scholarly journals Choice and Duration of Antimicrobial Therapy for Neonatal Sepsis and Meningitis

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Sindhu Sivanandan ◽  
Amuchou S. Soraisham ◽  
Kamala Swarnam
Keyword(s):  
Developing Countries ◽  
Hospital Stay ◽  
Antimicrobial Therapy ◽  
Neonatal Sepsis ◽  
Antimicrobial Agents ◽  
Clinical Symptoms ◽  
Late Onset ◽  
Developed Countries ◽  
Causative Organism ◽  
Duration Of Therapy

Neonatal sepsis is associated with increased mortality and morbidity including neurodevelopmental impairment and prolonged hospital stay. Signs and symptoms of sepsis are nonspecific, and empiric antimicrobial therapy is promptly initiated after obtaining appropriate cultures. However, many preterm and low birth weight infants who do not have infection receive antimicrobial agents during hospital stay. Prolonged and unnecessary use of antimicrobial agents is associated with deleterious effects on the host and the environment. Traditionally, the choice of antimicrobial agents is based on the local policy, and the duration of therapy is decided by the treating physician based on clinical symptoms and blood culture results. In this paper, we discuss briefly the causative organism of neonatal sepsis in both the developed and developing countries. We review the evidence for appropriate choice of empiric antimicrobial agents and optimal duration of therapy in neonates with suspected sepsis, culture-proven sepsis, and meningitis. Moreover, there is significant similarity between the causative organisms for early- and late-onset sepsis in developing countries. The choice of antibiotic described in this paper may be more applicable in developed countries.

scholarly journals A ten-year review of neonatal bloodstream infections in a tertiary private hospital in Kenya

2011 ◽  
Vol 5 (11) ◽  
pp. 799-803 ◽  
Author(s):  
Ruchika Kohli-Kochhar ◽  
Geoffrey Omuse ◽  
Gunturu Revathi
Keyword(s):  
Developing Countries ◽  
Neonatal Sepsis ◽  
Late Onset ◽  
Group B Streptococcus ◽  
Bloodstream Infections ◽  
Empiric Therapy ◽  
Gram Positive ◽  
Late Onset Sepsis ◽  
Group B ◽  
The Right

Introduction: Neonatal mortality in developing countries is usually due to an infectious cause.  The gold standard of investigation in developing countries is a positive blood culture.  It is important to know the aetiology of neonatal bloodstream infections so that empiric treatment can be effective.  Methodology: We conducted a retrospective clinical audit over ten years between January 2000 until December 2009, looking at the aetiology of both early and late onset neonatal sepsis.  We analysed data from 152 (23%) patient isolates out of 662 suspected cases of neonatal sepsis.  Results: Our study revealed that Gram-positive organisms were the predominant cause of both early and late onset sepsis; the common isolates were Staphylococcus epidermidis (34%) and Staphylococcus aureus (27%).  There were no isolates of group B Streptococcus.  Candida species was isolated only in patients with late onset sepsis (6.9%).  Bacterial isolates were relatively sensitive to the commonly used first- and second-line empiric antibiotics. Conclusion: Gram-positive organisms remain the major cause of neonatal bloodstream infections in our setup.  The findings of this study will guide clinicians in prescribing the right empiric therapy in cases of suspected neonatal sepsis before the definitive culture results are obtained.

DISEASE PATTERNS;

2014 ◽  
Vol 21 (03) ◽  
pp. 570-574
Author(s):  
Muhammad Ashraf ◽  
Muhammad Zakria
Keyword(s):  
Developing Countries ◽  
Hospital Admission ◽  
Hospital Stay ◽  
Average Duration ◽  
Gastrointestinal Diseases ◽  
Developed Countries ◽  
Communicable Diseases ◽  
Medical Ward ◽  
Cross Sectional ◽  
Common Diagnosis

Communicable and gastrointestinal diseases followed by respiratory diseasesare the main reasons of admission in medical ward of developing countries. This is different fromthe developed countries where non communicable diseases are the main reasons of hospitaladmission. In developing countries the data of hospital admission are still lacking. Therefore thisstudy will help us to assess the common patterns of diseases admitted in a medical ward, theaverage length of hospital stay etc. Objective: The objectives of this study are to assess thepatterns and prevalence of diseases, the most common diagnosis and average duration ofpatient’s hospital stay. Design: Observational retrospective cross-sectional study. Patients andmethods: The record of 327 hospitalized patients in medical ward was analyzed for the period ofthirteen months from Mar 2013 to Mar 2014. Patient’s medical records were retrieved and dataanalysis was done to obtain age, sex, common diagnosis, the affected system and the duration ofthe hospital stay. The data was analyzed by using SPSSV 16. Results: After reviewing the data,the most common age of patients being admitted were between 46-65 yrs (37.6%), followed bybetween 26-45yrs (33%), < 25yrs (15.9 %) , between 66-85 yrs (12.5 % )and > 85 yrs were only1% . Among the admitted patients females were more than the males except in case of liverdiseases. The most affected system was gastrointestinal ( 22.63 % ) and the most commondiagnosis was Diabetes Mellitus (12.84 %). The next common system involved wascardiovascular (15.29 %), respiratory (14.37 %), endocrine / DM (10.70 %), neurology (9.48 %),heamatology (3.36 %), renal (2.45 %) , rheumatology (1.84 %) and others ( including pyschiarty ,poisoning, infectious , electric shock etc ) (5.81 %). The cause for hospital admission by infectionin different system was (20.48%) The average duration of hospital stay of the patients was 4 days.Conclusions: The gastrointestinal diseases and the infectious diseases are the most commondiseases. The communicable diseases still hold a greater position in developing countries, whilenon communicable diseases are main reasons for admission to the medical wards in developedcountries.

scholarly journals Ritual scalp shaving-a risk factor for community acquired late onset neonatal sepsis

2014 ◽  
Vol 9 (3) ◽  
pp. 35-44
Author(s):  
S Sen ◽  
KB Mondal ◽  
A Roy ◽  
N Kumar ◽  
P Pant ◽  
...  
Keyword(s):  
Risk Factor ◽  
Neonatal Sepsis ◽  
Late Onset ◽  
Teaching Hospitals ◽  
Causative Organism ◽  
Medical Sciences ◽  
Tertiary Teaching ◽  
History Of ◽  
Independent Variable ◽  
The Difference

Background Neonatal sepsis is one of the major causes of morbidity and mortality at the community and hospital levels in India. There are several community practices associated with and contributing to Neonatal sepsis, especially late onset variety.Objective To analyze whether scalp shaving is an independent risk factor associated with community acquired late onset neonatal sepsis and the causative organism responsible.Methods This was a prospective, non-interventional, observational study. The study was conducted at two tertiary teaching hospitals in Eastern India from 1st May 2010 to 30th April 2011. A total of 382 babies were diagnosed as Late Onset Neonatal Sepsis and 410 , age and sex matched controls were taken from the Well Baby and Immunization clinics. The patients were clinically screened for sepsis and "septic screen" and blood, urine and CSF cultures sent, as needed.Results History of scalp shaving was present in 46(12.04%) out of 382 cases of Late Onset Neonatal Sepsis as compared to 20(4.87%) of 410 matched community controls, the difference was statistically significant (p<0.005). Positive blood cultures were obtained in 20(43.48%) out of 46 scalp shaven babies as compared to 118(35.11%) out of 336 non scalp shaven babies. The commonest organism in babies with scalp shaving was found to be methicillin resistant Staphylococcus aureus(MRSA), whereas the most common organism in non scalp shaven babies was Klebsiella pnuemoniae.Conclusion Scalp shaving appears to be an independent variable associated with community acquired Late Onset Neonatal Sepsis.Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-3, 35-44

scholarly journals Bacteriological Profile of Neonatal Sepsis in a Tertiary Level Hospital of Nepal

2015 ◽  
Vol 34 (3) ◽  
pp. 175-180 ◽  
Author(s):  
R Khanal ◽  
S Manandhar ◽  
GP Acharya
Keyword(s):  
Developing Countries ◽  
Neonatal Sepsis ◽  
Antimicrobial Agents ◽  
Diffusion Method ◽  
Multiple Drug ◽  
Drug Resistant ◽  
Gram Positive ◽  
Gram Negative ◽  
Multiple Drug Resistant ◽  
Gram Positive Cocci

Introduction: Neonatal sepsis is one of the most common reasons for admission to neonatal units in developing countries. It is also a major cause of mortality in both developed and developing countries. This study was done to determine the bacterial profile causing neonatal sepsis and to assess their susceptibility pattern to various antimicrobial agents. Materials and Methods: A cross-sectional prospective study was conducted in Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal among 340 neonates suspected of neonatal sepsis. Blood culture was performed and organisms were identified with Gram staining and conventional biochemical methods. Antimicrobial susceptibility testing was performed by Kirby-Bauer disk diffusion method according to the Clinical and Laboratory Standards Institute (CLSI). Results: The prevalence rate of neonatal sepsis was 20.3%. Among 340 neonates, 52.17% were males and 47.82% were females. Gram positive cocci were the most predominant isolates (88.40%). Among Gram positive cocci Staphylococcus epidermidis was the most common isolates (72.46%) followed by Staphylococcus aureus (7.24%), Staphylococcus saprophyticus (4.34%) and Enterococcus fecalis (4.34%). Gram negative bacilli were found in 11.60% of the growth positive samples of which E.coli and Klebsiella spp were found in 10.14% and 1.44% respectively. Sensitivity to Amikacin was highest among all types of organisms isolated. Vancomycin and Gentamycin sensitivity was highest for Gram positive and Gram negative organisms respectively. Ampicillin resistance was highest among isolates. Among the 69 isolates 48 were Multiple drug resistant. Conclusion: The predominance of Gram positive cocci particularly Coagulase negative Staphylococci is shown. Empirical antibiotic therapy should be reviewed for Multiple drug resistant strains. DOI: http://dx.doi.org/10.3126/jnps.v34i3.9183 J Nepal Paediatr Soc 2014;34(3):175-180

scholarly journals Etiology and risk factors of early and late onset neonatal sepsis

2021 ◽  
Author(s):  
Tariq Homoud Althagafi ◽  
Mona Abdullah Alharbi ◽  
Ashjan Nasser Bamarhool ◽  
Zahra Dheya Almajed ◽  
Leen Hani Natto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Neonatal Sepsis ◽  
Viral Infections ◽  
Clinical Symptoms ◽  
Late Onset ◽  
Systemic Disease ◽  
Clinical Manifestations ◽  
Different Types ◽  
Lead Levels ◽  
Total Birth Rate

Neonatal sepsis is a systemic disease caused by bacterial organisms, viral infections, or fungus that causes hemodynamic abnormalities and other clinical symptoms resulting in severe complications and may progress into mortality. Parturition can be used to diagnose organisms caused by the premature onset of sepsis in some cases, but only after an average of three days of life. Clinical manifestations of infection may also diagnose the organisms caused by the early onset of sepsis. Late sepsis can refer to any incident of sepsis from delivery to discharge in high-risk newborns, and the majority of them have been hospitalized for a lengthy period. Late-onset Guillain-Barré syndrome infections generally refer to the infections that occur between one week and up to three months post-labor. The precise load fraction for newborn sepsis varies by context, with differing load estimations between nations with varying lead levels. With the diversity of treatments utilized, explaining the degree of obstetric palsy is crucial and complicated. When comparing birthing sepsis rates, it is critical to understand if a tiny figure represents a total birth rate or another rate, such as a hospital admission number. As stated, it is critical to evaluate if population estimates based on the numbers of neonatal sepsis episodes have been recorded. This article aims to review the literature regarding neonatal sepsis from different aspects including, the etiology, risk factors, and different types and onset of neonatal sepsis.

Ralstonia mannitolilytica, an unusual pathogen in the Neonatal Intensive Care Unit: a case of neonatal sepsis and literature review

2020 ◽  
Vol 20 ◽  
Author(s):  
Panagiotis Lampropoulos ◽  
Despoina Gkentzi ◽  
Sotirios Tzifas ◽  
Georgia Kapnisi ◽  
Ageliki Karatza ◽  
...  
Keyword(s):  
Premature Infant ◽  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Antimicrobial Agents ◽  
Late Onset ◽  
Extremely Low Birth Weight ◽  
Respiratory Impairment ◽  
Gram Negative ◽  
Sensitivity Pattern ◽  
Resistance Patterns

Background: Premature infants are considered high-risk subgroup for neonatal sepsis due to yet defective immune system, interventions practised and synergy of factors favoring multiple resistance of Gram-positive and Gram-negative pathogens to antimicrobial agents. Case presentation: We present a case of late-onset neonatal sepsis in a premature infant caused by an uncommon pathogen; a premature infant of extremely low birth weight had in his 4th week of life severe clinical deterioration with lethargy, fever, pallor, 1 mottling, abdominal distention, tachycardia, and worsening respiratory impairment. Full septic screen was performed, broad-spectrum antibiotic therapy was initiated and supportive care per needs was provided. Blood cultures (and endotracheal tube tip cultures) isolated meropenem- and gentamicin-resistant strain of rare pathogen Ralstonia mannitolilytica. Ralstonia spp are aerobic, Gram-negative, lactose nonfermenting, oxidase- and catalase-positive bacilli, thriving in water and soil. Ralstonia spp are identified only sporadically as causative agents of neonatal sepsis; to our knowledge this is the second report of neonatal sepsis due to R. mannitolilytica in the literature so far. Our patient was eventually treated (per sensitivity pattern) with intravenous ciprofloxacin, and recovered well from the infection. Conclusion: We intend to raise awareness among neonatologists with regards to early detection of unusual pathogens, emergence of antibiotic resistance patterns, and obligation for adherence to infection control policies.

scholarly journals Uropathogens from diabetic patients in Libya: virulence factors and phylogenetic groups of Escherichia coli isolates

2009 ◽  
Vol 58 (8) ◽  
pp. 1006-1014 ◽  
Author(s):  
Khalifa Sifaw Ghenghesh ◽  
Einass Elkateb ◽  
Nuri Berbash ◽  
Rania Abdel Nada ◽  
Salwa F. Ahmed ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Developing Countries ◽  
Virulence Factors ◽  
Antimicrobial Agents ◽  
Developed Countries ◽  
Diffusion Method ◽  
Diabetic Patients ◽  
Phylogenetic Groups ◽  
Phylogenetic Grouping ◽  
Tract Infections

Urinary tract infections (UTIs) in patients with diabetes mellitus (DM) are reported mainly from developed countries. In addition to this underreporting from developing countries, there is a lack of information pertaining to the virulence factors (VFs) and phylogenetic grouping of uropathogenic Escherichia coli (UPEC) from DM and non-DM patients in developing countries. Between July 2005 and June 2006, urine specimens were collected from 135 DM and 164 non-DM patients, all with clinically diagnosed UTIs, attending Elkhadra Hospital and the Diabetic Center in Tripoli, Libya. Specimens were examined for different uropathogens using standard microbiological procedures. Isolated uropathogens were tested for their susceptibility to antimicrobial agents by a disc diffusion method. In addition, UPEC was grouped phylogenetically by PCR and subsequently tested for 19 VFs. Uropathogens were isolated from 77 (57 %) of the DM group and from 110 (67 %) of the non-DM group (P >0.05). E. coli was isolated from 18 (13 %) and 29 (18 %), Klebsiella species from 18 (13 %) and 23 (14 %), and Staphylococcus aureus from 12 (9 %) and 12 (7 %) of the DM and non-DM groups, respectively (P >0.05). Age, gender, education level and marital status had no significant influence on the isolation rates of different organisms from the DM group compared with the non-DM group. With very few exceptions, no differences were observed in the antimicrobial resistance profiles of uropathogens from the DM and non-DM patients. In addition, UPEC from the DM patients was significantly less virulent and was associated with phylogenetic group A, whilst UPEC from the non-DM patients was significantly more virulent and was associated with group D. The results of our surveillance of UTI infections in DM patients agree, in general, with observations reported previously from several developed countries.

scholarly journals Early-Onset Neonatal Sepsis

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Marija Jovicic ◽  
Marko Folic ◽  
Slobodan Jankovic
Keyword(s):  
Neonatal Sepsis ◽  
Early Onset ◽  
Clinical Symptoms ◽  
Late Onset ◽  
Pediatric Population ◽  
Consensus Conference ◽  
Antibiotic Administration ◽  
Perinatal Medicine ◽  
Suspected Sepsis ◽  
Early Onset Sepsis

Abstract Despite the great progress made in neonatal and perinatal medicine over the last couple of decades, sepsis remains one of the main causes of morbidity and mortality. Sepsis in pediatric population was defined at the Pediatric Sepsis Consensus Conference in 2005. There is still no consensus on the definition of neonatal sepsis. Neonatal sepsis is a sepsis that occurs in the neonatal period. According to the time of occurrence, neonatal sepsis can be of early onset, when it occurs within the first 72 hours of birth and results from vertical transmission, and of late onset, in which the source of infection is found most often in the environment and occurs after the third day of life. The most common causes of early-onset sepsis are Group B Streptococcus (GBS) and E. coli. Risk factors can be mother-related and newborn-related. Clinical symptoms and signs of sepsis are quite unspecific. The dysfunction of different organs may imitate sepsis. On the other hand, infectious and non-infectious factors may exist simultaneously. The start of the antimicrobial therapy in any newborn with suspected sepsis should not be delayed. Pentoxifylline may have potential benefits in preterm newborns with sepsis. The only proven intervention that has been shown to reduce the risk of early-onset neonatal sepsis is intrapartum intravenous antibiotic administration to prevent GBS infection. It is still a great challenge to discontinue antibiotic treatment in non-infected newborns as soon as possible, because any extended antibiotic use may later be associated with other pathological conditions.

scholarly journals Clinico-bacteriological profile of neonatal sepsis in rural tertiary care hospital

2017 ◽  
Vol 4 (4) ◽  
pp. 1259
Author(s):  
K. Venkataramana Reddy ◽  
K. Sailaja ◽  
A. Ashok ◽  
K. Poojitha
Keyword(s):  
Developing Countries ◽  
Neonatal Mortality ◽  
Neonatal Sepsis ◽  
Opportunistic Infections ◽  
Tertiary Care ◽  
Developed Countries ◽  
Care Hospital ◽  
Group B Streptococci ◽  
Mortality And Morbidity ◽  
Group B

Background: Neonatal sepsis one of the most common cause for neonatal mortality and morbidity in developing countries. Group B Streptococci being the most common organism in developed countries, whereas CONS and Gram negative bacteria frequently encountered organisms in developing countries. It is advisable to have an individualised institutional protocol based on their own culture reports to reduce the antibiotic resistance.Methods:A prospective observational study was conducted from September 2016- February 2017, at the Department of Paediatrics, S.V.S. Medical College and Hospital, Mahabubnagar, Telangana, India. The study included 65 neonates admitted in our NICU. A questionnaire was filled by mothers after taking consent. Data was Collected data was analysed.Results: In present study, we found that CONS were the most commonly isolated organisms followed by Klebsiella.Conclusions:Neonatal sepsis creates a significant burden due to its impact on neonatal mortality and long-term morbidity. Following proper hand washing techniques with minimal handling in intensive care units will reduce neonatal sepsis from opportunistic infections. 

Clinical features and bacteriological profile of late onset sepsis

2017 ◽  
Vol 4 (2) ◽  
pp. 361
Author(s):  
Purnima Samayam ◽  
Ravichander B.
Keyword(s):  
Staphylococcus Aureus ◽  
Neonatal Sepsis ◽  
Late Onset ◽  
Birth Asphyxia ◽  
Hospital Environment ◽  
Preterm Neonates ◽  
Causative Organism ◽  
Coagulase Negative Staphylococcus ◽  
Bacteriological Profile ◽  
Late Onset Sepsis

Background: Neonatal sepsis is one of the major causes of morbidity and mortality in the neonatal period. Late onset sepsis (LOS) is associated with community environment or postnatal exposure to hospital environment. It's incidence is rising due to greater survival of preterm neonates and very low birth weight babies. The bacterial isolates of neonatal sepsis especially that in LOS are changing. An understanding of the changing epidemiology of neonatal LOS will help to reduce the associated mortality and morbidity. The objective was to study the clinical symptoms and signs of late onset sepsis, to study the bacteriological profile of LOS.Methods: A prospective observational study. All neonates presenting with signs and symptoms of sepsis after 72 hours of life up to day 28 were included. Babies with birth asphyxia and congenital anomalies were excluded from the study.Results: A total of 120 newborns with LOS were included in the study. Of this 42.5% had blood culture positive sepsis. Lethargy, refusal of feeds and apnoea were seen in 61.66%, 55.0% and 34.17% of babies respectively. Klebsiella (25.49%), Staphylococcus aureus (23.53%) and coagulase negative Staphylococcus (21.57%) were the predominant organisms isolated in LOS.Conclusions: Prompt diagnosis of neonatal sepsis is a challenge. The incidence of LOS in neonates is rising. Klebsiella is the most common gram negative organism; Staphylococcus aureus and CONS are the predominant gram positive organisms. CONS is emerging as an important causative organism in LOS.

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