Bacteriological profile and antibiotic susceptibility of neonatal sepsis in neonatal intensive care unit of a tertiary hospital in Nepal

Pokhrel, Bhishma; Koirala, Tapendra; Shah, Ganesh; Joshi, Suchita; Baral, Prakash

doi:10.1186/s12887-018-1176-x

Cited by 113 publications

(143 citation statements)

References 20 publications

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“…7 The morbidity and mortality may be caused by ineffective antibiotics to multidrug-resistant bacteria or a weak host defense mechanisms in preterm infants. [8][9][10] Adjuvant therapies may be increasingly important to increase the efficacy of antimicrobial agents and overcome excessive or uncontrolled inflammatory response in sepsis. [11][12][13] Redox-active agents (e.g.…”

Section: Introductionmentioning

confidence: 99%

Influency of pentoxifylline treatment for neonatal sepsis: A meta‐analysis of randomized controlled studies

Peng

Xia

2022

Hong Kong j. emerg. med.

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Introduction: Pentoxifylline may be an important approach to treat neonatal sepsis. However, its use has not been well established. We conduct a systematic review and meta-analysis to evaluate the efficacy of pentoxifylline treatment for neonatal sepsis. Methods: PubMed, Embase, and the Cochrane Central Register of Controlled Trials are searched. Randomized controlled trials assessing the influence of pentoxifylline treatment on neonatal sepsis are included. Two investigators independently have searched articles, extracted data, and assessed the quality of included studies. This meta-analysis is performed using the random-effect model. Results: Seven randomized controlled trials involving 439 patients are included in the meta-analysis. Compared with control intervention for neonatal sepsis, pentoxifylline treatment is associated with reduced hospital stay (standard mean differences = −0.61; 95% confidence interval = −0.93 to −0.29; p = 0.0002) and metabolic acidosis (risk ratio = 0.38; 95% confidence interval = 0.22 to 0.66; p = 0.0006), but has no remarkable impact on mortality (risk ratio = 0.59; 95% confidence interval = 0.30 to 1.16; p = 0.13), serum tumor necrosis factor-α (standard mean differences = −0.38; 95% confidence interval = −1.29 to 0.52; p = 0.41), serum C-reactive protein (standard mean differences = −0.25; 95% confidence interval = −0.92 to 0.42; p = 0.47), plasma interleukin-6 (standard mean differences = −0.13; 95% confidence interval = −0.41 to 0.15; p = 0.37), disseminated intravascular coagulopathy (risk ratio = 0.55; 95% confidence interval = 0.25 to 1.21; p = 0.14), and oliguria/anuria (risk ratio = 0.77; 95% confidence interval = 0.28 to 2.16; p = 0.62). Conclusion: Pentoxifylline treatment may be associated with reduced mortality and hospital stay in neonatal sepsis with caution.

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Section: Introductionmentioning

confidence: 99%

Influency of pentoxifylline treatment for neonatal sepsis: A meta‐analysis of randomized controlled studies

Peng

Xia

2022

Hong Kong j. emerg. med.

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“…Bacterial pathogens such as Klebsiella pneumoniae, Staphylococcus aureus, and coagulase-negative Staphylococcus are the most common causes of neonatal sepsis in developing countries [9]. These organisms are highly resistant to commonly used antibiotics, which makes them challenging to treat [10][11][12]. Moreover, early diagnosis and treatment of newborns with infection are unsatisfactory in resource-poor settings, which contributes to the high neonatal mortality due to sepsis [13].…”

Section: Introductionmentioning

confidence: 99%

Risk factors and etiology of neonatal sepsis after hospital delivery: A case-control study in a tertiary care hospital of Rajshahi, Bangladesh

et al. 2020

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Background Sepsis is one of the major causes of neonatal death worldwide as well as in Bangladesh. The objective of the present study was to identify the risk factors and causative organisms of neonatal sepsis after delivery in a tertiary care hospital, Bangladesh. Methods This was a case-control study conducted in the neonatal ward of Rajshahi Medical College Hospital (RMCH), a 1000-bed tertiary hospital situated in Rajshahi, Bangladesh. Neonates diagnosed as neonatal sepsis by clinical and laboratory parameters were included as cases in this study. Admitted neonates unsuspected or undiagnosed for sepsis were considered as controls. Maternal and neonatal information and their laboratory reports were collected and analyzed. Both bivariate and multiple logistic regression models were used to identify the risk factors of neonatal sepsis. Results A total of 91 cases and 193 controls were included in the study. Maternal history of urinary tract infection (UTI) during the third trimester of pregnancy (aOR 2.75, 95% CI: 1.04–7.23, p <0.05), premature birth (aOR 2.77, 95% CI: 1.08–7.13, p <0.05) and APGAR score <7 at five minutes (aOR 2.58, 95% CI: 1.04–6.39, p <0.05) were associated with onset of neonatal sepsis in multiple logistic regression model. All these factors were also associated with developing early-onset neonatal sepsis, while maternal UTI and male sex of neonates were associated with developing late-onset neonatal sepsis. Escherichia coli (40.7%), Staphylococcus aureus (27.5%), and Klebsiella pneumoniae (18.7%) were the commonly isolated organisms causing neonatal sepsis. All these organisms were highly resistant to common antibiotics like amoxicillin, cephalosporins, aminoglycosides and quinolones. Carbapenemase group of drugs along with amikacin, nitrofurantoin and linezolid were the most sensitive drugs. Conclusions Strengthening the existing facility for antenatal screening for early diagnosis and treatment of maternal infection during pregnancy as well as identifying high-risk pregnancy for adequate perinatal management is necessary to prevent neonatal sepsis-related morbidity and mortality. Rational use of antibiotics according to local epidemiology and culture and sensitivity reports may minimize the increasing hazards of antibiotic resistance.

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“…Gram positive isolates were most sensitive to Vancomycin (100%) while the gram negative isolates were most sensitive to Amikacin.100% sensitivity of CONS to Vancomycin was seen in a recent study from Nepal and from India. 7,16 High sensitivity of Gram negative isolates to Amikacin was also seen in the studies in Cameroon but some studies from India showed only 50% sensitivity. 5,7 Resistance to Crystalline Penicillin, Ampicillin and 3 rd generation cephalosporins was high.…”

Section: Discussionmentioning

confidence: 79%

Neonatal septicemia: bacteriological profile in a tertiary level hospital in South India

2019

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Background: Early onset bacterial sepsis remains a major cause of neonatal morbidity and death. The choice of antibiotic for an infant with sepsis depends on the predominant bacterial pathogens and the antibiotic susceptibility profiles for the microorganisms causing disease in a particular geographic region. The purpose of this study was to analyze the bacteriological profile and antibiotic sensitivity pattern of neonatal septicemia in our neonatal unit.Methods: A descriptive cross sectional study carried was out at the NICU of a tertiary level hospital in South India for a period of one year.Results: Clinically suspected septicemia comprised 18.14% of total NICU admissions. Organism was isolated by blood culture in 14.9% of cases. The most common organisms causing septicemia were Coagulase negative Staphylococci, Klebsiella and Staphylococcus aureus. Gram positive isolates were most sensitive to Vancomycin (100%) while the gram negative isolates were most sensitive to Amikacin. Resistance to Crystalline Penicillin, Ampicillin and 3rd generation cephalosporins was high.Conclusions: The most common organism isolated in septicemia was Coagulase negative staphylococcus in our NICU. Gram positive isolates were most sensitive to Vancomycin (100%) while the gram negative isolates were most sensitive to Amikacin. High resistance to commonly used antibiotics is worrisome. There should be a constant surveillance of the common microbes and their sensitivity pattern in each NICU and the antibiotic protocols should be periodically reviewed. Rational use of antibiotics and preventive measures like hand washing is the need of the hour.

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Bacteriological profile and antibiotic susceptibility of neonatal sepsis in neonatal intensive care unit of a tertiary hospital in Nepal

Cited by 113 publications

References 20 publications

Influency of pentoxifylline treatment for neonatal sepsis: A meta‐analysis of randomized controlled studies

Influency of pentoxifylline treatment for neonatal sepsis: A meta‐analysis of randomized controlled studies

Risk factors and etiology of neonatal sepsis after hospital delivery: A case-control study in a tertiary care hospital of Rajshahi, Bangladesh

Neonatal septicemia: bacteriological profile in a tertiary level hospital in South India

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