Neonatal sepsis: A risk approach

Bangi, Vijai Anand Babu; Devi, S

doi:10.4103/2277-8632.146632

Cited by 22 publications

(17 citation statements)

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“…Higher prevalence of EOS was also reported by other studies [ 13 , 14 ]. Slight male predominance noted was similar to other regional studies [ 15 – 17 ]. This sex difference may be due to a gene located on the X chromosome and involved with the function of the thymus or with synthesis of immunoglobulins in the male infants thus conferring less immunological protection compare to females [ 18 ].…”

Section: Discussionsupporting

confidence: 90%

Clinical and Bacteriological Profile of Neonatal Sepsis: A Prospective Hospital-Based Study

Jatsho

Nishizawa

Pelzom³

et al. 2020

International Journal of Pediatrics

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Background. Neonatal sepsis remains one of the leading causes of mortality and morbidity in developing countries. With a dearth of data on neonatal sepsis in our country, this study was conducted to determine the incidence of clinical neonatal sepsis and evaluate the clinical, bacteriological, and antimicrobial susceptibility profile of organisms. Material and Methods. A prospective cross-sectional study was conducted in the Neonatal Unit of the National Hospital from 1st January to 31st December 2016. All neonates admitted with suspected clinical sepsis were included. Sepsis screens and cultures were sent under aseptic conditions. Data was analyzed using STATA™ version 12. Clinical features and neonatal and maternal risk factors were analyzed using chi-squared test. Bacteriological profile was analyzed with descriptive statistics. Results. During the study period, incidence of culture positive neonatal sepsis was 19 per 1000 admissions with a blood culture positivity rate of 14%. 54.5% had culture-positive early-onset sepsis (EOS). Prematurity (p=0.012), APGAR<6 (p=0.018), low birth weight (p<0.001), and maternal intrapartum antibiotics (p=0.031) significantly increased risk for culture-positive EOS. Prematurity (p<0.001), low birth weight (p=0.001), and parental nutrition (p=0.007) were significantly associated with increased risk of culture-positive late-onset sepsis. A positive screen had sensitivity of 81.8% and negative predictive value of 87.7%. Gram-negative organisms were most commonly isolated (64.6%). Coagulase-negative Staphylococci (31%) were the commonest isolate followed by Klebsiella pneumoniae (27%) and Acinetobacter (18.8%). Ninety percent of Acinetobacter were carbapenem resistant. Gram-negative sepsis had mortality of 88.9%. Conclusion. Preterm, low birth weight, low APGAR scores, intrapartum antibiotics, and parental nutrition were significantly associated with neonatal sepsis. Coagulase-negative Staphylococci, Klebsiella pneumoniae, and Acinetobacter were the principal causative organisms. Gram-negative organisms had high resistance to commonly used antibiotics.

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Section: Discussionsupporting

confidence: 90%

Clinical and Bacteriological Profile of Neonatal Sepsis: A Prospective Hospital-Based Study

Jatsho

Nishizawa

Pelzom³

et al. 2020

International Journal of Pediatrics

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“…The incidence of sepsis in our study was 1.8%. This was significantly lower when compared to various studies across India and the world [7,9]. 20% of the affected neonates had meningitis.…”

Section: Discussioncontrasting

confidence: 54%

Microbiological Profile and Sensitivity Data among the Neonatal Population from a Tertiary Care Hospital in South India

Reshad

Balachandran

Sharief

et al. 2021

AJPR

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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.

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“…[3] The case fatality rate of sepsis among neonates ranges between 25% to 65% in India. [4, 5] These rates are likely to be underestimated, and more accurate data is expected from the ‘Global Maternal and Neonatal Sepsis Initiative’. [6–8]…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2019

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Background The incidence of neonatal sepsis in India is the highest in the world. Evidence regarding its risk factors can guide clinical practice and prevention strategies. Objective To review, assess and synthesize the available literature from India on the risk factors of sepsis among neonates. Methodology A systematic review was conducted. We searched PubMed, CINAHL, Scopus, Web of Science, Popline, IndMed, Indian Science Abstracts 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. Results Fifteen 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. Conclusions Male 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.

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Neonatal sepsis: A risk approach

Cited by 22 publications

References 0 publications

Clinical and Bacteriological Profile of Neonatal Sepsis: A Prospective Hospital-Based Study

Clinical and Bacteriological Profile of Neonatal Sepsis: A Prospective Hospital-Based Study

Microbiological Profile and Sensitivity Data among the Neonatal Population from a Tertiary Care Hospital in South India

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

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