English

Abstract

BACKGROUND This study was an attempt to find the association of physical parameters, risk factors, common signs & symptoms of septicaemia, analyse the distribution of microorganisms isolated from clinically suspected cases of septicaemia, and collect their antibiogram. We also wanted to evaluate the haematological findings in conventional culture, correlate them to the sensitivity and specificity, and quantitatively identify the relevance of these haematological tests through their positive and negative predictive values. METHODS A total of 350 blood samples were received from patients with clinically suspected cases of blood stream infections (BSI) at the Department of Microbiology for routine culture & sensitivity and were processed using standard microbiological techniques to determine the percentage distribution of bacterial pathogens causing BSI and their antibiotic susceptibility patterns. Mueller-Hinton agar (MHA) with 4 % NaCl was used to detect methicillin resistance. RESULTS Of the 350 septicaemic cases, 58.8 % were from neonatal ICU and 41.2 % were from paediatric wards. Maximum culture positivity (45.3 %) was seen in < 28 days age group. Bacterial growth was seen in 62.0 % preterm babies. Probability of sepsis was more with leukopenia (85.4 %) as compared to leucocytosis (68.9 %); positive C-reactive protein (CRP) findings (63.8 %) were more likely to be associated with sepsis as compared to negative CRP findings (2.1 %). Leukopenia (97.5 %) and leucocytosis (96.3 %) had the highest specificity values. CONCLUSIONS Low birth weight (LBW) neonates, preterm birth and Caesarean section deliveries are risk factors that predispose neonates to septicaemia. Meropenem can be used in septaemia, but it should be reserved for critical cases, particularly those with multidrug resistant (MDR) bacteria, rather than on routine basis to prevent inadvertent promotion of bacterial resistance. This study showed that leukopenia and CRP are good indicators of sepsis, when used in combination. KEYWORDS Blood Stream Infection, Early Onset Septicemia, Late Onset Septicemia