Clinical spectrum and outcomes of neonatal candidiasis in a tertiary care hospital in Karachi, Pakistan

Introduction: Candidal infections are a serious problem in neonatal intensive care units, increasing morbidity and mortality in low birth weight infants in addition to escalating health-care costs. Studies exploring the epidemiology of candidiasis in developing country hospitals are rare. This retrospective case-control study aimed to evaluate epidemiology and risk factors associated with candidiasis in a neonatal intensive care unit in Karachi, Pakistan. Methodology: Cases (neonates (age < 28days, (n = 45) with NICU discharge diagnosis of candidal sepsis or candidemia between January 1996 and December 2006 were matched with controls (newborns with discharge diagnoses other than the above during the same study period) for gender, gestational age, and admission within 72 hours of admission of an index case. Risk factors were identified and clinical course and outcomes (discharge disposition) described. P-value and match-adjusted odds ratios were calculated. Results: A frequency of 0.9% candidemia was documented in the NICU. The incidence was highest (46%) in VLBW (< 1500gm). C. albicans was the leading causative organism (55%), and neonatal risk factors identified were mechanical ventilation (> 7 days), positive bacterial culture, and duration of hospitalization of > 7 days. Conclusions: Prolonged ventilation, positive bacterial blood culture, and prolonged duration of NICU stay were the major risk factors associated with newborn fungal sepsis in our center. Presence of antenatal care was a significant protective factor in our subset of neonatal population.

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Retinopathy of Prematurity in A Tertiary Care Hospital in Eastern Nepal

Journal of Nepal Medical Association ◽

10.31729/jnma.213 ◽

2008 ◽

Vol 47 (169) ◽

Author(s):

Srijana Adhikari ◽

B P Badhu ◽

N K Bhatta ◽

R S Rajbhandari ◽

B K Kalakheti

Keyword(s):

Risk Factors ◽

Intensive Care ◽

Birth Weight ◽

Gestational Age ◽

Retinopathy Of Prematurity ◽

Neonatal Intensive Care ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Screening Criteria

World Health Organization’s Vision 2020 program has recognized Retinopathy of Prematurity(ROP) as an important cause of childhood blindness in industrialized and developing countries. Inthe last few years, it has been identifi ed in many under developed countries as well, as a result ofimproved neonatal intensive care. In Nepal, ROP screening is carried out in a few tertiary hospitalsbut there is no published data on this disease. The purpose of this study was to fi nd out the incidence,severity and risk factors of ROP among infants screened in a tertiary care hospital in the EasternRegion of Nepal.A prospective cohort study was carried out in neonates with gestational age of 34 weeks or less and,or birth weight of 1700 gm or less born over the period of one year. Dilated fundus examination ofall babies was done by indirect ophthalmoscopy between 2-4 weeks after birth and followed up tillthe retinal vascularization was complete. Classifi cation of ROP was done according to internationalclassifi cation (ICROP). Maternal and neonatal risk factors were also noted.A total of 55 babies fulfi lled the screening criteria. ROP was present in 25.45% (n=14) of the babies.Threshold disease was noted in 5.45% (n=3) of the babies screened. Low birth weight (p<0.01)and low gestational age (p<0.01) was signifi cantly associated with the incidence of ROP. Oxygensupplementation (p=<0.01) was an independent risk factor.ROP screening should be performed in all preterm low birth weight infants where there is availabilityof good neonatal intensive care units. The examination should be intensifi ed in those having riskfactors like oxygen. Further studies in the other tertiary care hospitals in Nepal would help toestablish the screening criteria for Nepalese infants.Key words: Retinopathy of prematurity, Eastern Nepal, screening

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Acinetobacter infection in the Neonatal Intensive Care Unit in a tertiary care hospital in India: Risk factors, susceptibility profiles

International Journal of Health & Allied Sciences ◽

10.4103/2278-344x.105092 ◽

2012 ◽

Vol 1 (3) ◽

pp. 208

Author(s):

Kalidas Rit ◽

Bipasa Chakraborty ◽

Parthasarathi Chakrabarty ◽

Rajdeep Saha

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Susceptibility Profiles ◽

Acinetobacter Infection

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A study of infections in neonatal intensive care unit at a tertiary care hospital

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20172664 ◽

2017 ◽

Vol 4 (4) ◽

pp. 1349 ◽

Cited By ~ 2

Author(s):

Hemangi D Ingale ◽

Vaishali A. Kongre ◽

Renu S. Bharadwaj

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Gram Negative Bacteria ◽

Care Hospital ◽

Gram Negative ◽

Gram Positive Bacteria

Background: As infection is a major cause of morbidity and mortality in neonates, early diagnosis and prompt treatment can prevent its serious consequences. The present study was conducted to determine the prevalence of infections in neonatal intensive care unit (NICU) of a tertiary care hospital and to study their risk factors, causative organisms and antimicrobial susceptibility pattern.Methods: Appropriate samples were collected from all neonates with clinical signs and symptoms of infections. Isolation of microorganisms, their identification and antimicrobial susceptibility was done according to standard microbiological techniques.Results: Among 1210 neonates admitted in the NICU, 393 (32.4%) were clinically suspected infections. The prevalence of Septicemia, Pneumonia, and Meningitis were 6%, 1.5%, 0.7% respectively. The predominant organisms causing neonatal infection were Gram negative bacteria followed by fungi and Gram positive bacteria. Among Gram negative bacteria, the antimicrobial resistance was highest for third generation Cephalosporins [Ceftazidime (81.1%), Cefotaxime (60.3%)]. In Gram positive bacteria highest resistance was observed for Penicillin and Ampicillin (91.3%). Methicillin resistance was observed in 91.6% of Coagulase negative Staphylococci (CoNS). All isolates of Candida parapsilosis were sensitive to Fluconazole, Voriconazole but resistant to Amphotericin B. Predominant risk factors were low birth weight (87.7%) and prematurity (75%). Maternal risk factors were pregnancy induced hypertension (13.4%) and premature rupture of membranes (PROM) (10.1%). The case fatality rate was 20.7%.Conclusions: There is a need of strict infection control measures and rational antibiotic policy to reduce the economic burden of hospital and community due to neonatal infections.

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