Incidence Of Neonatal Sepsis Research Articles

Association of Gene Polymorphism of Bactericidal Permeability Increasing Protein Rs4358188, Cluster of Differentiation 14 Rs2569190, Interleukin 1β Rs1143643 and Matrix Metalloproteinase-16 Rs2664349 with Neonatal Sepsis.

BACKGROUND:Neonatal sepsis is a health problem because it causes serious morbidity and mortality in neonate intensive care units. The susceptibility of neonates occurs due to the immaturity of immune system development as well as due to maternal and environmental risk factors that can cause infection. Identification of genetic variation in genes involved in the inflammatory process can help clarify the pathophysiology of sepsis in high-risk patients, useful for the development of new diagnostic tools, and specific management plans for more accurate predictions of patient’s prognosis.AIM:This study aims to determine the association between gene polymorphism of BPI rs4358188, CD14 rs2569190, IL1β rs1143643 or MMP16 rs2664349 and the incidence of neonatal sepsis.METHODS:Cross-sectional observational studies with genomic DNA samples from infants with sepsis and non-sepsis which were stored according to the standard storage of genetic materials in the Biomedical Laboratory of Faculty of Medicine Universitas Andalas Padang City, Indonesia. This study is part of a previous study by Rukmono P. Continued with PCR examination, sequencing and bioinformatics analysis.RESULTS:Only IL1β rs1143643 G > A gene polymorphism was associated with the incidence of neonatal sepsis and was statistically significant (p = 0.017). No significant association was found between gene polymorphisms of BPI rs4358188 G > T, CD14 rs2569190 A>G or MMP16 rs2664349 G > A and neonatal sepsis (p > 0.05).CONCLUSION:Gene polymorphism of IL1β rs1143643 G > A is associated with the incidence of neonatal sepsis.

Risk factors of neonatal sepsis in India: A systematic review and meta-analysis.

BackgroundThe incidence of neonatal sepsis in India is the highest in the world. Evidence regarding its risk factors can guide clinical practice and prevention strategies.ObjectiveTo review, assess and synthesize the available literature from India on the risk factors of sepsis among neonates.MethodologyA systematic review was conducted. We searched PubMed, CINAHL, Scopus, Web of Science, Popline, IndMed, Indian Science s and Google Scholar from inception up to March 23, 2018 to identify observational analytical studies reporting on risk factors of laboratory-confirmed neonatal sepsis in India. Two authors independently screened studies (title, abstract and full-text stages), extracted data, and assessed quality. A random-effects meta-analysis was performed as substantial heterogeneity was anticipated. Subgroup and sensitivity analyses were additionally performed. Effect size in our review included odds ratio and standardized mean difference.ResultsFifteen studies were included from 11,009 records, of which nine were prospective in design. Birthweight and gestational age at delivery were the most frequently reported factors. On meta-analyses, it was found that male sex (OR: 1.3, 95% CI: 1.02, 1.68), out born neonates (OR: 5.5, 95% CI: 2.39, 12.49), need for artificial ventilation (OR: 5.61; 95% CI: 8.21, 41.18), gestational age <37 weeks (OR: 2.05; 95% CI:1.40, 2.99) and premature rupture of membranes (OR:11.14, 95% CI: 5.54, 22.38) emerged as risk factors for neonatal sepsis. Included studies scored lowest on exposure assessment and confounding adjustment, which limited comparability. Inadequacy and variation in definitions and methodology affected the quality of included studies and increased heterogeneity.ConclusionsMale neonates, outborn admissions, need for artificial ventilation, gestational age <37 weeks and premature rupture of membranes are risk factors for sepsis among neonates in India. Robustly designed and reported research is urgently needed to confirm the role of other risk factors of neonatal sepsis in India.

NEONATAL SEPSIS AND RISK FACTORS, STUDY IN IN AVBRH TERTIARY CARE HOSPITAL

Introduction: Neonatal sepsis can be defined as a clinical condition which is characterized by signs and symptoms of infection in an infant 28 days of life or younger. This is manifested by systemic signs of infection and/ or isolation of a bacterial or other pathogen from the bloodstream. Sepsis is still one of the major causes of morbidity and mortality globally in neonates, despite of recent advances in healthcare units. The incidence of neonatal sepsis by bacteremia in asymptomatic infants is low. In neonatal sepsis we can include septicaemia, pneumonia, meningitis, osteomyelitis, and arthritis and urinary tract infections. The burden for neonatal sepsis was 2,202 (95% CI: 1,099–4,360) per 100,000 live births, with mortality between 11% and 19% and more than 40% of under-five deaths occur in the neonatal period, resulting in 3.1 million new-born deaths each year globally.&#x0D; Material and Methods: The total number neonates admitted in the hospital in given study period was 447, of which 198 were diagnosed for neonatal sepsis by the physician based on the signs and symptoms during admission. The data was collected in three parts: sociodemographic characteristics; maternal information; and part neonatal information for neonatal sepsis. Data was collected in the excel sheet and questionnaires were reviewed and organized by investigators. Results: Of the 198 neonates, 162 (81.8%) infants were in the age range of 0 to 7 days while 36 (18.2%) were aged between 8 and 28 days. Statistically significant difference was observed between early onset and late onset sepsis patients. Out of 198 cases 107 (54%) were male while 91(46%) were female. In early onset sepsis cases maternal UTI, Meconium stained amniotic fluid, Multipara and Premature rupture of membrane was seen in 24(14.8%), 21(13.0%), 19(11.7%) and 32 (19.8%) cases respectively. In late onset sepsis cases maternal UTI, Meconium stained amniotic fluid, Multipara and Premature rupture of membrane was seen in 1(2.8%), 2 (5.6%), 4(11.1%) and 2 (5.6%) cases respectively. Maternal risk factors were identified in 104(64.2%) of early onset sepsis cases while maternal risk factors in late onset sepsis cases were 10(27.8%). Culture positivity was observed in 28 (17.3%) cases of early neonatal sepsis while it was 4 (11.1%) in late onset sepsis. Conclusion: There was male preponderance in early as well as late onset neonatal sepsis. Maternal risk identification may help in the early identification and timely empirical antibiotic therapy. The prediction and/ or diagnosis of neonatal sepsis should be bases on culture-independent diagnostics and risk factor-based scoring systems.

Rising Postoperative C-Reactive Protein in Congenital Diaphragmatic Hernia: Sepsis or Inflammation?

This study aims to determine the incidence of sepsis in neonates operated for congenital diaphragmatic hernia and ascertain if the level or pattern of C-reactive protein (CRP) could be used to differentiate neonates with sepsis from noninfective inflammation. This study suggests that CRP patterns within the first 48-hours after surgical intervention for congenital diaphragmatic hernia could be used to differentiate neonates with noninfective inflammation from sepsis. A larger, multicentric study is needed to differentiate sepsis from inflammation on the basis of CRP rise and thereby help in avoiding unnecessary use of antibiotics.

3162 Colonization of Pregnant Women with Group B streptococcus in Latin America and Infant Outcomes

OBJECTIVES/SPECIFIC AIMS: The primary objective of this study is to determine the prevalence of maternal GBS colonization and demographic risk factors associated with maternal GBS colonization in Latin America. Secondary objectives include: To determine if there is an association between maternal colonization with GBS and stillbirth or preterm birth in Latin America. To determine the effect of cesarean section (CS) on the incidence of neonatal sepsis with GBS in mothers colonized with GBS. METHODS/STUDY POPULATION: Study Population: Pregnant women who received prenatal care at sites that utilize the Perinatal Information System (SIP) from 1989 through 2015, and were screened for GBS between 35 and 37 weeks of gestation. Maternal exclusion criteria included spontaneous abortion, stillbirth before 35 weeks, and lack of screening for GBS. Methods: Estimated prevalence (and 95% confidence interval) of maternal GBS colonization for the entire data set, by region, and by country. The prevalence data for each country further stratified by maternal age, ethnicity, education, civil status and habitation. Descriptive statistics calculated for each clinical prenatal and clinical perinatal health indicator as well as for each clinical history variable for GBS colonized and non-GBS colonized women. Odds ratios will be calculated for each demographic and clinical risk factor. Fisher’s exact tests will be used to test hypotheses about the relationship between maternal GBS colonization and specific perinatal outcomes such as stillbirth or preterm birth. We will use multiple logistic regression models to test the hypotheses about the relationships between demographic variables, maternal GBS colonization and perinatal outcomes. RESULTS/ANTICIPATED RESULTS: Preliminary results: 712,061 records included in database. 98,852 records with data for GBS screening. o90.6% White, 7.4% Mixed, 0.6% Black, 0.3% Native Indian, 0.1% Other. GBS prevalence among screened women, 17.5% There was a significant association between maternal GBS colonization and ethnicity (X2 (4, N=97006)=569.901, p&lt;0.01) o Prevalence rates by ethnicity: 20.5% Black, 18.4% White, 15.2% Native Indian, 8.8% Mixed, 3.3% Other. There was a significant association between maternal GBS colonization and age (X2 (4, N=98655)=119.901, p&lt;0.01) o Prevalence rates by age group:. Age ≤ 20 - 15.2%. Age 21-34 – 17.8%. Age ≥ 35 – 19.6% Anticipated results:. GBS positive mothers will have an increased burden of stillbirth and preterm birth compared to GBS negative mothers. Neonates born to GBS colonized mothers who deliver via cesarean section will have a decreased incidence of sepsis compared to neonates born to GBS colonized mothers who deliver vaginally DISCUSSION/SIGNIFICANCE OF IMPACT: There have been no comprehensive studies to date that use the CLAP data to characterize the epidemiology of maternal GBS colonization and GBS disease and the burden of neonatal GBS disease in Latin America. Taking advantage of this unique database, this is the first region-wide study using systematically collected data. Our preliminary analysis indicates that GBS colonization status among pregnant women in Latin America is 17.5%, which is greater than previously reported. While there is evidence that maternal carriage of GBS is associated with stillbirth, this will be the first study to quantify the burden of GBS-associated stillbirth in Latin America. Additionally, previous work has been inconclusive in regards to maternal colonization with GBS and its association with preterm birth. This will be the largest study to evaluate the association of maternal GBS carriage with preterm birth. Findings from this study have the potential to inform public health policy and interventions by identifying the prevalence and risk factors.

Hubungan prematuritas dengan kejadian sepsis neonatorum yang dirawat di ruang perinatologi dan neonatal intensive care unit (NICU) RSUD Wangaya kota Denpasar

Background: Premature neonates have an immature immune system due to the lack of IgG antibodies. These antibodies do not cross the placenta from mother to baby at last trimester that can increase the risk of neonatal sepsis. This study aims to determine the relationship between prematurity and the incidence of neonatal sepsis at Perinatology Ward and NICU Wangaya General Hospitals, Denpasar.Methods: This research used analytical observation with cross sectional study design from January-April 2018. The samples involved are 50 neonates, admitted at Perinatology Ward and NICU Wangaya Hospital and fulfilled the inclusion and exclusion criteria. Samples were obtained by using consecutive sampling method and using secondary data from the medical recordResult: 23 samples (46%) premature and 27 samples (54%) were not premature, out of 50 samples as many as 20 samples with neonatal sepsis. From the results of hypothesis testing using the chi-square test, the p-value is 0.005, and the prevalence risk was 2.73.Conclusion: Prematurity is significantly related with the incident of neonatal sepsis at Perinatology Ward and NICU Wangaya Hospital, Denpasar City.

Prevalence of multidrug drug resistant organisms and hand hygiene compliance in surgical NICU in Cairo University Specialized Pediatric Hospital

BackgroundThe incidence of neonatal sepsis increased during the recent years, it may be due to frequent use of invasive procedures and the development of resistant organisms. Bacterial resistance to commonly used antibiotics has emerged and complicated the management of NS. ObjectiveOur study aimed at determining the prevalence and risk factors of MDRO and hand hygiene compliance (HHC) in the SNICU, of Cairo University Specialized Pediatric Hospital (CUSPH) postoperatively. Materials and MethodsA prospective, observational study was carried out from April 2015 to September 2015 in the tertiary-care level SNICU of CUSPH. Fifty- eight neonates who were infection free on admission and were having any surgical pathology were studied. Baseline data collected include Demographic history, evidence of sepsis, Complete examination and investigations including quantitative C-reactive protein (QCRP), WBCs counts, blood culture, and treatment were also included. Hand hygiene was also assessed among the HCWs using the WHO checklist “My Five Moments for Hand Hygiene”. ResultsNinety-five samples were sent to the microbiology laboratory for culture and sensitivity. Some neonates had more than one sample type analyzed. All samples were collected 48 h postoperatively. The most common site of infection was blood stream infection (BSI) representing 39/95 of samples (41%) followed by SSI 16/95 (16.8%), RTI 8/95 (8.4%), and CLABSI 3/95(3.1%), 29/95 (30.5%) samples revealed no growth. Out of 66 isolated microorganisms, Gram-negative bacteria were the most prevalent pathogens of nosocomial infection with 35/66 (53%), while Gram-positive bacteria were 25/66 (37.9%). We found coagulase-negative Staphylococcus aureus (CONS) to be the most common organism 19/66 (28.7%) cultured from blood, followed by Klebsiella 13/66 (19.6%) and Acinetobactor 9/66 (13.6%) of all isolates. Candida was isolated from only one case of SSI 1/66 (1.5%). MRSA were found to be less frequently isolated 3/66 (4.5%). Profile of blood culture and susceptibility patterns provide guidance to start empiric antibiotic treatment which is cornerstone in sepsis management. The most sensitive antibiotic among Gram positive isolates were Teicoplanin and Vancomycin with 100% sensitivity for both antibiotics in MRSA isolates, while they showed sensitivity of 94.7 and 89.5% respectively in CONS isolates, both Ciprofloxicin and Clindamycin showed 33.3% sensitivity to MRSA isolates, while no single MRSA isolate showed sensitivity to Erythromycin nor Amikacin. CONS sensitivity to other antibiotics was as follows; 74% in Amikacin, 79% in ciprofloxacin and 58% in Clindamycin. In Gram negative organisms; Polymexin B and Colistin revealed highest sensitivity (100%) in all Gram negative isolates, followed by Amikacin with 60% sensitivity to E-coli and only 25% sensitivity in both Pseudomonas and Enterobacter, then Meropenem which was 55.6% sensitive to Acenitobacter and 25% sensitivity to both Pseudomonas and Enterobacter. Ciprofloxacin showed 50% sensitivity with Pseutomonas and 25% with Enterobacter, while it was sensitive in 22.2% and 20% of Acenitobacter and E-coli isolates respectively. Gentamicin was 33.3%, 25% and 20% sensitive in Acenitobacter Enterobacter and E-coli isolates respectively. No E-coli isolates showed sensitivity to imipenem, while only 25%, 22.2% and 15.4% of Enterobacter, acenitobacter and klebsiella isolates respectively were sensitive to imipenem. Among 39 blood culture positive cases, 26 isolates were MDRO (66.7%) meanwhile non-MDRO accounted for 13/39 (33.3%) isolates.Overall hand hygiene compliance (HHC) among the HCWs was found to be (30.5%). ConclusionPrevalence of MDRO among cases of sepsis was found to be (66.7%). Most isolated organisms were resistant to commonly used drugs. Antibiotic stewardship (ASP) program is essentially needed to stop abuse of antibiotics and accordingly development of MDROs. Strict infection control measures mainly HH procedures are needed, to minimize the spread of MDROs.

Burden and factors associated with clinical neonatal sepsis in urban Uganda: a community cohort study

BackgroundNeonatal sepsis is one of the most important causes of mortality in developing countries and yet the most preventable. In developing countries clinical algorithms are used to diagnose clinical neonatal sepsis because of inadequate microbiological services. Most information on incidence and risk factors of neonatal sepsis are from hospital studies which may not be generalized to communities where a significant proportion of mothers do not deliver from health facilities. This study, conducted in urban Uganda, sought to determine the community based incidence of clinical neonatal sepsis and the factors associated.MethodsThis was a cohort of mother-neonate pairs in Kampala, Uganda from March to May 2012. The enrolled neonates were assessed for clinical sepsis and factors associated, and followed up till the end of the neonatal period. STATA version 10 was used to analyse the data.ResultsThe community based incidence of neonatal sepsis was 11% (95% CI: 7.6–14.4). On bivariate analysis, lack of financial support from the father (OR 4.09, 95% CI 1.60–10.39) and prolonged rupture of membranes more than 18 h prior to delivery (OR 11.7, 95% CI 4.0–31.83) were significantly associated with neonatal sepsis. Maternal hand washing prior to handling the baby was found to be protective of neonatal sepsis (OR 0.41, 95% CI 0.18–0.94). Of the 317 infants who completed the follow up period, one died within the neonatal period giving a neonatal mortality of 0.003%.ConclusionThe high incidence of clinical neonatal sepsis in this urban community with high rates of antenatal care attendance and health facility delivery places a demand on the need to improve the quality of antenatal, perinatal and postnatal care in health facilities with regards to infection prevention including promoting simple practices like hand washing. The astoundingly low mortality rate is most likely because this was a low risk cohort. However it may also suggest that the neonatal mortality in developing countries may be reduced with promotion of simple low cost interventions like community follow up of neonates using village health teams or domiciliary care.

Common Pathogens Associated with Neonatal Sepsis and Their Antibiotic Resistance Pattern in Sohag University Hospital

Introduction: Neonatal sepsis is defined as a clinical syndrome in an infant 28 days of life or younger, manifested by systemic signs of infection and isolation of a bacterial pathogen from the bloodstream[EmanShehab El-Din et al, 2015]. Positive blood culture and sensitivity of the isolate is the best guide to antimicrobial therapy and once started should be modified according to the culture sensitivity reports[Aggarwalet al, 2001]. Aim of the work: To determine clinical and microbiological pattern of neonatal sepsis in Sohag university hospital with special focus on causative pathogens and their response to used antimicrobials. Patient and methods: Our study conducted over a period of 18 months between October 2015 and April 2017 at Sohag university hospital and included 75 neonates with suspected sepsis and positive blood culture using Egyptian neonatal network (EGNN) guidelines, subjected to full clinical examination, septic screen(CBC, ESR and CRP) and blood culture and sensitivity tests. Results: All studied neonates presented with late onset sepsis with higher incidence in infants born via CS especially with low and very low birth weight.The incidence of neonatal sepsis was predominantly due gram negative bacteria mainly Klepseillapneumonae followed by staphylococcus haemolyticusandstaphylococcus epidermidis. Klebseilla isolates showed high sensitivity for aminoglycosides and quinolones antibiotics with resistance to penicillin's group, Staphylococcus isolates showed resistance to penicillin's and aminoglycosides while sensitive to quinolones and nitrofurantions. E.coli and Pseudomonas species showed moderate sensitivity to 3rd generation cephalosporins, aminoglycosides, quinolones and nitrofurantoins with resistance to classic penicillin's. Conclusion: In our study gram negative bacteria mainly Klepseillapneumonae was the most causative agent of neonatal sepsis. Most isolated organisms showed resistance to classic penicillins.Klepseillapneumonaeshowed high sensitivity for aminoglycosides and quinolones, Staphylococcus isolates showed high sensitivity to quinolones and nitrofurantions while E.coli and Pseudomonas species showed moderate sensitivity to 3rd generation cephalosporins, aminoglycosides, quinolones and nitrofurantoins.

Risk Factors for Neonatal Sepsis in Pregnant Women with Premature Rupture of the Membrane.

Background Premature rupture of the membrane (PROM) is associated with high maternal as well as perinatal morbidity and mortality risks. It occurs in 5 to 10% of all pregnancy while incidence of amniotic membrane infection varies from 6 to 10%. This study aimed to determine the incidence of neonatal sepsis in Cipto Mangunkusumo Hospital and the risk factors. Methods A cross-sectional study was done in Cipto Mangunkusumo Hospital, Jakarta, from December 2016 to June 2017. The study used total sampling method including all pregnant women with gestational age of 20 weeks or more experiencing PROM, who came to the hospital at that time. Samples with existing comorbidities such as diabetes mellitus or other serious systemic illnesses such as heart disease or autoimmune condition were excluded from the analysis. Results A total of 405 pregnant women with PROM were included in this study. There were 21 cases (5.2%) of neonatal sepsis. The analysis showed that risk of neonatal sepsis was higher in pregnant women with prolonged rupture of membrane for ≥ 18 hours before hospital admission (OR 3.08), prolonged rupture of membrane for ≥ 15 hours during hospitalization (OR 7.32), and prolonged rupture of membrane for ≥ 48 hours until birth (OR 5.77). The risk of neonatal sepsis was higher in preterm pregnancy with gestational age of <37 weeks (OR 18.59). Conclusion Risk of neonatal sepsis is higher in longer duration of prolonged rupture of membrane as well as preterm pregnancy.

Aetiology of neonatal sepsis in Nigeria, and relevance of Group b streptococcus: A systematic review.

BackgroundGroup B Streptococcus (GBS) causes invasive infections in neonates and has been implicated as a cause of prelabour rupture of membranes, preterm delivery and stillbirths. The success of phase II trials of polyvalent polysaccharide GBS vaccines indicates that these infections are potentially preventable. Nigeria is the most populous country in Africa with one of the highest birth rates, one of the highest neonatal sepsis incidence rates and one of the highest mortality rates in the world. Therefore, before the possible introduction of preventive strategies such as intrapartum antibiotic prophylaxis or GBS vaccine into Nigeria, it is vital that there is accurate data on the aetiology of neonatal sepsis and on the incidence of GBS neonatal sepsis in particular. The objective of this study was to determine the incidence and aetiology of neonatal sepsis in Nigeria with a focus on GBS sepsis and also to assess the potential impact of a GBS vaccine.MethodsA literature search was conducted on the databases of African journals online, PubMed and Google Scholar for works conducted between 1987 to 2017. Case reports, reviews, and studies not stating specific culture methods or specific bacteria isolated were excluded. Data extracted included; incidence of neonatal sepsis, method of blood culture, blood volume, sample size, bacterial agents isolated and history of antibiotic use. PRISMA guidelines were followed and modified Down’s and Black criteria used to evaluate the quality of studies.ResultsA total of 5,114 studies were reviewed for neonatal sepsis out of which 24 consisting of a total of 2,280 cases were selected for final review. Nine studies met criteria for assessment of hospital based incidence of neonatal sepsis representing 31,305 hospital births. The incidence of neonatal sepsis was 18.2/1000 livebirths with range from 7-55/1000 livebirths while the GBS incidence was 0.06/1000 livebirths with range from 0-2/1000 live births. We discovered various limitations such as identification techniques that could result in underestimation of the true incidence of GBS sepsis. Pathogens such as Klebsiella pneumoniae and Staphylococcus aureus were more commonly isolated than GBS.Implications of key findingsThe hospital based incidence of neonatal sepsis was high at 18.2/1000 live births while that due to GBS was 0.06/1000 live births. The burden of neonatal sepsis, including that attributable to GBS is substantial and could be reduced by preventive strategies such as intrapartum antibiotic prophylaxis or GBS vaccine. There is however very sparse meaningful data currently. Well planned prospective studies with larger sample sizes, more advanced isolation and identification techniques and those following up invasive disease cases for possible short and long term sequelae are needed—not only prior to possible introduction of the vaccine to determine the baseline epidemiology, but also thereafter to monitor its impact on the population. Strategies need to be developed to also reduce the morbidity and mortality attributable to other bacteria that have an incidence even greater than that of GBS.

HUBUNGAN BBLR DENGAN KEJADIAN SEPSIS NEONATORUM DI RSUD DR. H. ABDUL MOELOEK PROVINSI LAMPUNG TAHUN 2015

Infection is one of the main causes of the high mortality rate of mothers and newborns. There are several factors that can cause infections in infants including Low Birth Weight (LBW). The aim of this study is to identify the relationship of LBW with the incidence of neonatal sepsis in the Dr. H. Abdul Moeloek hospital in Lampung in 2015. The method used in this research is analytical case-control study. This study population is 123 infants of cases group while the control group has 1363 infants. Simple Random Sampling is used to take a sample of 94 babies for cases group and 94 babies as control samples. The data are obtained by looking at medical records in the Dr. H Abdul Moeloek hospital. The data are processed using the univariate and bivariate analysis. The results showed that in the case group 63 infants (67%) of babies have low birth weight, whereas in the control group, 53 infants (56.4%) did not experience low birth weight, with (p-value = 0.002 and OR = 2.627), which means there is a relationship between the incidence of LBW with neonatal sepsis. The researcher therefore suggested to the hospital for early detection in antenatal care to prevent complications in childbirth, postpartum, taking care of newborn babies and provide counseling to maintain health in pregnancy and how to care for babies with neonatal emergencies.

Mortality profile of neonatal deaths and deaths due to neonatal sepsis in a tertiary care center in southern India: a retrospective study

Background: The Neonatal mortality rate is an important indicator for newborn care and directly reflects prenatal, intranatal, and postnatal care. Objective: Primary objective was to analyse the neonatal mortality profile, incidence of neonatal sepsis among neonatal deaths and the pattern of antimicrobial resistance.Methods: This was a retrospective descriptive study done in a tertiary care regional center. All neonatal deaths from January 2017 to December 2017 were reviewed and primary causes of deaths, incidence of sepsis among neonatal deaths and pattern of antimicrobial resistance were analyzed.Results: Common causes of neonatal deaths were respiratory distress syndrome (27.4%), asphyxia (23.3%), sepsis (20.1%), congenital malformations, extreme preterm, meconium aspiration syndrome. Case fatality rate was high in extreme preterm neonates (96.8%), followed by respiratory distress syndrome (35.9%), asphyxia (33%), meconium aspiration syndrome (29.4%), congenital malformations (28.8%), and sepsis (22.6%). In present study incidence of neonatal sepsis among total neonatal deaths was about 20.1%. Coagulase negative staphylococcus(CONS) (38.6%) and Klebsiella pneumoniae (32.7%) were the predominant organisms isolated. Highest case fatality rate was associated with Pseudomonas sepsis (80%), K. pneumoniae sepsis (64.8%), followed by Escherichia coli sepsis (57%) and non fermenting Gram negative bacilli (55.6%).Conclusions: Sepsis still remains one of the leading cause of death in developing countries. Coagulase negative staphylococcus (CONS) and Klebsiella pneumoniae were the most common organism. 15 % enterococci and 9.7 % of CONS were resistant to vancomycin. 24 % of K. pneumoniae and 16.6% non fermenting Gram negative bacilli were resistant to amikacin. Multidrug resistance is an emerging problem.

Epidemiological and clinicobacteriological study of neonatal sepsis

Background: Neonatal mortality is still high in developing countries like India, which is mostly contributed by sepsis. Early diagnosis and appropriate management can improve the outcome of neonatal sepsis. Diagnosis of neonatal sepsis can be difficult at times as the symptoms and signs are nonspecific. To study the incidence of sepsis in different gestational age and birth weight categories.Methods: The study conducted prospectively in1169 babies admitted to NICU from first May 2011 to 30th April 2012. Data was collected using performance. Investigations including CBC, CXR, Blood culture sensitivity and CRP were done on the same day (IT ratio and micro ESR were not done). CSF study and cultures of urine, surface swab, tracheal aspirate etc done only in selected cases.Results: There were 238 episodes of sepsis and the incidence of sepsis in this study was 20.01% among the babies admitted during the study period. The incidence was more in extreme preterm and extremely low birth weight categories. Among babies with sepsis culture positive sepsis was seen in 18.45%. E. coli was the commonest organism in EOS and Klebsiella in LOS.Conclusions: In this study incidence of neonatal sepsis was 20.35%. Lower the birth weight and gestational age, higher was the incidence of sepsis. PROM &gt;18 hours, MSAF and prematurity were found to be associated with EOS while extreme prematurity, prolonged ventilation, indwelling catheters and prolonged hospital stay were found to be statistically significant in causing LOS.

\u2018Elective caesarean section at 38\u201339\xa0weeks gestation compared to >\u200939\xa0weeks on neonatal outcomes: a prospective cohort study

BackgroundThis study was conducted to compare neonatal complications in scheduled cesarean sections (CS) between 38 and 39 gestational weeks with CS performed after 39 gestational weeks in Iranian low -risk pregnant women.MethodsIn this cohort study, 2086 patients were enrolled based on the inclusion and exclusion criteria. The neonates were evaluated in terms of the following items: transient tachypnea of the newborn (TTN), respiratory distress syndrome (RDS), sepsis, need for NICU hospitalization, birth weight, birth height, head circumference, and the first minute and fifth minute Apgar score. Several multiple logistic regression models were performed for each response variable (adverse outcome) separately.ResultsThe incidence of NICU admission was significantly higher in neonates born at 38–39 gestational weeks than those who were born after 39 gestational weeks. No significant differences were found in the incidence of neonatal sepsis, TTN, and RDS between the two groups.ConclusionAccording to our study results, elective CS at 38–9 weeks’ gestation is associated with a higher rate of TTN and NICU admission in comparison with elective CS performed after 39 completed gestational weeks.

Presepsin as a predictor of positive blood culture in suspected neonatal sepsis.

Although the incidence of neonatal sepsis is decreasing, neonatal sepsis remains a severe life-threatening disease. No current biochemical marker can provide perfect diagnostic accuracy for neonatal sepsis. The aim of this study was therefore to evaluate the accuracy of presepsin (P-SEP) as a novel biomarker of bacterial infection for neonatal sepsis diagnosis. We prospectively studied newborns with sepsis (sepsis group; n = 13) during the first 30days after birth and compared them with control preterm newborns (control group; n = 18). In addition, we evaluated term newborns with some clinical signs of early onset sepsis (non-sepsis term group; n = 35). P-SEP in the sepsis group was significantly higher than in the control group (P < 0.001) The area under the curve for P-SEP was 0.868 (95%CI: 0.71-1.00). A P-SEP cut-off of 795pg/mL was established, with 85% sensitivity and 89% specificity. The positive and negative predictive values were 85% and 89%, respectively. In the non-sepsis term group, P-SEP had better stability than white blood cells and C-reactive protein for 3days after birth. P-SEP can better discriminate between infections and non-infectious inflammatory conditions than the currently used biomarkers.

Early breastfeeding initiation and incidence of neonatal sepsis in Chipinge District Zimbabwe

Background: Neonatal sepsis is one of the leading causes of neonatal morbidity and mortality during the neonatal period especially in the first week of life. The objectives of this study were to determine early breastfeeding initiation (EBFI) and the incidence of neonatal sepsis in in the first week of life in Chipinge District, Zimbabwe.Methods: After obtaining approval from the ethical institutional review board and Medical research council of Zimbabwe, a total of 200 healthy term neonates were recruited into a prospective cohort study within 24 hours of birth after the mothers had given an informed consent. Mother and baby pair was followed up at day 3 and day 7 to assess presence of infection using clinical checklist and physical examination.Results: The Pearson correlation was significant at 0.01 level (2 tailed) at day 3 and day 7. The findings revealed a significant association between EBFI and neonatal sepsis in the first week of life.Conclusions: Neonatal sepsis is one of the leading causes of death during the neonatal period especially in the first week of life. Findings of the study revealed a significant Pearson correlation at 0.01 levels (2 tailed) at day 3 and day 7. Delayed initiation of breastfeeding increases the risk of neonatal sepsis and about 33 % neonatal deaths can be averted if breastfeeding is initiated within an hour of birth.

Incidence and serotype characterisation of Streptococcus agalactiae in a Portuguese hospital

AimsStreptococcus agalactiae, commonly known as group B Streptococcus (GBS), has been recognised as a worldwide causative pathogenic agent of neonatal sepsis, meningitis and pneumonia. To better understand the behaviour of...

Mortality profile and incidence of deaths due to neonatal sepsis in an urban tertiary care center in South India: A retrospective study

Background: The neonatal mortality rate is a key outcome indicator for newborn care and directly reflects prenatal, intrapartum, and neonatal care. Objective: Primary objective was to assess the neonatal mortality profile, incidence of neonatal sepsis among total neonatal deaths and pattern of antimicrobial resistance. Methodology: This was a retrospective descriptive study done at a tertiary care center. All neonatal deaths from January 2014 to December 2014 were reviewed, and primary causes of mortality, incidence of sepsis among neonatal deaths and pattern of antimicrobial resistance were analyzed. Results: Common causes of neonatal mortality were sepsis, respiratory distress syndrome, congenital malformations, asphyxia, extreme preterm, meconium aspiration syndrome. Case fatality rate was high in extreme preterm neonates (82%), followed by respiratory distress syndrome (29%), congenital malformations (29%), sepsis (25%), asphyxia (25%). In our study incidence of neonatal sepsis among total neonatal deaths was about 20.5%. Staphylococcus aureus (60%) and Klebsiella pneumoniae (23%) were predominant organisms. Highest case fatality rate was associated with K. pneumoniae sepsis about 60%, followed by Escherichia coli sepsis (54%) and Acinetobacter sepsis (50%). Multidrug resistance is an emerging problem, especially in Acinetobacter sepsis. Conclusion: Sepsis still remains the leading cause of death in developing countries. S. aureus was the most common predominant organism; of this, two-thirds were methicillin-resistant S. aureus. About 90% of K. pneumoniae were resistant to extended-spectrum cephalosporins. Multidrug resistance is an emerging problem, especially in Acinetobacter sepsis.

Prospective study to evaluate the risk factors associated with mortality in neonatal septicemia

Background: Neonatal sepsis is a clinical syndrome of bacteremia characterized by systemic signs and symptoms of infection in the first month of life. Neonatal sepsis refers to infection occuring within the neonatal period i.e. first 28 days of life for a term baby and up to 4 weeks beyond the expected date of delivery in a preterm baby. Neonatal sepsis is one of the major cause of neonatal morbidity and mortality.Methods: The present study is a prospective observational study conducted in the neonatal intensive care unit (NICU) of Sri Guru Ram Das Institute of Medical Sciences and Research (SGRDIMSAR), Sri Amritsar over a period of one year from January 2015 to January 2016. Aim of the study is to know the incidence of neonatal sepsis, to study bacteriology of neonatal septicemia and to evaluate the risk factors associated with mortality in neonatal sepsis in our hospital.Results: During the study period (January 2015 to January 2016), 727 neonates were admitted in NICU of SGRDIMSAR, Sri Amritsar. Out of them, 109 neonates were diagnosed as having septicemia. Incidence of neonatal sepsis in our hospital in this study is 149.9/1000 neonatal admissions. 59 (54.1%) neonates had positive blood culture. Out of 109 septic neonates, 50 died and 59 survived. Mortality observed in the present study is 45.9%.Conclusions: It is concluded from present study that the main factors associated with neonatal mortality are low birth weight, prematurity, positive blood culture, neutropenia and prolonged prothrombin time. Some of the risk factors like low birth weight and prematurity are preventable by proper antenatal check ups and measures can be taken for safe and hygienic delivery. Babies with risk factors should be monitored closely for early detection of sepsis and the neonates with sepsis having abnormal laboratory parameters should be subjected to appropriate therapeutic intervention in order to decrease the mortality.