scholarly journals Neonatal sepsis: A review of the literature

2021 ◽  
Vol 3 (1) ◽  
pp. 94-101
Author(s):  
Adonis Muganza Nyenga ◽  
◽  
Olivier Mukuku ◽  
Stanis Okitotsho Wembonyama ◽  
◽  
...  
Keyword(s):  
Risk Factors ◽  
Neonatal Sepsis ◽  
Neonatal Morbidity ◽  
Essential Elements ◽  
Postnatal Period ◽  
Therapeutic Interventions ◽  
Hospital Environment ◽  
Definitive Treatment ◽  
Microbial Culture ◽  
Transmitted Infection

Neonatal sepsis contributes significantly to neonatal morbidity and mortality and is a major public health challenge around the world. Depending on the mode of occurrence, a distinction is made between maternal-transmitted infection and that acquired in the postnatal period. Although the etiologies maternally transmitted diseases are well understood, those of postnatal acquired infections are variable depending on the epidemiology of each hospital environment. On the one hand, risk factors for maternal-transmitted infections are maternal sepsis, prolonged premature rupture of membranes, chorioamnionitis, and bacteriuria in the mother during pregnancy. On the other hand, risk factors for postnatal acquired infections are prematurity, low birth weight, lack of hygiene, and invasive therapeutic interventions. The diagnosis is based on a series of anamnestic, clinical and biological features. Although the positive diagnosis is based on the isolation of the germ by culture on a body sample (blood, cerebrospinal fluid, urine, etc.); its low sensitivity leads to the use of markers of the acute phase of inflammation such as C-reactive protein, procalcitonin and interleukins. New molecular biology techniques are promising and offer precise diagnosis with rapid results. Empirical management is a function of microbial ecology while definitive treatment is guided by the results of microbial culture. This article presents the essential elements for understanding neonatal sepsis and discusses new diagnosis and therapeutic management. It offers a thorough reading based on the issue of infections in newborns.

Neonatal Sepsis: A Review of the Literature

2021 ◽  
Vol 6 (2) ◽  
Author(s):  
Nyenga AM ◽  
◽  
Mukuku O ◽  
Wembonyama SO ◽  
◽  
...  
Keyword(s):  
Risk Factors ◽  
Neonatal Sepsis ◽  
Neonatal Morbidity ◽  
Essential Elements ◽  
Postnatal Period ◽  
Therapeutic Interventions ◽  
Hospital Environment ◽  
Definitive Treatment ◽  
Microbial Culture ◽  
Transmitted Infection

Neonatal sepsis contributes significantly to neonatal morbidity and mortality and is a major public health challenge around the world. Depending on the mode of occurrence, a distinction is made between maternal-transmitted infection and that acquired in the postnatal period. Although the etiologies maternally transmitted diseases are well understood, those of postnatal acquired infections are variable depending on the epidemiology of each hospital environment. On the one hand, risk factors for maternal-transmitted infections are maternal sepsis, prolonged premature rupture of membranes, chorioamnionitis, and bacteriuria in the mother during pregnancy. On the other hand, risk factors for postnatal acquired infections are prematurity, low birth weight, lack of hygiene, and invasive therapeutic interventions. The diagnosis is based on a series of anamnestic, clinical and biological features. Although the positive diagnosis is based on the isolation of the germ by culture on a body sample (blood, cerebrospinal fluid, urine, etc.); its low sensitivity leads to the use of markers of the acute phase of inflammation such as C-reactive protein, procalcitonin and interleukins. New molecular biology techniques are promising and offer precise diagnosis with rapid results. Empirical management is a function of microbial ecology while definitive treatment is guided by the results of microbial culture. This article presents the essential elements for understanding neonatal sepsis and discusses new diagnosis and therapeutic management. It offers a thorough reading based on the issue of infections in newborns.

scholarly journals A study on the obstetric outcome in preterm pre-labour rupture of membranes

2020 ◽  
Vol 10 (1) ◽  
pp. 78
Author(s):  
Anusree Saraswathy ◽  
Ajitha Ravindran ◽  
Jayshree V. Vaman ◽  
C. Nirmala
Keyword(s):  
Neonatal Sepsis ◽  
Early Onset ◽  
Tertiary Care ◽  
Expectant Management ◽  
Neonatal Morbidity ◽  
Fetal Distress ◽  
Postnatal Period ◽  
Neonatal Deaths ◽  
Management Scheme ◽  
Gestational Age At Delivery

Background: The major risks to the baby following preterm pre-labour rupture of membranes (PPROM) are related to the complications of prematurity. Since the goal of management in PPROM is prolongation of pregnancy, the most commonly accepted management scheme for the patient less than 34 weeks is expectant management in the hospital which consists of careful observation for signs of infection, labour or fetal distress in an effort to gain time for fetal growth and maturation.Methods: Patients admitted in Obstetrics and Gynaecology Department SAT Hospital, Medical College Trivandrum, Kerala with PPROM meeting the inclusion and exclusion criteria were recruited for the study. They were followed in the antenatal, intrapartum and postnatal period and the babies were also followed in the postnatal ward. The maternal and neonatal outcome were analysed and studied.Results: Maternal chorioamnionitis developed in 12.1% of cases, abruption 1.7%, puerperal pyrexia 8.8%, early onset neonatal sepsis in 22.9% of cases, congenital pneumonia in 17% cases and neonatal deaths in 6.3% of cases. The mean gestational age at delivery in this study was 33.42 weeks with majority of cases delivering between 32-34 weeks.Conclusions: The study suggests that maternal chorioamnionitis, puerperal pyrexia, congenital pneumonia, early onset neonatal sepsis, neonatal death, and requirement for ICU care occur with increased frequency in cohorts with PPROM. The present study concluded that most common maternal morbidity associated with PPROM was chorioamnionitis, that of neonatal morbidity was prematurity and its complications. A team effort by the obstetrician and neonatologist in a tertiary care setting can ensure healthy and fruitful life for the mother and her baby.

scholarly journals Frequency of maternal risk factors in diagnosed cases of early neonatal sepsis.

2019 ◽  
Vol 26 (12) ◽  
pp. 2044-2047
Author(s):  
Faraz Ahmed ◽  
Mohsin Ali ◽  
Hussan Ali Sarwar ◽  
Miqdad Haider ◽  
Muhammad Bilal Safdar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Preterm Delivery ◽  
Neonatal Sepsis ◽  
Neonatal Morbidity ◽  
Cross Sectional Study ◽  
Maternal Risk Factors ◽  
Cross Sectional ◽  
Maternal Risk ◽  
Early Neonatal Sepsis ◽  
Study Setting

One of the major and important but preventable causes of neonatal morbidity and mortality is Neonatal sepsis. Objectives: To determine the frequency of maternal risk factors in diagnosed cases of early neonatal sepsis. Study Design: Descriptive cross sectional study. Setting: Nursery, Department of Children Hospital and the institute of child health, Lahore. Period: 15-01-2016 to 15-07-2016. Material and Methods: After approval from hospital ethical committee, according to inclusion and exclusion criteria, 250 patients were enrolled in the study from nursery department of children hospital, Lahore. Maternal risk factors i.e. PROM, meconium stained liquor and preterm delivery were recorded along with the demographic information of each case. Results: In our study, out of 250 cases, cases between 1-2 days were 64.8% (n=162) while cases between 3 days of life were 35.2% (n=88), mean+sd was resulted as 2.17+0.69 days. Frequency of maternal risk factors in diagnosed cases of early neonatal sepsis was turned out as 64.8% (n=162) PROM, 29.6% (n=74) meconium stained liquor and preterm delivery was resulted in 21.2% (n=53). Conclusion: The leading maternal risk factor is PROM followed by meconium stained liquor and preterm delivery in diagnosed cases of early neonatal sepsis.

scholarly journals Study of renal profile in septicemic neonates

2018 ◽  
Vol 5 (2) ◽  
pp. 448
Author(s):  
Sharwari J. Bhutada ◽  
Chandrakant M. Bokade
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Gestational Age ◽  
Neonatal Sepsis ◽  
Age Of Onset ◽  
Tertiary Care ◽  
Neonatal Morbidity ◽  
Morbidity And Mortality ◽  
P Value ◽  
Etiological Agents

Background: Neonatal sepsis can cause multiorgan involvement causing neonatal morbidity and mortality. The kidneys are an important organ affected in septicemic newborns. In this study we evaluated the renal functions and its association with various risk factors along with outcome in septicemic neonates.Methods: This study was a prospective observational study conducted in a tertiary care teaching hospital. The sample size was 276 cases of septicemic new-borns and study duration was 2 years. The profile of acute renal failure (ARF) and various risk factors were studied in a sample of 276 septicemic neonates. Detailed clinical examination and investigations were done to confirm the diagnosis of neonatal sepsis and the occurrence of ARF was studied among these septicemic newborns. Risk factors like birth weight, gestational age, shock, etiological agents, DIC were studied for the occurrence of ARF and mortality in ARF patients among septicemic neonates.Results: 30.07% of septicemic neonates developed ARF. DIC (p value=0.014), shock (p value=<0.0001), gestational age (p value=0.005), birth weight (p value=0.003), were found to be analytically significant for the occurrence of ARF. Birth weight (p value=0.006), age of onset of sepsis (p value=0.019), shock (p value =<0.0001), oliguria (p value =<0.0001), and DIC (p value=0.015) were significant predictors of mortality in ARF among septicemic neonates.Conclusions: Awareness and early identification of various risk factors and ARF in septicemic neonates can prevent morbidity and mortality among neonates. 

scholarly journals Neonatal sepsis following prolonged rupture of membranes in a tertiary care hospital in Karachi, Pakistan

2014 ◽  
Vol 8 (01) ◽  
pp. 067-073 ◽  
Author(s):  
Muhammad Matloob Alam ◽  
Ali Faisal Saleem ◽  
Abdul Sattar Shaikh ◽  
Owais Munir ◽  
Maqbool Qadir
Keyword(s):  
Risk Factors ◽  
Neonatal Sepsis ◽  
Tertiary Care ◽  
Group B Streptococcus ◽  
Neonatal Morbidity ◽  
Cost Effective ◽  
Klebsiella Pneumonia ◽  
Care Hospital ◽  
Local Data ◽  
Group B

Introduction: Prolonged rupture of membrane (PROM) is an important risk factor for early onset neonatal sepsis (EONS), which is associated with increased neonatal morbidity and mortality. We reported the incidence and associated risk factors of PROM for culture-proven EONS. Methodology:The medical records of all neonates born at Aga Khan University, Karachi over a period of five years (2007-2011) with PROM (> 18 hours) were reviewed. Data about maternal and neonatal risk factors for EONS was collected and adjusted logistic regression (AOR) analysis was applied. Results:Incidence of PROM in this neonatal birth cohort was 27/1,000 live births. A total of 17 (4%) cases with blood-culture proven bacterial sepsis were identified within 72 hours of birth. Klebsiella pneumonia (n = 5; 29%) and Pseudomonas aeruginosa (n = 4; 24%) were the commonest isolates followed by group B Streptococcus (n = 3; 18%) and Escherichia coli (n = 2; 12%). Maternal fever (p = <0.001; AOR, 36.6), chorioamnionitis (p < 0.001; AOR, 4.1), PROM > 48 hr. (p < 0.001; AOR, 8.2), neonatal prematurity < 34 weeks (p < 0.001; AOR, 4.1) and low birth weight < 1,500 grams (p 0.001; AOR, 9.8) along with neonatal thrombocytopenia and raised CRP were found to be independent risk factors associated with culture-proven EONS in PROM. Conclusions: Preventive measures should focus on recognition of these high-risk infants with prompt laboratory screening for sepsis and early institution of empirical antibiotic based on local data. Such approaches would be a safe and cost-effective strategy, especially in developing countries.

scholarly journals The Risk Factors of Bacterial Meningitis in Late-Onset Neonatal Sepsis

2021 ◽  
Vol 9 (B) ◽  
pp. 1224-1228
Author(s):  
Ni Made Reditya Noviyani ◽  
I Made Kardana ◽  
Dewi Sutriani Mahalini ◽  
Ida Bagus Gede Suparyatha ◽  
Ketut Ariawati ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Bacterial Meningitis ◽  
Gestational Age ◽  
Neonatal Sepsis ◽  
Late Onset ◽  
Invasive Procedure ◽  
Neonatal Morbidity ◽  
Chi Square ◽  
Comprehensive Management

BACKGROUND: Neonatal bacterial meningitis has a significant contribution on neonatal morbidity and mortality. It is the most common complication of late-onset neonatal sepsis. An understanding of the risk factors for bacterial meningitis in late-onset neonatal sepsis is required to provide comprehensive management. AIM: To identify the risk factors of bacterial meningitis in late-onset neonatal sepsis. METHODS: This is an analytical study with a case–control design, conducted in May 2019-February 2021, involving neonates aged 4–28 days who suffered from late-onset neonatal sepsis in Level II and III Neonatal Care Unit, Sanglah General Hospital Denpasar. Statistical analysis was performed using Chi-square and logistic regression. RESULTS: A total of 54 patients were analyzed in this study. The mean age of subjects with neonatal bacterial meningitis was 13 days and the majority of them were male (51.9%). The risk factor of bacterial meningitis in late-onset neonatal sepsis was gestational age <37 weeks with odds ratio 4.22 (95% confidence interval 1.28–13.86, p = 0.01). There was no significant association of birth weight <2500 g, neonatal asphyxia, and invasive procedure on neonatal bacterial meningitis. CONCLUSION: Gestational age <37 weeks is a risk factor for bacterial meningitis in late-onset neonatal sepsis.

NEONATAL SEPSIS AND IDENTIFICATION OF RISK FACTORS: STUDY IN AVBRH HOSPITAL SAWANGI

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Pramod P. Singhavi
Keyword(s):  
Risk Factors ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Late Onset ◽  
Signs And Symptoms ◽  
Premature Rupture ◽  
Maternal Risk ◽  
Late Onset Sepsis ◽  
Early Onset Sepsis ◽  
Meconium Stained Amniotic Fluid

Introduction: India has the highest incidence of clinical sepsis i.e.17,000/ 1,00,000 live births. In Neonatal sepsis septicaemia, pneumonia, meningitis, osteomyelitis, arthritis and urinary tract infections can be included. Mortality in the neonatal period each year account for 41% (3.6 million) of all deaths in children under 5 years and most of these deaths occur in low income countries and about one million of these deaths are due to infectious causes including neonatal sepsis, meningitis, and pneumonia. In early onset neonatal sepsis (EOS) Clinical features are non-specific and are inefficient for identifying neonates with early-onset sepsis. Culture results take up to 48 hours and may give false-positive or low-yield results because of the antenatal antibiotic exposure. Reviews of risk factors has been used globally to guide the development of management guidelines for neonatal sepsis, and it is similarly recommended that such evidence be used to inform guideline development for management of neonatal sepsis. Material and Methods: This study was carried out using institution based cross section study . The total number neonates admitted in the hospital in given study period was 644, of which 234 were diagnosed for neonatal sepsis by the treating pediatrician based on the signs and symptoms during admission. The data was collected: Sociodemographic characteristics; maternal information; and neonatal information for neonatal sepsis like neonatal age on admission, sex, gestational age, birth weight, crying immediately at birth, and resuscitation at birth. Results: Out of 644 neonates admitted 234 (36.34%) were diagnosed for neonatal sepsis by the paediatrician based on the signs and symptoms during admission. Of the 234 neonates, 189 (80.77%) infants were in the age range of 0 to 7 days (Early onset sepsis) while 45 (19.23%) were aged between 8 and 28 days (Late onset sepsis). Male to female ratio in our study was 53.8% and 46% respectively. Out of total 126 male neonates 91(72.2%) were having early onset sepsis while 35 (27.8%) were late onset type. Out of total 108 female neonates 89(82.4%) were having early onset sepsis while 19 (17.6%) were late onset type. Maternal risk factors were identified in 103(57.2%) of early onset sepsis cases while in late onset sepsis cases were 11(20.4%). Foul smelling liquor in early onset sepsis and in late onset sepsis was 10(5.56%) and 2 (3.70%) respectively. In early onset sepsis cases maternal UTI, Meconium stained amniotic fluid, Multipara and Premature rupture of membrane was seen in 21(11.67%), 19 (10.56%), 20(11.11%) and 33 (18.33%) cases respectively. In late onset sepsis cases maternal UTI, Meconium stained amniotic fluid, Multipara and Premature rupture of membrane was seen in 2 (3.70%), 1(1.85%), 3 (5.56%) and 3 (5.56%) cases respectively. Conclusion: Maternal risk identification may help in the early identification and empirical antibiotic treatment in neonatal sepsis and thus mortality and morbidity can be reduced.

Cardiovascular Risk in Perimenopausal Women

2019 ◽  
Vol 17 (6) ◽  
pp. 591-594 ◽  
Author(s):  
John C. Stevenson ◽  
Sophia Tsiligiannis ◽  
Nick Panay
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Ovarian Function ◽  
Density Lipoprotein ◽  
Premenopausal Women ◽  
Therapeutic Interventions ◽  
Additional Risk Factor ◽  
Chd Risk ◽  
Perimenopausal Women ◽  
Chd Risk Factors

Cardiovascular disease, and particularly coronary heart disease (CHD), has a low incidence in premenopausal women. Loss of ovarian hormones during the perimenopause and menopause leads to a sharp increase in incidence. Although most CHD risk factors are common to both men and women, the menopause is a unique additional risk factor for women. Sex steroids have profound effects on many CHD risk factors. Their loss leads to adverse changes in lipids and lipoproteins, with increases being seen in low density lipoprotein (LDL) cholesterol and triglycerides, and decreases in high density lipoprotein (HDL) cholesterol. There is a reduction in insulin secretion and elimination, but increases in insulin resistance eventually result in increasing circulating insulin levels. There are changes in body fat distribution with accumulation in central and visceral fat which links to the other adverse metabolic changes. There is an increase in the incidence of hypertension and of type 2 diabetes mellitus, both major risk factors for CHD. Oestrogens have potent effects on blood vessels and their loss leads to dysfunction of the vascular endothelium. All of these changes result from loss of ovarian function contributing to the increased development of CHD. Risk factor assessment in perimenopausal women is recommended, thereby permitting the timely introduction of lifestyle, hormonal and therapeutic interventions to modify or reverse these adverse changes.

scholarly journals A Review of Colorectal Cancer in Terms of Epidemiology, Risk Factors, Development, Symptoms and Diagnosis

Cancers ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 2025
Author(s):  
Tomasz Sawicki ◽  
Monika Ruszkowska ◽  
Anna Danielewicz ◽  
Ewa Niedźwiedzka ◽  
Tomasz Arłukowicz ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Physical Inactivity ◽  
Ecological Factors ◽  
Population Based ◽  
Review Article ◽  
Therapeutic Interventions ◽  
Factors Associated ◽  
Hereditary Factors ◽  
Disease Stages

This review article contains a concise consideration of genetic and environmental risk factors for colorectal cancer. Known risk factors associated with colorectal cancer include familial and hereditary factors and lifestyle-related and ecological factors. Lifestyle factors are significant because of the potential for improving our understanding of the disease. Physical inactivity, obesity, smoking and alcohol consumption can also be addressed through therapeutic interventions. We also made efforts to systematize available literature and data on epidemiology, diagnosis, type and nature of symptoms and disease stages. Further study of colorectal cancer and progress made globally is crucial to inform future strategies in controlling the disease’s burden through population-based preventative initiatives.

scholarly journals A comparative risk assessment of dialysis care processes in the home and hospital care contexts

2020 ◽  
Vol 11 (5) ◽  
pp. 985-1002
Author(s):  
Peter Chemweno ◽  
Liliane Pintelon
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Home Care ◽  
Domain Knowledge ◽  
Assessment Process ◽  
Hospital Environment ◽  
Negative Consequences ◽  
Comparative Risk Assessment ◽  
Care Givers ◽  
Comparative Risk

Abstract Dialysis processes within the home care context is associated with risk factors which are not very prominent in the hospital context. This includes risk factors such as unanticipated device malfunction, or erroneous operation of the equipment, which exposes the patient to injury while undergoing dialysis. Importantly, the mentioned risk factors are further attributed to technical aspects such as sub-optimal equipment maintenance or following improper clinical procedures when administering care to the patient. Hence, it is important to follow a methodological approach to identify and assess hazards embedded within the dialysis treatment process, and on this basis, formulate effective strategies to mitigate their negative consequences on patient safety. This paper presents a comparative risk assessment for in-hospital versus in-home dialysis care. For the two cases, the risk assessment considers expertise of care givers involved in administering dialysis. The findings show that performing risk assessment for hospital environment, is more structured owing to expertise of clinicians and care givers responsible for administering dialysis. However, assessing risks for the home-care environment is more challenging owing to absence of domain knowledge, hence a survey approach to structure the risk assessment process is necessary. Moreover, risks in the home care context is influenced by logistical aspects, and lack of domain knowledge for maintaining dialysis equipment. Overall, insights from the comparative studies yields important learning points expected to improve dialysis care as more healthcare providers transfer care to the home environment.

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