DOI: https://dx.doi.org/10.18203/2349-3291.ijcp20221607
Published: 2022-06-23

A study of clinico-bacteriological profile and to determine incidence of meningitis in late onset sepsis in newborn unit of tertiary care teaching hospital in Northern India

Mohit Bajaj, Susheel Kumar, Jyoti Sharma, Swati Mahajan, Milap Sharma

Abstract


Background: The daily risk of mortality in first 4 weeks of life is almost 30-fold higher than post-neonatal period. Late onset sepsis (LONS) and meningitis still continue to be major causes of mortality and morbidity in newborn period. Our study was done to study clinical profile of enrolled newborns with LONS along with incidence of meningitis in them. The objective of this study was to study clinico-bacteriological profile and to determine associated incidence of meningitis in neonates with late onset sepsis (LONS) in a hospital setting in Northern India.

Methods: It was a hospital based prospective observational study conducted over a period of 12 months enrolling 122 newborn with >72 hours of age fulfilling inclusion criterias.

Results: Out of total 122 enrolled newborn, 37 (30.3%) neonates had meningitis. 71 (58.20%) were of term gestation with majority 61 (50.0%) in age group of 4-7days of life. Incidence of LONS in low birth weight and very low birth weight were 54% and 13.5%. Most commonly seen symptoms in at admission were lethargy, refusal to feed and fever. Blood culture was positive in 45 (36.88%) in neonates with Acinetobacter baumanii, klebsiella pneumonia and Escherichiae coli being most commonly seen organisms. Cerebrospinalfluid (CSF) culture was positive in 4 (10.81%) newborns. Mean duration of hospital stay was 24.75±13.96 days. Mortality in neonatal meningitis was 3 (3.2%).

Conclusions: Our study proved that about one third of newborn admitted with LONS also had coexistent meningitis. Thus CSF analysis is a must and it should not be missed as untreated meningitis can be devastating for newborn. Antibiotics must be added as per antibiogram of specified institute.

 


Keywords


Late onset sepsis, Meningitis, Newborn, Blood culture, Northern India

Full Text:

PDF

References


Sankar MJ, Neogi SB, Sharma J, Chauhan M, Srivastava R, Prabhakar PK et al. State of newborn health in India. Journal of Perinatology. 2016;36:S3-8.

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

Bang AT, Bang RA, Baitule SB, Reddy MH, 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.

Bhagat R, Hussain SQ, Gattoo IA, Wani SA. Incidence of meningitis in late onset sepsis. Int J ContempPediatr. 2015;2(2):96-S.

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

Jeevashankar M, Agarwal R, Deorari AK, Paul VK. Sepsis in new-born. Indian J Pediatr. 2008;75(3):261-6.

National Neonatology Forum India. Evidence Based Clinical Practice Guidelines; 2010. Available at: http://www.nnfi.org/ images/pdf/nnf_cpg_consolida ted_file‐. january102011.pdf. Accessed on 8 August 2021.

Kaul V, Harish R, Ganjoo S, Mahajan B, Raina SK, Koul D et al. Importance of obtaining lumbar puncture in neonates with late onset septicemia a hospital based observational study from North‐West India. J Clin Neonatol. 2013;2:83‐7.

Roshi B, Sheikh Quyoom H, Imran Ahmad G. Incidence of meningitis in late onset sepsis. Int J Contemp Pediatr. 2015;2(2):96-102.

Kaul V, Harish R, Ganjoo S, Mahajan B, Raina SK, Koul D. Importance of Obtaining Lumbar Puncture in Neonates with Late Onset Septicemia a Hospital Based Observational Study from North-West India. J Clin Neonatol. 2013;2(2):83-7.

Bhagat R, Hussain SQ, Gattoo IA, Wani SA. Incidence of meningitis in late onset sepsis. Int J ContempPediatr. 2015, 2(2): 96-102.1.

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

da Silva LP, Cavalheiro LG, Queirós F, Nova CV, Lucena R. Prevalence of newborn bacterial meningitis and sepsis during the pregnancy period for public health care system participants in Salvador, Bahia, Brazil. Braz J Infect Dis. 2007;11:272‐6.

Saleem S, Akbar N, Anwar A, Mehmood R. Frequency Of Meningitis In Neonatal Late Onset Sepsis In Ganga Ram Hospital, Lahore. APMC 2015;9(3):140-144.

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 vs. late onset. J Microbial Immunol Infect. 2004;37:301-6.

Hoque MM, Ahmed ASM, Chowdhury MA, Darmstadt GL, Saha SK. Septicemic neonates without lumbar puncture: what are we missing? J Trop Pediatr. 2006;52(1):63-5.

Mehta S. Late onset sepsis in newborns with incidence of meningitis. Eur J Pharm Med Res. 2017;4:588‐91.

Zhu ML, Zheng G, Chen JN, Lin ZL, Zhu JH, Lin J. Comparative analysis of the pathogens responsible for hospital acquired and community acquired late onset neonatal septicemia. Zhonghua Er Ke Za Zhi. 2008;46(2):124-7.

Kuruvilla KA, Pillai S, Jesudason M, Jana AK. Bacterial profile of sepsis in a neonatal unit in south India. Indian Pediatr. 1998;35:851-8.

Al-Harthi AA. Neonatal Meningitis. Saudi Med J. 2000;21(6):550-3.

Thermiany AS. Diagnostic accuracy of septic markers for neonatal sepsis. PaediatrIndones. 2008;48(5):299-305.

Zawar MP. Early diagnosis of neonatal septicaemiua by sepsis screen. Indian J PatholMicrobiol. 2003;46(4):610-2.

Tiskumara R, Fakharee SH, Liu CQ, Nuntnarumit P, Lui KM, Hammoud M et al. Neonatal infections in Asia. Arch Dis Child Fetal Neonatal Ed. 2009;94:F144‐8.