Clinical features and bacteriological profile of late onset sepsis

Authors

  • Purnima Samayam Department of Pediatrics, BGS Global Institute of Medical Sciences, Bangalore, Karnataka, India
  • Ravichander B. Department of Pediatrics, MVJMC and RH, Hoskote, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20170068

Keywords:

Blood culture, Bacterial etiology, Neonatal sepsis

Abstract

Background: Neonatal sepsis is one of the major causes of morbidity and mortality in the neonatal period. Late onset sepsis (LOS) is associated with community environment or postnatal exposure to hospital environment. It's incidence is rising due to greater survival of preterm neonates and very low birth weight babies. The bacterial isolates of neonatal sepsis especially that in LOS are changing. An understanding of the changing epidemiology of neonatal LOS will help to reduce the associated mortality and morbidity. The objective was to study the clinical symptoms and signs of late onset sepsis, to study the bacteriological profile of LOS.

Methods: A prospective observational study. All neonates presenting with signs and symptoms of sepsis after 72 hours of life up to day 28 were included. Babies with birth asphyxia and congenital anomalies were excluded from the study.

Results: A total of 120 newborns with LOS were included in the study. Of this 42.5% had blood culture positive sepsis. Lethargy, refusal of feeds and apnoea were seen in 61.66%, 55.0% and 34.17% of babies respectively. Klebsiella (25.49%), Staphylococcus aureus (23.53%) and coagulase negative Staphylococcus (21.57%) were the predominant organisms isolated in LOS.

Conclusions: Prompt diagnosis of neonatal sepsis is a challenge. The incidence of LOS in neonates is rising. Klebsiella is the most common gram negative organism; Staphylococcus aureus and CONS are the predominant gram positive organisms. CONS is emerging as an important causative organism in LOS.

Author Biographies

Purnima Samayam, Department of Pediatrics, BGS Global Institute of Medical Sciences, Bangalore, Karnataka, India

Professor

Department of Pediatrics 

BGS GIMS

Ravichander B., Department of Pediatrics, MVJMC and RH, Hoskote, Bangalore, Karnataka, India

Professor Department of Pediatrics MVJMC&RH, Hoskote, Bangalore

References

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

Report of the National Neonatal Perinatal Database( National Neonatology Forum) 2002-2003. Available at http:// www.newbornwhocc.org /pdf /nnpd _report_2002-03. PDF. Accessed on 19 January 2016.

Shankar MJ, Agarwal R, Deorari AK, Paul VI. Sepsis in the newborn. Indian J Pediatr. 2008;75(3):261-6.

Wolach B. Neonatal sepsis: pathogenesis and supportive therapy. Semin Perinatol. 1997;21(1):28-38.

Baltimore RS. Neonatal nosocomial infections. Semin Perinatol. 1998;22(1):25-32.

Bizzarro MJ, Raskind C, Baltimore RS, Gallagher PG. Seventy-five years of neonatal sepsis at Yale: 1928-2003. Pediatrics. 2005;116(3):595-602.

Shim GH, Kim SD, Kim HS, Kim ES, Lee NJ, Lee JA, et al. Trends in epidemiology of neonatal sepsis in a tertiary center in Korea: a 26-year longitudinal analysis, 1980-2005. J Korean Med Sci. 2011;26(2):284-9.

Dong Y, Speer CP. Late-onset neonatal sepsis: recent developments. Arch Dis Child Fetal Neonatal. 2014;10:1-7.

Roy I, Jain A, Kumar M, Agarwal SK. Bacteriology of neonatal septicaemia in a tertiary care hospital of Northern India. Indian J Med Microbiol. 2002;20(3):156-9.

Joshi SG, Ghole VS, Niphadkar KB. Neonatal gram-negative bacteremia. Indian J Pediatr. 2000;67(1):27-32.

Tallur SS, Kasturi AV, Nadgir SD, Krishna BVS. Clinico-bacteriologicai study of neonatal septicemia in Hubli. Indian J Pediatr. 2000;67(3):169-79.

Kar SS, Dube R, Mahapatro S, Kar SS. The role of clinical signs in the diagnosis of late-onset neonatal sepsis and formulation of clinical score. Indian J Clin Practice. 2013;23(10):654-60.

Waters D, Jawad I, Ahmad A, Luksic I, Nair H, Zgaga L et al. Aetiology of community-acquired neonatal sepsis in low and middle income countries. J Glob Health. 2011;1(2):154-70.

Vishwanathan R, Singh AK, Ghosh C, Dasgupta S, Mukherjee S, Basu S. Profile of neonatal septicaemia at a district-level sick newborn care unit. J Health Popul Nutr. 2012;30(1):41-8.

Hammoud MS, Taiar A, Thalib L, Sweih N, Pathan S, Isaacs D. Incidence, aetiology and resistance of late-onset neonatal sepsis: a five-year prospective study. J Paediatr Child Health. 2012;48(7):604-9.

Tsai MH, Hsu JF, Chu SM, Lien R, Huang HR, Chiang MC, et al. Incidence, clinical characteristics, and risk factors for adverse outcome in neonates with late onset sepsis. Pediatr Infect Dis J. 2014;33(1):7-13.

Downloads

Published

2017-02-22

Issue

Section

Original Research Articles