No abstract

Background: According to the status of newborns report 2014, about 0.76 million neonatal deaths occur in India, the highest for any country in the world. Although the neonatal mortality rate (NMR) has declined in the last 2 decades, the early NMR has been the slowest to decline. The three major causes of neonatal deaths are preterm birth complications, infections, and intrapartum related complications; together, they contribute to nearly 90% of total neonatal deaths. The aim of the study was to study the immediate clinical outcomes of culture proven neonatal sepsis in the NICU of Yenepoya Medical College Hospital during the period January 2016 to June 2016.Methods: Retrospective hospital based study of records of all neonates admitted to the NICU with blood culture positive neonatal sepsis from January 2016 till June 2016. Blood cultures were done using the BACTEC 460. Data analysed using SPSS version 20.Results: A diagnosis of probable sepsis was made in 84 (54%) of the total neonates (154) admitted to the NICU during the study period of which 6 were out born babies. Culture positive sepsis was found in 11.6% (18).  The most commonly isolated organisms were Escherichia coli, Enterococcus and coagulase negative Staphylococcus aureus. Of the total 18 culture positive cases, urine culture was positive in only 2 cases while the remaining had a positive blood culture. Among the 18 cases of culture positive neonatal sepsis, 8 died while 10 survived.Conclusions: Incidence of neonatal sepsis was relatively high in YMCH with the most predominant organism being coagulase negative Staphylococcus aureus. 12.7% of the sepsis cases died. Resistance to cefotaxime and ampicillin was prevalent.

Background: High levels of total serum bilirubin can cause life threatening complications in neonates requiring management either with phototherapy or exchange blood transfusion. Most commonly used modality of phototherapy is with blue light. There are many bulbs like fluorescent tubes, halogen spotlights etc. Due to disadvantages of the available bulbs, newer method like light-emitting diodes (LEDs) has been investigated as possible alternatives as they produce low heat, has a longer life span with lower energy consumption and rapid reduction of serum bilirubin level. The aim was to compare the efficacy between phototherapy equipped with light emitting diode (LED) to compact fluorescent lamp (CFL) in the treatment of neonatal hyperbilirubinemia among neonates.Methods: A hospital-based intervention study was conducted among 50 neonates born in the hospital during the study period, with gestational age more than equal to 35 weeks, being breastfed and healthy in a private medical college teaching hospital in Dakshina Kannada district from August to September 2016.  Following ethical committee clearance the neonates looking icteric by clinical examination were randomly allocated to receive CFL or LED phototherapy. Baseline, 24 hour total serum bilirubin and rectal temperature was measured.  Results: A total of 50 neonates were randomly allocated into two groups with almost similar characteristics between the two groups with respect to gender, type of delivery and gestational age. The mean bilirubin values (in mg/dl) among neonates in the CFL group and LED group were 14.8 and 15.6 respectively and post 24 hour values were 11.54 and 10.68 respectively. The mean difference in the reduction in the bilirubin values before and after receiving phototherapy between the two groups were significant (p <0.001). The increase in temperature was lesser among LED treatment group.Conclusions: LED therapy is better than the CFL therapy in terms of mean reduction in the total serum bilirubin after a fixed duration of time and lesser raise in temperature among the neonates.

Background: Sepsis is one of the most common causes of mortality and morbidity among neonates. The prevalence of microorganisms varies with regions, and the sensitivity pattern also changes over time.   Aim: To study the prevalence of various microorganisms and their sensitivity pattern among the neonatal population in a tertiary care hospital in South India. Methods: This was a retrospective descriptive study. We screened the records of all neonates admitted to the hospital during a period starting from January 1st, 2016, to September 30th, 2018. The details of the patients with any sterile body fluids showing microbial growth were collected. Descriptive analysis was done using IBM SPSS version 20. Results: There were 77 organisms isolated during the study period, with the majority among outborn babies. Seventy-two isolates were from blood, two from CSF and urine, with one from the central line. The most common organism was Klebsiella (22%), followed by Burkholderia cepacia (12%), Staphylococcus aureus (9%), and Streptococcus agalactiae (7%). 9% of the organisms were fungus, with the most common being Kodamaea Ohmeri. Among the antibiotics tested for sensitivity, Meropenem had the maximum sensitivity ratio (84%), followed by Co-trimoxazole (83%) and Vancomycin (82%). Piperacillin tazobactam sensitivity was only 56%, and Ciprofloxacin was sensitive in 65% of cases. Most (6 out of 7) of the fungal isolates were sensitive to fluconazole. Conclusions: Klebsiella remains to be the most common organism causing severe infection in young infants. Worrying rise in the incidence of uncommon organisms (like Kodamaea Ohmeri, GBS, Burkholderia) and carbapenem resistance was noted.  It is, therefore, essential to update the antibiotic policy of the neonatal units on a timely basis.

No abstract