Time to positive blood culture in early onset neonatal sepsis: A retrospective clinical study and review of the literature

2020 ◽  
Vol 56 (9) ◽  
pp. 1371-1375
Author(s):  
Lucinda Marks ◽  
Koert Waal ◽  
John K Ferguson
Keyword(s):  
Clinical Study ◽  
Blood Culture ◽  
Positive Blood Culture ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Review Of The Literature ◽  
Retrospective Clinical Study

scholarly journals Utility of Red Cell Distribution Width (RDW) In Diagnosis and Prognosis of Early-Onset Neonatal Sepsis in Term Neonates

2021 ◽  
Vol 3 (3) ◽  
pp. 257-264
Author(s):  
Sandeep Golhar ◽  
Abhishek Madhura ◽  
Urmila Chauhan ◽  
Abinash Nayak
Keyword(s):  
Blood Culture ◽  
Hospital Mortality ◽  
Positive Blood Culture ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Red Cell ◽  
Cell Distribution ◽  
Distribution Width ◽  
Term Neonates ◽  
Diagnosis And Prognosis

Objective: To assess the increased Red Cell Distribution Width (RDW) in diagnosis and prognosis of early-onset neonatal sepsis in term neonates. Methods: In a prospective, observational study, we enrolled term neonates ( 37 weeks of gestation) clinically suspected for Early-Onset Neonatal Sepsis (EONS) (within 7 days of birth). A cut-off of 18% and above was taken to consider RDW as abnormal or increased. The primary outcome was to assess the relation of increased RDW with in-hospital mortality. The secondary outcome was to determine the diagnostic yield of increased RDW in culture-proven sepsis. Results: In 166 neonates, 60% were males. Increased RDW was seen in 42.42% of neonates and 15.75% of neonates had positive blood culture. Compared to normal RDW, in-hospital mortality was significantly higher in neonates with increased mortality (27.14% vs. 10.52%, respectively; p=0.006). Also, abnormal RDW was seen in 46.15% of neonates with positive blood culture compared to 35.25% of neonates with negative blood culture (p<0.0001). Thus, elevated RDW had a sensitivity of 44.4% and specificity of 57.97% in the diagnosis of EONS. Conclusion: Increased RDW can be a diagnostic as well as a prognostic marker in neonates with EONS. Such observation indicates it may serve as a simple and easily available marker for EONS in resource-limited settings. However, these findings need to be confirmed in a larger sample. Doi: 10.28991/SciMedJ-2021-0303-7 Full Text: PDF

scholarly journals Increased Risk Of Early-Onset Neonatal Sepsis After Laser Surgery For Twin-to-Twin Transfusion Syndrome

2016 ◽  
Vol 19 (3) ◽  
pp. 234-240 ◽  
Author(s):  
Liselotte E. M. van Kempen ◽  
Depeng Zhao ◽  
Sylke J. Steggerda ◽  
Vincent Bekker ◽  
Johanna M. Middeldorp ◽  
...  
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Gestational Age ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Laser Surgery ◽  
Premature Delivery ◽  
Increased Risk ◽  
Gestational Age At Birth ◽  
Age At Birth

Objective: To investigate the occurrence of early-onset neonatal sepsis (EOS) in twin–twin transfusion syndrome (TTTS) managed with laser surgery.Study design: We performed a prospective cohort study of all consecutive TTTS cases treated with laser surgery (TTTS group) delivered at the Leiden University Medical Center. We recorded the occurrence of EOS, defined as a positive blood culture ≤72 hours postpartum (proven sepsis) or administration of a full course of antibiotics due to risk factors or signs of sepsis, in the absence of a positive blood culture (suspected sepsis). Perinatal variables in the TTTS group were compared with uncomplicated monochorionic twins (no-TTTS group). A multivariate model was generated, examining the association between EOS and gestational age at birth, interval between laser surgery and birth, anterior placenta, laser period (first study period: 2002–2008; second study period: 2009–2015), and preterm premature rupture of membranes (PPROM).Results: The rates of combined suspected and proven EOS in the TTTS group and no-TTTS group were 16% (68/416) and 10% (55/542), respectively (relative ratio [RR] 1.74, 95% confidence interval [CI] 1.19–2.55). Multivariate analysis showed that EOS in the TTTS group was independently associated with lower gestational age at birth (odds ratio [OR] 0.75, 95% CI 0.63–0.88), first study period (OR 2.25, 95% CI 1.08–4.67) and PPROM (OR 2.47, 95% CI 1.28–4.75).Conclusion: The rate of EOS in the TTTS group is low, but increased compared to the no-TTTS group. EOS in TTTS is independently associated with premature delivery, earlier laser period, and PPROM.

scholarly journals Predictors of positive blood culture and deaths among neonates with suspected neonatal sepsis in a tertiary hospital, Mwanza- Tanzania

2010 ◽  
Vol 10 (1) ◽  
Author(s):  
Neema Kayange ◽  
Erasmus Kamugisha ◽  
Damas L Mwizamholya ◽  
Seni Jeremiah ◽  
Stephen E Mshana
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Neonatal Sepsis ◽  
Tertiary Hospital

scholarly journals Clinical and Bacteriological Profile of Early Onset Neonatal Sepsis Admitted in NICU of Tertiary Hospital in Biratnagar

2018 ◽  
Vol 3 (1) ◽  
pp. 370-376
Author(s):  
Arun Giri ◽  
Vijay Kumar Sah ◽  
Bikash Sharma Poudel ◽  
Niraj Niraula ◽  
Raju Sedai
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Blood Culture ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Coagulase Negative Staphylococcus ◽  
Sensitivity Pattern ◽  
Clinical Signs And Symptoms

Introduction: Neonatal sepsis is one of the major causes of neonatal morbidity and mortality especially in developing countries. The clinical signs and symptoms of neonatal sepsis are non specific and blood culture report is considered gold standard for confirmation of neonatal sepsis. Organisms and their sensitivity pattern vary from place to place. The confirmation of diagnosis and management of neonatal sepsis is challenging and time consuming.Objective: The aim of this study was to find incidence of blood culture proven sepsis in suspected early onset neonatal sepsis, find out sensitivity pattern of isolated organism and to find association of risk factors and clinical signs and symptoms with blood culture proven sepsis.Methodology: Prospective study was conducted in Nobel Medical College, Biratnagar from November 2016 to November 2017. Sample size was calculated to be 300 and blood culture was sent of each neonates admitted with suspected early onset neonatal sepsis before giving neonates with first dose of antibiotics and report of 72 hours was taken into consideration.Results: Out of 300 cases of suspected early onset neonatal sepsis 70.3% presented with lethargy, followed by other symptoms like poor feeding, respiratory distress, fever, hypothermia, feeding intolerance, abnormal body movement and abdominal distension. Low birth weight neonates, preterm neonates, prolonged duration of per vaginal leaking and low platelets count were significantly associated with blood culture proven sepsis in this study. Incidence of blood culture positive sepsis in suspected early onset neonatal sepsis was 27%. Coagulase negative Staphylococcus aureus(21%) was predominant organism isolated followed by Klebsiella Pneumonia, Pseudomonas, Escherichia coli. All of the isolated Klebsiella and Pseudomonas and 86% of Escherichia coli were found to be resistant to ampicillin. All isolated Coagulase negative Staphylococcus aureus were sensitive to vancomycin.Conclusion: Coagulase negative Staphyloccus aureus was predominant organism detected but majority of organisms were gram negative organisms. High resistance to ampicillin was found and cefotaxime was also less sensitive to isolated organism. Vancomycin was found to be sensitive to all isolated Staphylococcus aureus and coagulase negative Staphylococcus aureus. Amikacin was highly sensitive among causative organisms isolated. BJHS 2018;3(1)5 : 370-376

scholarly journals Clinical profile and outcome of early onset sepsis in high risk very low birth weight neonates

2018 ◽  
Vol 5 (2) ◽  
pp. 389 ◽  
Author(s):  
Omprakash S. Shukla ◽  
Aditi Rawat
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Blood Culture ◽  
Low Birth Weight ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Very Low Birth Weight ◽  
Gram Negative ◽  
Early Onset Sepsis ◽  
Culture Positive

Background: Neonatal sepsis is one of the main causes of mortality and morbidity, especially in very low birth weight neonates (birth weight <1499 grams) despite the progress in hygiene, introduction of new and potent antimicrobial agents for treatment and advanced measures for diagnosis. The aim of the study was to find correlation of clinical features and risk factors of neonatal sepsis in culture positive cases.Methods: A cross- sectional study was carried out in one hundred neonates with risk factors of septicemia after obtaining informed consent. Blood culture was done using Bactec Peds Plus/F Culture as a gold standard to diagnose septicaemia. Correlation of  risk factors, clinical features with laboratory findings was obtained by using chi-square test. p-value of less than 0.05 was considered as significant.Results: Out of 100 neonates with suspected sepsis, BACTEC culture proven sepsis was seen in 40% cases. Gram negative sepsis was seen in 62.5% cases. The most common bacteria for early onset sepsis were Klebsiella, Pseudomonas and MRSA contributing 17% each to the bacteriological profile. The most common predisposing factor and clinical feature in culture positive cases were Premature rupture of membrane >24 hours (67%) and bleeding/petechia/pupura (72%) respectively. The major cause of mortality was pulmonary hemorrhage.Conclusions: Gram negative organism were more common and associated with higher mortality. Blood culture positivity increases with increase in number of risk factors in neonatal septicemia. A detailed history and thorough clinical examination is vital for early recognition of sepsis. 

To Study the Clinical Profile of Neonatal Sepsis and the Sensitivity of Various Markers of Sepsis Screen

2014 ◽  
Vol 1 (1) ◽  
pp. 19
Author(s):  
Sagar Sonawane ◽  
Milind Suryawanshi ◽  
Priyanka Patil ◽  
Ravindra Sonawane ◽  
M. K. Tolani
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Neonatal Sepsis ◽  
Clinical Manifestations ◽  
Clinical Profile ◽  
Gastric Bleeding ◽  
Automated Method ◽  
Feed Intolerance ◽  
Sepsis Screen ◽  
A Prospective Study

<strong>Objective:</strong> To study the clinical profile of Neonatal Sepsis &amp; the sensitivity of various markers of sepsis screen. <strong>Material &amp; Methods:</strong> This was a prospective study of neonates admitted to our NICU from January 2010 to October 2011 with diagnosis of neonatal sepsis or those who developed sepsis later on during their stay in NICU. All newborns diagnosed as a case of neonatal sepsis, based on clinical features with positive sepsis screen and/or positive blood culture, were included in our study. Blood Culture &amp; Sensitivity was done with conventional non–automated method using Herley’s Broth. <strong>Result:</strong> Common clinical manifestations of Neonatal Sepsis among the study group were Lethargy (96.36%), Tachypnea (92.73%), Refusal to suck/feeding difficulty (76.36%), Delayed CRT, Poor Pulses (74.55%), Sclerema (61.82%), Gastric Bleeding (45.45%) &amp; Feed Intolerance (45.45%). 46 babies had positive sepsis screen (sensitivity 84%), while 27 babies had a positive blood culture (sensitivity 49.09%).

scholarly journals Lichen planus of the lips: an intermediate disease between the skin and mucosa? Retrospective clinical study and review of the literature

2016 ◽  
Vol 55 (9) ◽  
pp. e473-e481 ◽  
Author(s):  
Paolo Nuzzolo ◽  
Antonio Celentano ◽  
Paolo Bucci ◽  
Daniela Adamo ◽  
Elvira Ruoppo ◽  
...  
Keyword(s):  
Clinical Study ◽  
Lichen Planus ◽  
Review Of The Literature ◽  
Retrospective Clinical Study

scholarly journals How Can the Microbiologist Help in Diagnosing Neonatal Sepsis?

2012 ◽  
Vol 2012 ◽  
pp. 1-14 ◽  
Author(s):  
Michela Paolucci ◽  
Maria Paola Landini ◽  
Vittorio Sambri
Keyword(s):  
Blood Culture ◽  
Neonatal Sepsis ◽  
Gold Standard ◽  
Early Onset ◽  
Late Onset ◽  
Molecular Techniques ◽  
Diagnosis And Treatment ◽  
Diagnosis And Management ◽  
Sepsis Diagnosis ◽  
Expected Outcomes

Neonatal sepsis can be classified into two subtypes depending upon whether the onset of symptoms is before 72 hours of life (early-onset neonatal sepsis—EONS) or later (late-onset neonatal sepsis—LONS). These definitions have contributed greatly to diagnosis and treatment by identifying which microorganisms are likely to be responsible for sepsis during these periods and the expected outcomes of infection. This paper focuses on the tools that microbiologist can offer to diagnose and eventually prevent neonatal sepsis. Here, we discuss the advantages and limitation of the blood culture, the actual gold standard for sepsis diagnosis. In addition, we examine the utility of molecular techniques in the diagnosis and management of neonatal sepsis.

scholarly journals Statistical validity of interleukin-6 as a biomarker for the diagnosis of early-onset neonatal sepsis

2012 ◽  
Vol 3 (1) ◽  
pp. 5 ◽  
Author(s):  
Sriparna Basu ◽  
Shashikant Dewangan ◽  
Shampa Anupurva ◽  
Ashok Kumar
Keyword(s):  
Risk Factors ◽  
Blood Culture ◽  
Cord Blood ◽  
Interleukin 6 ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Diagnostic Marker ◽  
Statistical Validity ◽  
Sepsis Screening ◽  
Early Diagnostic

Use of empirical antibiotics in neonates with risk factors of early-onset neonatal sepsis (EOS) is a common practice. A laboratory parameter is needed to help in the accurate diagnosis of EOS to avoid unnecessary use of antibiotics. The aim of this prospective observational cohort study was to compare the statistical validity of cord blood interleukin-6 (IL-6) with conventional sepsis screening as an early diagnostic marker for EOS. Eighty-seven neonates with antenatal risk factors for sepsis were followed up for 72 h for the development of EOS. Cord blood was collected for measurement of IL-6 concentrations. Blood culture and conventional sepsis screening (total leukocyte count, absolute neutrophil count, C-reactive protein and micro-erythrocyte sedimentation rate) were sent for analysis soon after delivery. The study group comprised of symptomatic neonates with positive blood culture (n=36). An equal number of gestational-age matched asymptomatic neonates without risk factor of sepsis served as controls. Statistical validity of IL-6 was compared with sepsis screening parameters as the diagnostic marker for EOS. Gram negative organisms were the predominant cause of EOS. The most commonly isolated organism was <em>Acinetobacter baumanii</em>. The sensitivity and specificity of IL-6 with a cut-off value of 40.5 pg/mL and area under curve of 0.959 were 92.3 and 90.48%, respectively. In contrast, the sensitivity and specificity of different parameters of sepsis screening ranged from 37.5-68.75% and 47.95-57.35%, respectively. In conclusion, cord blood IL-6 can be used as a highly sensitive and specific early diagnostic marker of EOS at a cut-off concentration of 40.5 pg/mL.

scholarly journals Nasopharyngeal colonization at birth and the development of early-onset neonatal sepsis

2020 ◽  
Vol 60 (6) ◽  
pp. 287-92
Author(s):  
Andi Dwi Bahagia Febriani ◽  
Nilam Sartika Putri ◽  
Ema Alasiry ◽  
Dasril Daud
Keyword(s):  
Blood Culture ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Bacterial Colonization ◽  
Bacterial Species ◽  
Nasopharyngeal Swab ◽  
Nasopharyngeal Colonization ◽  
Blood Culture Isolate ◽  
Significant Difference ◽  
Culture Isolate

Background Neonatal sepsis is one of the major causes of morbidity and mortality in neonates. Exposure to maternal bacteria during pregnancy or delivery allows for colonization of the normal upper airway. Such bacteria become the major ecological species in the infant. If the colonizing bacteria invade the bloodstream, early-onset neonatal sepsis (EONS) could occur. Objective To evaluate for an association between colonization of the newborn nasopharynx and EONS, as well as for agreement between nasopharyngeal swab culture and blood culture isolate results. Methods This prospective cohort study was conducted in Dr. Wahidin Sudirohusodo General Hospital and Ibnu Sina Hospital, Makassar, South Sulawesi. Nasopharyngeal swab culture was taken within 2 hours of life from newborns who met the inclusion criteria, then they were followed up for signs of EONS. Blood culture was taken from subject with EONS. Results Of the 100 newborns, 69 (69%) had nasopharyngeal bacterial colonization, of whom 5.8% (4/69) experienced EONS. Of the remaining 31 (31%) without colonization, 9.7% (3/31) experienced EONS. There was no significant difference in frequency of EONS between newborns with and without nasopharyngeal colonization. Although Gram-negative bacteria were predominant among colonized newborns, there was no significant difference to numbers of Gram-positive bacteria as a causative agent of EONS. Only one patient with EONS had the same bacterial species in both the nasopharynx and blood culture isolate. Conclusion  Newborn nasopharyngeal colonization at birth is not associated with EONS.

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