Mortality audit of neonatal sepsis secondary to Acinetobacter

Abstract

Background:Multidrug resistant Acinetobacter infection has emerged as an important pathogen in neonatal sepsis in the recent years causing morbidity as well as mortality.Materials and Methods:A retrospective analysis was performed over a one and a half year period of all neonates admitted with sepsis in our neonatal intensive care unit (NICU), who developed Acinetobacter infection and to identify mortality-associated risk factors in these neonates.Results:Incidence of neonatal septicaemia due to Acinetobacter species was 9.18%. All were cases of early onset sepsis. Predominant species isolated was Acinetobacter baumanii (67.5%). The major symptoms were lethargy and poor feeding. The major signs were tachypnoea, rib retraction, and respiratory distress. The major fetal risk factors were low birth weight and prematurity. Overall, 53.75% were multidrug resistant (MDR) Acinetobacter. Resistance to more than two drugs (MDR) was statistically significant in A. baumanii as compared with nonbaumanii. Overall mortality due to Acinetobacter neonatal sepsis was 20%. Septicemia due to A. baumanii was associated with higher mortality than those due to nonbaumanii isolates. Lethargy, tachypnoea, rib retraction, tachycardia, respiratory distress, and mechanical ventilation were significant predictors of mortality.Conclusion:Multidrug resistant Acinetobacter infection is fatal, particularly in premature and low birth weight neonates. Therefore, an effective infection control policy and rational antibiotic use are mandatory in neonatal intensive care areas of each hospital in order to control Acinetobacter infection and improve outcome.

Neonatal Sepsis-Culture Positive Sepsis vs Clinical Sepsis

“…Staphylococcus aureus was the predominant isolate may be from carriers as we got some carriers from NICU on MRSA surveillance. The results of the present study were comparable with the study conducted by De A Set al [5] , Sankar MJ et al [8] , Roy I et al [12] and Shah AJ et al [13] . Neonatal sepsis is a serious national health concern.…”

Neonatal Sepsis-Culture Positive Sepsis Vs Clinical Sepsis

“…Staphylococcus aureus was the predominant isolate may be from carriers as we got some carriers from NICU on MRSA surveillance. The results of the present study were comparable with the study conducted by De A Set al [5] , Sankar MJ et al [8] , Roy I et al [12] and Shah AJ et al [13] . Neonatal sepsis is a serious national health concern.…”

“…[4] On the other hand, multidrug resistant (MDR) strains are emerging. [5] In this perspective, the purpose of the study is to evaluate the results of different diagnostic tests in the presence of risk factors and/or clinical picture. Blood culture, sepsis screen, biochemical markers, cerebrospinal fluid (CSF) study, radiology were included in this study.…”

Risk Factors and Outcomes for Patients with Bloodstream Infection Due to Acinetobacter baumannii-calcoaceticus Complex

“…A. baumannii infection also occurs in neonatal ICUs. One study reported A. baumannii as the causative agent in 6.2% of cases of septicemia resulting in an overall attributable mortality rate of 20% (7). Higher morbidity and mortality rates have been reported in patients infected with MDR A. baumannii strains as opposed to those infected with non-MDR A. baumannii strains (8).…”