Drug-resistant organism in early-onset and late-onset neonatal sepsis at tertiary care hospital

2016 ◽  
Vol 5 (4) ◽  
pp. 254
Author(s):  
Suraiya Begum ◽  
Kanij Fatema
Keyword(s):  
Neonatal Sepsis ◽  
Early Onset ◽  
Tertiary Care Hospital ◽  
Late Onset ◽  
Tertiary Care ◽  
Resistant Organism ◽  
Care Hospital ◽  
Drug Resistant

scholarly journals Extensively Drug-Resistant Hypervirulent Klebsiella pneumoniae From a Series of Neonatal Sepsis in a Tertiary Care Hospital, India

2021 ◽  
Vol 8 ◽  
Author(s):  
Tuhina Banerjee ◽  
Jayalaxmi Wangkheimayum ◽  
Swati Sharma ◽  
Ashok Kumar ◽  
Amitabha Bhattacharjee
Keyword(s):  
Klebsiella Pneumoniae ◽  
Neonatal Sepsis ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Plasmid Profile ◽  
Care Hospital ◽  
Drug Resistant ◽  
Maternal Complications ◽  
Extensively Drug Resistant ◽  
Recent Emergence

The recent emergence of multidrug-resistant (MDR) Klebsiella pneumoniae with hypervirulent traits causing severe infections and considerable mortality is a global cause for concern. The challenges posed by these hypermucoviscous strains of K. pneumoniae with regard to their optimal treatment, management, and control policies are yet to be answered. We studied a series of extensively drug-resistant (XDR) and hypervirulent K. pneumoniae ST5235 isolates with resistance to carbapenems and polymyxins causing neonatal sepsis in a tertiary care hospital in India. A total of 9 K. pneumoniae isolates from 9 cases of neonatal sepsis were studied with respect to their clinical relevance, antimicrobial susceptibility profile, presence of extended spectrum β lactamase (ESBL) production, and responsible genes, carbapenemases (classes A, B, and D), and aminoglycoside-resistant genes. Hypervirulence genes encoding hypermucoid nature, iron uptake, and siderophores were detected by multiplex PCR. The plasmid profile was studied by replicon typing. Isolates were typed by multilocus sequence typing (MLST) and enterobacterial repetitive intergenic consensus (ERIC) PCR to study the sequence types (STs) and clonal relation, respectively. The neonates in the studied cases had history of pre-maturity or low birth weight with maternal complications. All the cases were empirically treated with piperacillin–tazobactam and amikacin followed by imipenem/meropenem and vancomycin and polymyxin B as a last resort. However, all the neonates finally succumbed to the condition (100%). The studied isolates were XDR including resistance to polymyxins harboring multiple ESBL genes and carbapenemase genes (blaNDM and blaOXA−48). Hypervirulence genes were present in various combinations with rmpA/A2 genes present in all the isolates. IncFI plasmids were detected in these isolates. All belonged to ST5235. In ERIC PCR, 6 different clusters were seen. The study highlighted the emergence and burden of XDR hypervirulent isolates of K. pneumoniae causing neonatal sepsis in a tertiary care hospital.

scholarly journals Clinical profile and outcomes among neonatal pneumonia patients admitted in a tertiary care hospital, Gujarat, India

2021 ◽  
Vol 8 (5) ◽  
pp. 914
Author(s):  
Jigisha R. Patadia ◽  
Ankit Parmar ◽  
Vijay B. Shah ◽  
Praful R. Bambharoliya
Keyword(s):  
Early Onset ◽  
Tertiary Care Hospital ◽  
Late Onset ◽  
Tertiary Care ◽  
Ventilatory Support ◽  
Antibiotic Sensitivity ◽  
Clinical Profile ◽  
Care Hospital ◽  
Mortality And Morbidity ◽  
X Ray

Background: Neonates are highly vulnerable to infection due to factors like immaturity, immunologic deficiencies at time of birth and in-utero maternal infection. Neonatal pneumonia continues to remain important cause of mortality and morbidity in developing countries like India. The aim of this study was to study the clinical profile and outcome of neonatal pneumonia.Methods: This descriptive observational study was carried out at NICU of tertiary care hospital with level III nursery during August-October 2012. A total of 200 neonates admitted in NICU during the study period were included as per inclusion criteria. All neonates were observed on day of admission, on day of deterioration and day of discharge. Clinical parameters, investigation profile, probable aetiology, intervention required and outcome was noted.Results: Out of 200 neonates admitted during study period, 64 neonates were having neonatal pneumonia, making incidence of 32%. All symptomatic patients having respiratory distress were evaluated by taking blood samples for blood culture with antibiotic sensitivity, C-reactive protein, sepsis screen and X-ray chest. Onset of pneumonia was decided on basis of appearance of symptoms like early onset (<72hours) or late onset (>72 hours). Half of the patients had shown improvement after intervention but 16% deteriorated which required ventilatory support. Mortality was 32.81% and it was more in early onset (40%) than late onset (28.2%).Conclusions: There was no single parameter which can be used for diagnosis of neonatal pneumonia. Clinical features with chest X-ray with sepsis markers have to be considered in diagnosing pneumonia.

scholarly journals PATTERN OF ANTIBIOTICS UTILIZATION IN NEONATAL SEPTICEMIA: A CROSS-SECTIONAL STUDY FROM RURAL TERTIARY CARE HOSPITAL WESTERN MAHARASHTRA, INDIA

2017 ◽  
Vol 9 (3) ◽  
pp. 60 ◽  
Author(s):  
Shinde A. R. ◽  
Mohite R. V. ◽  
Shinde R. V.
Keyword(s):  
Neonatal Sepsis ◽  
Tertiary Care Hospital ◽  
Late Onset ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Antibiotic Regimen ◽  
Sectional Study ◽  
Cross Sectional ◽  
Empiric Antibiotic

Objective: To assess the quantification of use of antibiotics and to find out empiric antibiotic regimen practiced for neonatal sepsis in rural tertiary health care centre.Methods: A hospital, record based cross-sectional study was conducted in Neonatal Intensive Care Unit(NICU) at tertiary care hospital located in western Maharashtra, India. The study was planned during the year 2011-12 among 84 neonates with sepsis. Data were collected by using proforma includes demographic details, antibiotic prescriptions and relevant information.Results: Among the total 84 neonates, max, 60.71% had a history of term delivery. The proportion of early and late onset of sepsis was 47.61% and 52.38% for which total 18 antibiotics were used of which max, 88.88% were injectables. Amikacin was used in max, 78.57% neonates followed by cefotaxime, 45.23% and ampicillin, 35.71% in single or combination form respectively. Amikacin was used for max; 929 d followed by cefotaxime, 523 d and ampicillin 331 d respectively. Antibiotics used in single, double and multiple regimens were 19.04%, 46.42% and 34.52% respectively. Empiric antibiotic regimens practiced were cefotaxim+amikacin and cefotaxim+ampicillin, of which max, 80% patients were treated with the cefotaxim+amikacin antibiotic regimen. Out of 84 neonates max, 70% were improved at the time of discharge.Conclusion: Neonatal sepsis was well treated by cefotaxim+amikacin empirical injectable regimen with maximum survival.

scholarly journals Spectrum of Early Onset and Late Onset Ventilator Associated Pneumonia (VAP) in a Tertiary Care Hospital of Bangladesh: A Prospective Cohort Study

2015 ◽  
Vol 3 (1) ◽  
pp. 9-13 ◽  
Author(s):  
Uzzwal Kumar Mallick ◽  
Mohammad Omar Faruq ◽  
ASM Areef Ahsan ◽  
Kaniz Fatema ◽  
Fatema Ahmed ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Early Onset ◽  
Prospective Cohort ◽  
Tertiary Care Hospital ◽  
Late Onset ◽  
Tertiary Care ◽  
Ventilator Associated Pneumonia ◽  
Care Hospital

Objective : To compare the outcome of critically ill patients developing early onset Ventilator-associated pneumonia (VAP) occurring within 96 h of ICU admission and late onset VAP occurring after 96 h of ICU admission in critically ill patients admitted in the ICU of BIRDEM General Hospital of Bangladesh.Study Design: Prospective cohort study.Material and Methods: Study data obtained over a period of 24 months (July 2012 - June 2014) in the ICU of a tertiary care hospital was prospectively analyzed. Subjects were classified by ventilator status: early onset VAP (< 96 hrs of mechanical ventilation) or late-onset VAP (?96 hrs of mechanical ventilation). Baseline demographics and bacterial etiology were analyzed according to the spectrum of status of VAP.Results: The incidence of VAP was 35.73 per 1,000 ventilator days. In our study 52% of the cases were early-onset VAP, while 48% were late-onset VAP. Acinetobacter was the commonest organism isolated from late-onset VAP (p = 0.029) while Pseudomonas was the commonest isolates obtained from early-onset VAP (p = 0.046). Klebsiella, MRSA and E. coli were almost identically distributed between groups (p > 0.05). There is significant difference of sensitivity pattern of Acinetobacter baumannii and pseudomonas aeruginosa in both early and late-onset VAP (p=0.01). The overall mortality rate in our study was 44%. The mortality was significantly higher in the late-onset VAP (62.5%) than that in the early-onset VAP (26.9%) (p=0.011).Conclusion: From this study we conclude that late-onset VAP had poor prognosis in terms of mortality as compared to the early-onset type. The higher mortality in the late-onset VAP could be attributed to older age, higher co-morbidities like diabetes mellitus, COPD and CKD. The findings are similar to findings of other international studiesBangladesh Crit Care J March 2015; 3 (1): 9-13

scholarly journals Ventilator-associated pneumonia in a tertiary care hospital in India: incidence and risk factors

2009 ◽  
Vol 3 (10) ◽  
pp. 771-777 ◽  
Author(s):  
Noyal Mariya Joseph ◽  
Sujatha Sistla ◽  
Tarun Kumar Dutta ◽  
Ashok Shankar Badhe ◽  
Subhash Chandra Parija
Keyword(s):  
Risk Factors ◽  
Early Onset ◽  
Preventive Measures ◽  
Tertiary Care Hospital ◽  
Late Onset ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Ventilator Associated Pneumonia ◽  
Care Hospital ◽  
Emergency Intubation

Background: Knowledge of the incidence of ventilator-associated pneumonia (VAP) and its associated risk factors is imperative for the development and use of more effective preventive measures. Methodology: We performed a prospective study over a period of 15 months to determine the incidence and the risk factors for development of VAP in critically ill adult patients admitted in different intensive care units (ICUs) of Jawaharlal Institute of Post-graduate Medical Education and Research (JIPMER), a tertiary care hospital in Pondicherry, India. Results: The incidence of VAP was 30.67 and 15.87 per 1,000 ventilator days in the two different ICUs. In our study 58.3% of the cases were late-onset VAP, while 41.7% were early-onset VAP. Univariate analysis indicated that the following were significantly associated with VAP: impaired consciousness, tracheostomy, re-intubation, emergency intubation, and nasogastric tube. Emergency intubation and intravenous sedatives were found to be the specific risk factors for early onset VAP, while tracheostomy and re-intubation were the independent predictors of late-onset VAP by multivariate logistic regression analysis. Conclusions: Knowledge of these risk factors may be useful in implementing simple and effective preventive measures including non-invasive ventilation, precaution during emergency intubation, minimizing the occurrence of reintubation, avoidance of tracheostomy as far as possible, and minimization of sedation.

scholarly journals Predictive model for bacterial late-onset neonatal sepsis in a tertiary care hospital in Thailand

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Dominicus Husada ◽  
Pornthep Chanthavanich ◽  
Uraiwan Chotigeat ◽  
Piyarat Sunttarattiwong ◽  
Chukiat Sirivichayakul ◽  
...  
Keyword(s):  
Predictive Model ◽  
Neonatal Sepsis ◽  
Tertiary Care Hospital ◽  
Late Onset ◽  
Tertiary Care ◽  
Care Hospital
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