DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20203163

Clinical and etiological profile of neonatal sepsis in children admitted to tertiary care hospital

Jawad Nazir Wani, Vivek Pandita, Saleem Yousuf, Nusrat Yousuf

Abstract


Background: Neonatal sepsis is leading cause of mortality in children. The clinical presentation of neonatal sepsis is non-specific and variable. This study was undertaken to study clinical and etiological profile of neonatal sepsis.

Methods: This was a prospective study conducted over a period of one year from March 2018 to March 2019. The patients with clinically suspected sepsis were included in this study. Detailed history and examination was done in all patients. In addition to baseline investigations, C-reactive protein and blood culture was done in all patients. Blood culture was done prior to administration of antibiotics.

Results: In this study there were total of 102 patients out of which 54 were male and 48 were female. Among 102 patients, 69 patients were premature born before 37 weeks of gestation. Prematurity   emerged to be the most common   risk factor. In this study 62% patients had EOS (<72 hours of life) and 38% had LOS (>72 hours of life). The most common presenting feature were refusal of feeds, lethargy, respiratory distress and hypothermia. Other features were seizures, abdominal distension, apnea and sclerema. Blood culture was positive in 41% patients. The most common organism isolated on culture was Kleibsella followed by E. coli.

Conclusions: Neonatal sepsis is leading cause of mortality in children. Early diagnosis and treatment is of paramount importance to prevent mortality. The clinical presentation of neonatal sepsis is non-specific and variable. So, high index of suspicion is required to detect sepsis at earliest. Gram negative organism like Kleibsella and E. coli are the common causative organism in neonatal sepsis.


Keywords


Early onset sepsis, Late onset sepsis, Neonatal sepsis

Full Text:

PDF

References


Edwards MS. Postnatal infections. In: Martin RJ, Fanaroff AA, Walsh MC, editors. Neonatal-Perinatal Medicine. 8th ed. Philadelphia: Mosby Elsevier; 2006:791-804.

Vergnano S, Sharland M, Kazembe P, Mwansambo C, Heath PT. Neonatal sepsis: Aninternational perspective. Arch Dis Child Fetal Neonatal Ed. 2005;90:F220-4.

Bang AT, Bang RA, Bactule SB, Reddy HM, Deshmukh MD. Effect of home-based neonatal care and management of sepsis on neonatal mortality: field trial in rural India. Lancet. 1999;354:1955-61.

Chacko B, Sohi I. Early Onset Neonatal Sepsis. Indian J Pediatr. 2005;72:23.

Távora AF, Castro AB, Militão MA, Girão JE. Risk Factors for Nosocomial Infection in a Brazilian Neonatal Intensive Care Unit. Brazilian J Inf Dis. 2008;12(1):75-9.

Stoll BJ. The global impact of neonatal infection. Clin Perinatol. 1997;24:1-21.

Cloberty JP, Eichenwald EC, Hansen AR, Stark AR. Manual of neonatal case. 7th Ed.: Lippincott Williams & Wilkins; 1998:271-299.

Polin RA. The ins and outs of neonatal sepsis. J Pediatr. 2003;143:3-4.

Escobar GJ. The neonatal sepsis work-up: Personal reflections on the development of an evidence-based approach toward newborn infectionsin a managed care organization. Pediatr. 1999;103(Suppl E):360-73.

Désinor OY, Silva JL, Ménos MJ. Neonatal sepsis and meningitis in Haiti. J Trop Pediatr. 2004;50:48-50.

Palazzi D, Klein J, Baker C. Bacterial sepsis and meningitis. In: Remmington JS, Klein JO, Wilson CB, Baker CJ, editors. Infectious Diseases of the Fetus and Newborn Infant. 6th edn. Philadelphia: Elsevier Saunders; 2006:247-295.

Galhotra S, Gupta V, Bains HS, Chhina D. Clinico-bacteriological profi le of neonatal septicemia in a tertiary care hospital. J Mahatma Gandhi Inst Med Sci. 2015;20:148-52.

Tallur SS, Kasturi AV, Nadgir SD, Krishna BV. Clinico-bacteriological study of neonatal septicemia in Hubli. Indian J Pediatr. 2000;67:169-74.

Aletayeb SM, Khosravi AD, Dehdashtian M, Kompani F, Mortazavi SM, Aramesh MR. Identification of bacterial agents and antimicrobial susceptibility of neonatal sepsis: A 54-month study in a tertiary hospital. African J Microbiol Res. 2011;5:528-31.

Bhat R, Lewis LE, Vandana KE. Bacterial isolates of early-onset neonatal sepsis and their antibioticsusceptibility pattern between 1998 and 2004: An audit from a centre in India. Ital J Pediatr. 2011;37:32.

Chacko B, Sohi I. Early onset neonatal sepsis. Indian J Pediatr. 2005;72:23-6.

Jain NK, Jain VM, Maheshwari S. Clinical profile of neonatal sepsis. Kathmandu Univ Med J. 2003;1:117-20.

Vinodkumar CS, Neelagund YF, Suneeta K, Sudha B, Kalapannavar NK, Basavarajapa KG. Perinatal risk factors and microbial profile of neonatal septicemia: A multicentred study. J Obstet Gynecol India. 2008;58:32-40.

Sathyamurthi B, Leela KV, Narayanababu R, Padmanaban, Sreedevi S, Sujatha, Anandan H. Clinical and Bacteriological Profile of Neonatal Sepsis in a Tertiary Care Hospital. Int J Sci Stud. 2016;4(8):57-60.

Begum S, Baki MA, Kundu GK, Islam I, Kumar M, Ahaque A. Bacteriological Profile of Neonatal Sepsis in a Tertiary Hospital in Bangladesh. J Bangladesh Coll Phys Surg. 2012; 30:66-70.

Awaisua A, Sulaiman SA, Ibrahim MI, Saad A. Antimicrobials utilization and outcomes of neonatal sepsis among patients admitted to a University teaching hospital in Malaysia. Eastern J Med. 2007;12:6-14.

Ahmed AS, Chowdhury MA, Hoque M, Darmstadt GL. Clinical and bacteriological profile of neonatal septicemia in a tertiary level pediatric hospital in Bangladesh. Indian Pediatr 2002;39:1034-9.

Martin TC, Adamson J, Dickson T, DiGiantomasso E, Nesbitt C. Does group B streptococcal infection contribute significantly to neonatal sepsis in Antigua and Barbuda West. Indian Med J. 2007;56:498-501.

Bhttacharjee A, Sen MR, Prakash P, Gaur A, Anuprba S. Increased prevalence of extended spectrumbeta lactamase producers in neonatal septicaemic cases at a tertiary referral hospital. Indian J Med Microbiol. 2008;26:356-60.

Ghotaslou R, Ghorashi Z, Nahaei MR. Klebsiella pneumoniae in neonatal sepsis: A 3-year study in the pediatric hospital of Tabriz, Iran. Jpn J Infect Dis. 2007;60:126-8.

Sundaram V, Kumar P, Dutta S, Mukhopadhyay K, Ray P, Gautam V. Blood culture confirmed bacterial sepsis in neonates in North Indian tertiary care centre: Changes over the last decade. Jpn J Infect Dis. 2009;62:46-50.