A study of bacteriological profile and outcome of babies born to mother with Premature rupture of membrane and its correlation with blood and gastric culture
DOI:
https://doi.org/10.18203/2349-3291.ijcp20194749Keywords:
Blood culture, Gastric culture, Neonates, Micro-organisms, Outcome, Premature rupture of membraneAbstract
Background: PROM, a condition that occurs when fetal membranes are ruptured at least one hour before onset of labor. While PROM is observed in 10% of all pregnancies, 60-80% of PROM is observed in term and 20-40% in pregnancies less than 37th gestational week. PROM is the most significant reason for preterm labor. The three causes of neonatal death associated with PROM are prematurity, sepsis and pulmonary hypoplasia. Infants born with sepsis have a mortality rate four times higher than those without sepsis. Objective of the study was correlation of blood and gastric culture positive sepsis in PROM newborns. It helps to find out the incidence of PROM in our locality.
Methods: This retrospective study enrolled 90 neonates born to healthy mothers with history of PROM more than 18 hours duration, admitted in SNCU/ward at a tertiary care hospital for six months duration from 1st January 2017 to 30 June 2017. Clinical profile of these Newborn with history of PROM was noted such as birth weight, gender, gestation, duration of membrane rupture, history of maternal fever. For all newborns with PROM, sepsis screen had been sent. The neonatal outcome was also recorded, and the data was collected and analyzed by using frequency and percentages.
Results: Gram negative bacilli were the commonest cause of neonatal sepsis and male neonates were more prone to infection. PROM and low birth weight especially, ELBW and VLBW are the common high-risk factors for early onset sepsis. Most common organisms isolated in blood and gastric culture were Klebsiella and Staphylococcus aureus respectively.
Conclusions: PROM is a high-risk obstetric condition. Active management is needed to enable delivery within 24 hours of PROM as it offers better neonatal outcome. Morbidity and mortality increase as the duration of PROM increases. This can be reduced by early diagnosis, specific treatment and strict infection control practices in neonatal units.
References
Ozkan H, Cetinkaya M, Koksal N, Celebi S, Hacımustafaoglu M. Culture-proven neonatal sepsis in preterm infants in a neonatal intensive care unit over a 7 year period, CoNS as a predominant pathogen. Paediatr Int. 2014;56:60-6.
Jiang JH, Chiu NC, Huang FY, Kao HA, Hsu CH, Hung HY, et al. Neonatal sepsis in the neonatal intensive care unit: characteristics of early versus late onset. J MicrobiolImmunol Infect. 2004;37:301-6.
Sriram R. Correlation of blood culture results with the sepsis score and the sepsis screen in the diagnosis of neonatal septicaemia. Int J Biol Med Res. 2011;2(1):360-8.
Shah MN, Desai PB. Clinical and bacteriological profiles of blood culture positive sepsis in newborns. Int J Pharm Life Sci. 2011;2(9):1041-5.
Assudani HJ, Gusani JK, Mehta SJ, Agravat HH, Kothari K. Bacteriological profiles of septicaemia in neonates at tertiary care hospital, Gujarat, India. J Res Med Den Sci. 2015;3(2):148-51.
Thayi S, Paramahamsa R. Outcome of newborns born to mothers with prolonged rupture of membrane. Int J Pediatr Res. 2016;3(11):835-41.
Korn WR, Jariya WS. Incidence of neonatal infection in newborn infants with matneral history of premature rupture of membranes (PROM) for 18 hours or longer by using Kutklar Hospital clinical practice guidelines. J Med Assoc. 2005;8:7.
Lokhande S, Nistane R. Incidence of morbidity and mortality in neonate born to mothers with premature rupture of membranes. Int J Contemp Pediatr. 2016;3:1394-400.
Aletayeb SM, Khosravi AD, Dehdashtian M, Kompani F, Mortazavi SM, Aramesh RM. Identification of bacterial agents and antimicrobial susceptibility of neonatal sepsis: A 54-month study in a tertiary hospital. Afr J Microb Res. 2011;5(5):528-31.
Cecilia CM, Mary AC, Elizabeth EG, Jonathan GL, Joanne JL et al. Etiology of neonatal sepsis in five urban hospitals in the Philippines. PIDSP J. 2011;12(2):75-85.
Al-Bayaa YJ, Ayoub NS, Alwan SN. Relationship between Neonatal septicemia and birth weight. Fac Med Baghdad. 2012;54(2):151-3.
Basu R, Bandyopadhyay S. Study on Correlation between Sepsis Screening Blood Culture in Neonatal Sepsis. IOSR J Dent Medi Sci. 2014;13(5):52-6.
Khante SV, Raut SS. Clinical and bacteriological study of neonatal septicaemia in a tertiary care hospital. Int J Res Med Sci. 2017;5:4455-62.
Shukla OS, Rawat A. Clinical profile and outcome of early onset sepsis in high risk very low birth weight neonates. Int J Cont Pediatr. 2018;5:389-94.
Al-QaQa K, Al-Awaysheh F. Neonatal outcome and prenatal antibiotic treatment in premature rupture of membranes. Pakistan J Medi Scie. 2005;21(4):441.
Doyle C. Premature rupture of membranes. IN: RS Gibbs, BY Karlan, AF Haney, IE Nygaard (eds). Donforth’s obstetrics and gynaecology. 9th edi, Philadelphia. Lippincott Williams and Wilkins Publishers. 2008;2:91.
Sriram R: Correlation of blood culture results with the sepsis score and the sepsis screen in the diagnosis of neonatal septicemia. Int J Biolog Medi Res. 2011;2(1):360-8.
Lazarus M, Seth RJ, KinnareA. Role of Sepsis Screen Parameters in Early Diagnosis of Neonatal Septicemia. Int J Curr Microbiol App Sci B 2018;7(01):2410-9.
Kerur BM, Bhat BV, Harish BN, Habeebullah S, Kumar CU. Maternal Genital Bacteria and Surface Colonization in Early Neonatal Sepsis. Indi J Pediatr. 2006;73(1):29-32.
Hornik CP, Fort P, Clark RH, Watt K, Benjamin DKJ, Smith PB, et al. Early and late onset sepsis in very-low-birth-weight infants from a large group of neonatal intensive care units. Early Hum Dev. 2012;88(2):S69-74.
Chiabi A, Djoupomb M, Mah E et al. The Clinical and Bacteriogical Spectrum of Neonatal Sepsis in aTertiary Hospital in Yaounde, Cameroon. iran J Pediatr. 2011;21(4);441-8.
United Nations Children’s Fund and World Health Organization. Low birthweight: Country, regional and global estimates. UNICEF, New York, 2004. Available at: https://www.unicef.org/publications/index_24840. Accessed on 2004.
Cisse CT, Mbengue-Diop R, Moubarek M, et al. Infections néonatalesbactériennes au CHU de Dakar. Gynecol Obstet Fertil. 2001;29:433-9.
Nilli F, Ansari SA. Neonatal complications of premature rupture of membrane. Acta Medica Iranica. 2003;41(3):176.
