Background: Neonatal sepsis is one of the main causes of mortality and morbidity, especially in very low birth weight neonates (birth weight <1499 grams) despite the progress in hygiene, introduction of new and potent antimicrobial agents for treatment and advanced measures for diagnosis. The aim of the study was to find correlation of clinical features and risk factors of neonatal sepsis in culture positive cases.Methods: A cross- sectional study was carried out in one hundred neonates with risk factors of septicemia after obtaining informed consent. Blood culture was done using Bactec Peds Plus/F Culture as a gold standard to diagnose septicaemia. Correlation of  risk factors, clinical features with laboratory findings was obtained by using chi-square test. p-value of less than 0.05 was considered as significant.Results: Out of 100 neonates with suspected sepsis, BACTEC culture proven sepsis was seen in 40% cases. Gram negative sepsis was seen in 62.5% cases. The most common bacteria for early onset sepsis were Klebsiella, Pseudomonas and MRSA contributing 17% each to the bacteriological profile. The most common predisposing factor and clinical feature in culture positive cases were Premature rupture of membrane >24 hours (67%) and bleeding/petechia/pupura (72%) respectively. The major cause of mortality was pulmonary hemorrhage.Conclusions: Gram negative organism were more common and associated with higher mortality. Blood culture positivity increases with increase in number of risk factors in neonatal septicemia. A detailed history and thorough clinical examination is vital for early recognition of sepsis.

Introduction: The current Indian neonatal mortality rate is 28 per 1000 live births. Whilst the leading cause of mortality is prematurity and its complications, the second is neonatal sepsis. Objectives:To describe spectrum of isolates in neonatal sepsis together with their antibiotic sensitivity pattern and significance of routine blood investigations for diagnosis of early onset septicaemia. Method:A cross-sectional study was performed in 100 neonates with risk factors for septicaemia after obtaining informed consent. Routine blood investigations such as complete blood count and Creactive protein (CRP) were done on the first day of life. Specificity, sensitivity, positive predictive value and negative predictive value of total leucocyte count, absolute neutrophil count and CRP were calculated. Blood culture was done using Bactec Peds Plus/F culture as a gold standard to diagnose septicaemia. The study was approved by the Institutional Ethics Committee. Results:Out of 100 neonates with suspected sepsis, 40 were found to have culture proven sepsis. CRP had the highest sensitivity (45%) and negative predictive value (71%), leucopenia had the highest positive predictive value (72%) and neutropenia had the highest specificity (91.7%). The common bacteria for early onset sepsis (EOS) were Klebsiella, Pseudomonas and methicillin resistant Staphylococcus Aureus (MRSA) contributing 17% each to the bacteriological profile. All the gram negative bacteria in our study were sensitive to gentamicin and gram positive bacteria were sensitive to nitrofurantoin, tigecycline, tetracycline, vancomycin, teicoplanin, and linezolid. _________________________________________ 1 Third Year M.D. Resident, 2 Additional Professor, The authors declare that there are no conflicts of interest Personal funding was used for the project. Open Access Article published under the Creative Commons Attribution CC-BY LicenseConclusions: This study showed that leucopenia, neutropenia and CRP are good indicators of sepsis, when used in combination. A negative CRP can exclude sepsis as it has the highest negative predictive value. This study also showed that gram negative bacilli (Klebsiella and Pseudomonas) were the common organisms associated with early onset neonatal sepsis.

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not availableBangladesh J Child Health 2016; VOL 40 (3) :183-185

We report a case of a two day old female child with congenital facial palsy, bilateral microtia, congenital heart disease, renal ectopia and unilateral hypoplasia of depressor anguli oris muscle. These constellation of symptoms have not been found together in any case before. This unknown syndrome could be considered to be in a gray zone between Caylers Cardiofacial syndrome and Pearls syndrome.