors were collected using structured questionnaire. Blood glucose was measured using glucometer with a test strip. Random blood glucose level < 47mg/dl was taken as a cut-off point to define hypoglycaemia. The data was entered and analysed using SPSS version 20. Results Neonatal hypoglycaemia was detected in 25% (49/196) of the neonates. Birth weight, duration of labor, maternal age, time of feeding initiation, hypothermia and respiratory distress syndrome were associated with hypoglycaemia. From these factors, maternal age, birth weight and hypothermia were found to be independent predictors of the outcome. Conclusion Hypoglycaemia was prevalent in neonates admitted to the NICU of SPHMMC and was associated with low birth weight and hypothermia. These findings calls for early detection of hypoglycaemia, prevention of hypothermia and early initiation of feeding to prevent neonatal morbidity and mortality.

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Isolation and Identification of Serratia marcescens from Suspected Late Neonatal Sepsis in Intensive Care Unit

International Journal of Pharmaceutical Quality Assurance ◽

10.25258/ijpqa.v9i01.11362 ◽

2018 ◽

Vol 9 (01) ◽

Author(s):

Jabbar S. Hassan ◽

Ahmed E. Salman ◽

Ahmed S. Obeid ◽

Thana R. Abdul Rhman

Keyword(s):

Serratia Marcescens ◽

Neonatal Sepsis ◽

Late Onset ◽

Venous Blood ◽

Cross Sectional Study ◽

Molecular Technique ◽

Luxs Gene ◽

Isolation And Identification ◽

Cross Sectional ◽

Late Onset Sepsis

Background: Neonatal sepsis stays one of the main sources of morbidity and mortality both among infant in ICU, in light of the planning of the disease neonatal sepsis has been categorized into early and late-onset sepsis, where the latter occurs after one week of life and is often more insidious in onset than the former. Objective: To detect the rate of Serratia marcescens infection in neonatal sepsis in ICU by molecular technique. Methods: A total of 50 neonates with the age group 8 days to 30 days who were admitted to AL-Kadhumiya Teaching Hospital/ Baghdad during the period January to March ,2017 were recruited for this cross-sectional study. Approximately 3 ml of venous blood were obtained from each patients. These samples were examined for septicemia by blood culturing followed by API20 for quick identification of relevant bacteria. Furthermore, bacteria DNA was isolated directly from blood samples, and conventional PCR based on luxS gene, highly specific to S. marcescens, was achieved. Results: Blood culture were positive in 36(72 %) out of 50 samples; the most common bacterial causes were Staphylococcus aureus (18.7%), Pseudomonas aeruginosa (13.8%) and Serratia marcescens (11.1%), Molecular method revealed specific amplification of luxS gene in 12 samples (24%). Conclusion: Serratia marcescens has risen as a most widely recognized causative agent in late onset sepsis.

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Characteristics of neonatal late onset sepsis in Sanglah Hospital, Bali

GSC Advanced Research and Reviews ◽

10.30574/gscarr.2021.7.2.0105 ◽

2021 ◽

Vol 7 (2) ◽

pp. 073-082

Author(s):

Arya Wisnu Prayoga ◽

Made Kardana ◽

I Wayan Dharma Artana ◽

Putu Junara Putra ◽

Made Sukmawati

Keyword(s):

Gestational Age ◽

Neonatal Intensive Care ◽

Late Onset ◽

Laboratory Finding ◽

Cross Sectional ◽

Microbial Characteristics ◽

Level Ii ◽

Late Onset Sepsis ◽

Poor Outcome Group ◽

Outcome Group

Neonatal Late-Onset Sepsis (LOS) is a leading cause of mortality in the Neonatal Intensive Care Unit (NICU). The microbial characteristics of LOS are of primary importance in guiding clinical antisepsis practice, and strategies to prevent and treat neonatal LOS, in turn, influence the pattern of LOS pathogens. This study is a retrospective descriptive study with a cross-sectional approach conducted between 2016 until 2020 in the neonatal ward (level II-III) of the Sanglah General Hospital, Bali. Data collected consists of demography, clinical characteristics, laboratory results, and outcomes. Subjects in this study dominated by male (64%), gestational age > 37 weeks (56%), born ≥ 2.500 grams (54%), last mother education mostly in Senior High School (56%), spontaneous delivery method (54%) and 31 (62%) subjects were referral from other hospital and primary health care. Most of the subjects were lethargic (68%) and 15 (30%) subjects were died. Laboratory finding normal leukocyte, neutrophil, lymphocyte, hemoglobin, thrombocyte and IT ratio but have higher procalcitonin result. Poor outcome group were dominated by male, smaller gestational age, VLBW, and neonates who experience lethargy, temperature instability, respiratory distress and got positive blood culture.

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