Neonatal sepsis in rural India: timing, microbiology and antibiotic resistance in a population-based prospective study in the community setting

Panigrahi, Pinaki; Chandel, Dinesh S.; Hansen, Nellie I.; Sharma, Nidhi; Kandefer, Sarah; Parida, Sailajanandan; Satpathy, Radhanath; Pradhan, Lingaraj; Mohapatra, Arjit; Mohapatra, Subhranshu S.; Misra, Pravas R.; Banaji, Nandita; Johnson, Judith A.; Morris, J. Glenn; Gewolb, Ira H; Chaudhry, Rama

doi:10.1038/jp.2017.67

Cited by 35 publications

(24 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The antibiogram of Klebsiella spp in Pinaki et al, were sensitive to amikacin (84%), gentamicin (86%), ciprofloxacin (73%), imipenem (100%), and cephalosporin (56%). 4 In South India study majority of the Klebsiella pneumonia isolates were resistant to all the antibiotics except amikacin and meropenem and 32% of them were ESBL producers. 6 In Delhi cohort study the prevalence of carbapenem resisstance among Klebsiella spp, Acinetobacter spp, were 38% and 78% respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Similar pattern of bacteriological profile i.e.69% gram negative organisms and 26% gram positives bacteria were found in Pinaki et al which was conducted on microbiological pattern in rural India and the most common organism were Klebsiella sp, followed by Staph aureus. 4 In Delhi cohort study conducted in multiple tertiary care centres, 64% isolates were gramnegative including Acinetobacter (22%), Klebsiella (17%), and Escherichia coli (14%). 5 Study conducted in South India tertiary care hospital by Bambala et al, found that Klebsiella pneumoniae was isolated from 66% of culture positive cases followed by Coagulasenegative staphylococci in 12% of cases.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Blood culture positive sepsis and sensitivity pattern in a tertiary care neonatal centre in eastern India

Rath

Panda

Nayak

et al. 2019

Int J Contemp Pediatr

View full text Add to dashboard Cite

Background: The objective of this study is to evaluate sensitive pattern of causative organisms of neonatal sepsis with its clinical outcome in a tertiary neonatal care unit of eastern India.Methods: This retrospective observational cohort study was done in a tertiary care hospital of Odisha. All the blood culture positive neonatal sepsis cases, excluding neonates with multiple congenital malformations, diagnosed during January 2017 to December 2018 were analysed using descriptive summary statistics.Results: A total of 73 neonatal sepsis cases were diagnosed by BacT/Alert and VITEK-2 blood culture method. Among them, 50 (68%) babies had gram negative sepsis,14 (19%) cases of gram-positive sepsis and nine (13%) cases of fungal sepsis. In present study 38 (52%) cases were early onset sepsis, 38(52 %) babies were term, 55(75%) were male and 44 (60%) babies were out born. Klebsiella pneumonia and Acinetobacter were the most common organism in early onset and late onset sepsis respectively. Among gram negative organism (GNB), 66% were multi drug resistant. A fifty percent of gram-negative organism were sensitive to meropenem and 28% were sensitive to piperacillin/tazobactam. The sensitivity of GNB to colistin, ciprofloxacin, amikacin was 76%, 64% and 56% respectively. The sensitivity of gram-positive organisms to linezolid, vancomycin, teicoplanin and penicillin were 92%, 85%,85% and 20% respectively. Survival rate among culture positive sepsis was 83%.Conclusions: Multi drug organisms are emerging in modern neonatal care practice. Practice of antibiotic stewardship may save the babies from multidrug resistance organism in future.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Blood culture positive sepsis and sensitivity pattern in a tertiary care neonatal centre in eastern India

Rath

Panda

Nayak

et al. 2019

Int J Contemp Pediatr

View full text Add to dashboard Cite

show abstract

“…10 , 11 , 12 A study in India showed 10% positivity by blood culture, with organisms being predominantly Gram-negative (69%). 13 A study in Bangladesh examined 62 respiratory samples and found a high burden of viral infections (48%). 14 …”

Section: Introductionmentioning

confidence: 99%

Causes and incidence of community-acquired serious infections among young children in south Asia (ANISA): an observational cohort study

et al. 2018

View full text Add to dashboard Cite

SummaryBackgroundMore than 500 000 neonatal deaths per year result from possible serious bacterial infections (pSBIs), but the causes are largely unknown. We investigated the incidence of community-acquired infections caused by specific organisms among neonates in south Asia.MethodsFrom 2011 to 2014, we identified babies through population-based pregnancy surveillance at five sites in Bangladesh, India, and Pakistan. Babies were visited at home by community health workers up to ten times from age 0 to 59 days. Illness meeting the WHO definition of pSBI and randomly selected healthy babies were referred to study physicians. The primary objective was to estimate proportions of specific infectious causes by blood culture and Custom TaqMan Array Cards molecular assay (Thermo Fisher, Bartlesville, OK, USA) of blood and respiratory samples.Findings6022 pSBI episodes were identified among 63 114 babies (95·4 per 1000 livebirths). Causes were attributed in 28% of episodes (16% bacterial and 12% viral). Mean incidence of bacterial infections was 13·2 (95% credible interval [CrI] 11·2–15·6) per 1000 livebirths and of viral infections was 10·1 (9·4–11·6) per 1000 livebirths. The leading pathogen was respiratory syncytial virus (5·4, 95% CrI 4·8–6·3 episodes per 1000 livebirths), followed by Ureaplasma spp (2·4, 1·6–3·2 episodes per 1000 livebirths). Among babies who died, causes were attributed to 46% of pSBI episodes, among which 92% were bacterial. 85 (83%) of 102 blood culture isolates were susceptible to penicillin, ampicillin, gentamicin, or a combination of these drugs.InterpretationNon-attribution of a cause in a high proportion of patients suggests that a substantial proportion of pSBI episodes might not have been due to infection. The predominance of bacterial causes among babies who died, however, indicates that appropriate prevention measures and management could substantially affect neonatal mortality. Susceptibility of bacterial isolates to first-line antibiotics emphasises the need for prudent and limited use of newer-generation antibiotics. Furthermore, the predominance of atypical bacteria we found and high incidence of respiratory syncytial virus indicated that changes in management strategies for treatment and prevention are needed. Given the burden of disease, prevention of respiratory syncytial virus would have a notable effect on the overall health system and achievement of Sustainable Development Goal.FundingBill & Melinda Gates Foundation

show abstract

“…CRP has been used to monitor response to infection and to assist in ruling out an infection. Most of these studies have been done in children, term, or near-term neonates using the lower CRP level cutoffs of <8 mg/dL or <10 mg/dL [35]. What does the study add to the existing knowledge?…”

Section: Resultsmentioning

confidence: 99%

Study of the hematological scoring system and C-reactive protein (CRP) in determining Neonatal sepsis

Godbole

Joshi

Jaison

2020

Trop J Pathol Microbiol

View full text Add to dashboard Cite

Background: Laboratory sepsis markers play an important role in the assessment of a neonate with clinical signs of a probable infection with. C-reactive protein (CRP), Blood culture (BC), Hematological Scoring System (HSS) are three well-identified parameters designated for the investigation of Neonatal Sepsis or infection. Material and Methods: The current study was a prospective hospital-based cross-sectional study carried out at the Department of Pathology, MIMER Medical College, Talegaon (D), Maharashtra, India. Neonates with features suggestive of sepsis and Neonates with recent maternal infection were included in the study. Sensitivity, specificity, Positive Predictive Values (PPVs) and Negative Predictive Values (NPVs) were calculated for each parameter. Results: A total of 40 neonates suspected of having sepsis were enrolled in the current study. In the current study, blood culture was positive in 10 cases (25%), out of which 6 (60%) were Grampositive and 4 (40%) were Gram-negative, whereas 30 cases were found to be negative for blood culture. The mean CRP levels in positive culture cases were 85.7±17, whereas, in the negative culture case, the mean CRP Levels were 38.7±23, whereas the mean value in control was 5.88±0.72. Conclusion: HSS is a simple, easy, cheap, and rapid adjunct for the diagnosis of clinically suspected cases of neonatal sepsis. C-reactive protein values correlate well with HSS in predicting sepsis. However, C-reactive protein does not have any advantage over HSS, either as a single test or in combination.

show abstract

Neonatal sepsis in rural India: timing, microbiology and antibiotic resistance in a population-based prospective study in the community setting

Cited by 35 publications

References 14 publications

Blood culture positive sepsis and sensitivity pattern in a tertiary care neonatal centre in eastern India

Blood culture positive sepsis and sensitivity pattern in a tertiary care neonatal centre in eastern India

Causes and incidence of community-acquired serious infections among young children in south Asia (ANISA): an observational cohort study

Study of the hematological scoring system and C-reactive protein (CRP) in determining Neonatal sepsis

Contact Info

Product

Resources

About