DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20205100

Neonatal sepsis-blood culture, antibiotic stewardship and clinico-bacteriological study

Purva Shah, Ketan Gadhvi, Bharat Muliya, Khushi Shah

Abstract


Background: Neonatal sepsis refers to an infection involving bloodstream in newborn infants less than 28 days old. It continues to remain a leading cause of morbidity and mortality among infants, especially in middle and lower-income countries. Neonatal sepsis is divided into 2 groups based on the time of presentation after birth: early-onset sepsis and late-onset sepsis.

Methods: This study was done in the neonatal intensive care unit of tertiary hospital, Surendranagar. Study design being observational, data collected from clinical examination and records of the neonates admitted with positive septic screen, neonates admitted with suspected clinical sepsis (temperature >990F or <950F, respiratory rate more than 60 per minute, change in behavior, abnormal cry, not accepting feed, drowsy or unconscious, septic focus on skin or umbilicus, diarrhea and seizures) and neonates admitted with culture positive sepsis.

Results: As per this research, neonatal sepsis has more male preponderance, with more commonly occurring in low birth weights and preterm. Klebsiella, Staphylococcus aureus and Pseudomonas being the most isolated organisms. Their resistance pattern, antibiotic profile and newer trends also came across.

Conclusions: Neonatal sepsis comes as one of the major causes of mortality and morbidity of the newborns admitted. By this research, analyzing the sex, age, gestational weeks, organism isolated and the antibiotic profile, emerging new resistance and newer useful antibiotics can thus be studied and can be taken as a base for further study as well as evaluation of the same, along with also guiding to manage and treat neonatal sepsis better.


Keywords


Neonatal sepsis, Newborn, Preterm, Antibiotic, Blood culture

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References


Taeusch HW, Ballard RA, Avery ME, Gleason CA. Avery's diseases of the newborn. 7th Ed Philadelphia, Pa: W.B. Saunders. 2004: 490-512.

Bagga P. Neonatal Sepsis. Ghai Essential Paediatrics. 6th Ed India. CBS Publishers. 2013: 161-163.

Eichenwald EC, Hansen AR., Martin C, Stark AR. Cloherty and Stark's manual of neonatal care (Eighth edition). South Asian Ed. Philadelphia: Wolters Kluwer; 2017: 684-719.

Kliegman R. Nelson textbook of pediatrics (Edition 17.). Philadelphia, PA: Elsevier; 2007: 623-640.

Agarwal R, Deorari A, Paul V, Sankar M, Sachdeva A. Neonatal Sepsis. AIIMS Protocols in Neonatology. 2nd Ed Delhi; 2019: 303-315.

Huletsky A, Giroux R, Rossbach V, Rossbach V, Rossbach V, Bernier M et al. New Real-time PCR assay for Rapid detection of methicillin-resistant Staphylococcus aureus directly from specimens containing a mixture of staphylococci. J Clin Microbiol. 2004;42(5):1875-84.

Forbes BA, Sahm DF, Weissfeld AS, Bailey WR. Bailey and Scott's diagnostic microbiology (11th ed.). St. Louis, Mo, Elsevier Mosby. 2007;871-9.

Bhakoo ON, Agarwal KC, Narang A, Bhattacharya S. Prognosis and treatment of neonatal septicemia a clinico bacteriological study of 100 cases. Indian Pediat. 1974;11:519.

Bhakoo ON, Agarwal KC, Mahajan MC, Walia BNS. Septicemia in infants and children-a bacteriological study. Indian Pediat. 19685:518.

Chaudhury A, Rao TV. Bacteraemia in a tertiary care urban hospital in South India. Indian J Pathol Microbiol. 1999;42:317-20.

Sharma A, Krishnakutty CV, Sabharwal U, Rathee S, Mohan H. Evaluation of Sepsis screen for diagnosis of neonatal septicemia. Indian J Pediat. 1993;60:559-63.

Ghosal SP, Chaudhuri M, Dutta N, Sarkar Ak, Mukherjee AK, Sen Gupta PC. Noma neonatorum. Indian Pediatrics. 1977:14:709.

Guha DK, Dalbir J, Krishna MS, Guha AR, Khatri RL, Srikumar R. Outcome of neonatal septicemia, clinical and bacteriological profile. Indian Pediat. 1978;15:423-7.

Karthikeyan G, Premkumar K. Neonatal sepsis Staphylococcus aureus as the predominant pathogen. Indian J Paediat. 2001;68(8):715-7.

Monga K, Fernandez A, Deodhar L. Changing bacteriological patterns in Neonatal Septicemia. Indian J Pediatr. 1986;53:505-8.

Banerjee M, Sahu K, Bhattacharya S, Adhya SP, Bhownick, Chakraborty P. Outbreak of Neonatal septicemia with multi drug resistant Klebsiella pneumoniae. Indian J Pediat. 1993;60:25-7.

Jaitwani AJ. Acinetabacter spp. An emerging Pathogen in Neonatal Septicemia in Amritsar. Indian J Med microbiol. 2006;81.

Khatua SP, Das AK, Chaterjee BD, Khatua S, Ghose B, Saha A. Neonatal Septicemia. Indian J Pediat. 1986;53:509-14.

Esper F. Postnatal bacterial infections. Chap 48, In Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin's Neonatal-Perinatal Medicine. 11th ed. Philadelphia, PA: Elsevier. 2020.

Greenberg JM, Haberman B, Narendran V, Nathan AT, Schibler K. Neonatal morbidities of prenatal and perinatal origin. Chap 73, In: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 8th ed. Philadelphia, PA: Elsevier. 2019.

Jaganath D, Same RG. Microbiology and infectious disease. Chap 17, In: The Johns Hopkins Hospital; Hughes HK, Kahl LK, eds. The Harriet Lane Handbook. 21st ed. Philadelphia, PA: Elsevier; 2018.