scholarly journals Presentation and outcomes of early and late onset neonatal sepsis in a Nigerian Hospital

2019 ◽  
Vol 19 (3) ◽  
pp. 2390-2399
Author(s):  
Ezra Ogundare ◽  
Akinyemi Akintayo ◽  
Theophilus Aladekomo ◽  
Lateef Adeyemi ◽  
Tinuade Ogunlesi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Life Support ◽  
Late Onset ◽  
Significant Risk ◽  
Birth Asphyxia ◽  
Diffusion Method

Background: Neonatal Sepsis remains a major cause of morbidity and mortality in neonates despite great advances in antimicrobial therapy and life support measures.Objectives: To compare the aetiology, risk factors, presentation and outcomes of care between early onset neonatal sepsis (EOS) and late onset neonatal sepsis (LOS).Methods: Bacterial isolates were identified using blood cultures and antibiotic susceptibility testing was done using disc diffusion method. The risk factors, clinical presentation, laboratory findings and neonatal outcomes of the babies with EOS were compared with LOS. Statistical significance was set at P <0.05.Results: Neonatal Sepsis was responsible for 16% of Special Care Baby Unit (SCBU) admissions. Of the 72 babies with sepsis, 56 (77.8%) had EOS as against 16 (22.2%) who had late-onset sepsis. Low birth weight (p=0.01) and perinatal asphyxia (p=0.01) were significantly associated with EOS while for LOS, delivery outside the health facility (p=0.01) was the only significant risk factor. Respiratory distress was more significantly observed in EOS (p = 0.01). Neonatal deaths occurred in 32% of babies with EOS while all babies with culture positive LOS survived.Conclusion: Early onset neonatal sepsis is associated with high likelihood of neonatal mortality. Unsupervised delivery, birth asphyxia and low birth weight are risk factors associated with neonatal sepsis. Efforts to ensure supervised hospital delivery and improvement in neonatal resuscitation may reduce the incidence of neonatal sepsis and its attendant complications.Keywords: Onset neonatal , Nigerian Hospital.

scholarly journals Study of risk factors of neonatal thrombocytopenia

2016 ◽  
Vol 4 (1) ◽  
pp. 191 ◽  
Author(s):  
Keerthi Tirupathi ◽  
Keerti Swarnkar ◽  
Jayant Vagha
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Early Onset ◽  
Late Onset ◽  
Birth Asphyxia ◽  
Severe Thrombocytopenia ◽  
Low Birth Weight Babies ◽  
Neonatal Thrombocytopenia ◽  
Neonatal Risk Factors

Background: Neonatal thrombocytopenia (platelet count < 1.5 lac/µl) is the commonest haematological abnormality encountered in neonatal intensive care unit (NICU). Thrombocytopenia if not detected can result in devastating complications. Determining the risk factors of thrombocytopenia enables us to prevent the inevitable and irreversible complications. The present study highlights the pattern, severity and risk factors of neonatal thrombocytopenia in our hospital.Methods: Prospective observational study was conducted on 200 neonates with thrombocytopenia admitted in NICU of our hospital. Maternal and neonatal risk factors were recorded. Neonates were grouped based on the severity of thrombocytopenia. The risk factors were compared with severity of thrombocytopenia.Results: 200 neonates with thrombocytopenia were divided into three groups based on severity of thrombocytopenia. 81% of babies had moderate to severe thrombocytopenia. The most common maternal predisposing factors were pregnancy induced hypertension (PIH), premature rupture of membranes (PROM) and anemia.62.5% babies were low birth weight babies and they had severe thrombocytopenia. 56% babies had late onset neonatal thrombocytopenia and 44% had early onset thrombocytopenia. The most common neonatal risk factors were sepsis in 48.5% babies and birth asphyxia in 20% babies.Conclusions: The severity of neonatal thrombocytopenia in our NICU was moderate to severe type. PIH, PROM and anemia were the commonest maternal risk factors. Preterm and low birth weight babies had severe thrombocytopenia. Sepsis and birth asphyxia were the commonest neonatal risk factors. Birth asphyxia was associated with early onset neonatal thrombocytopenia and sepsis was associated with late onset thrombocytopenia. Severe thrombocytopenia can be used as a prognostic indicator in sick neonates. 

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. 

scholarly journals Patient characteristics, Bacteriological profile & outcome of Neonatal Sepsis: A Hospital Based Study

2013 ◽  
Vol 2 (1) ◽  
pp. 49-54
Author(s):  
Nasim Jahan ◽  
Zabrul SM Haque ◽  
Md Abdul Mannan ◽  
Morsheda Akhter ◽  
Sabina Yasmin ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Late Onset ◽  
Female Ratio ◽  
Gram Negative ◽  
Common Pathogen ◽  
Late Onset Sepsis ◽  
Early Onset Sepsis

Neonatal sepsis is a major cause of mortality and morbidity in newborn. The spectrum of bacteria which causes neonatal sepsis varies in different parts of the world. The organisms responsible for early onset and late onset sepsis are different. The objective of the study was undertaken to determine the pattern of bacterial isolates responsible for early and late onset neonatal sepsis. A prospective descriptive study over the period of one year was conducted at the Department of Neonatal Intensive care unit of Ad-din Women’s Medical College and Hospital, Dhaka, Bangladesh.Organisms were isolated from 8.7% of collected blood samples. The male female ratio of culture proven sepsis was 1.7:1. More than half (52.8%) of the evaluated neonates were preterm. & 56.3% had low birth weight. The gram positive and gram negative bacteria accounted for 24.1% and 75.9% of the isolates respectively. Around three fourth of the neonates (75.8%) presented with early onset sepsis, while 24.2% presented with late onset sepsis. Acinetobacter was the most common pathogen both in early onset (70%) and late onset (30%) sepsis. Pseudomonas (89.4%) was the second most common pathogen in early onset sepsis. Total mortality rate was 5.7%. Pre term, low birth weight and gram negative sepsis contributes majority of mortality.Gram negative organism especially Acinetobacter found to be commonest cause of sepsis. Pseudomonas was second most common but contributed highest in late onset sepsis and neonatal death due to sepsis. DOI: http://dx.doi.org/10.3329/cbmj.v2i1.14184 Community Based Medical Journal Vol.2(1) 2013 49-54

Neonatal sepsis in southwest of Iran; prevalence of microbial pathogens, risk factors, clinical manifestations and laboratory findings

2020 ◽  
Author(s):  
Marjan Salahi ◽  
Abdolkarim Ghadimi Moghadam ◽  
Ali Mousavizadeh ◽  
Masoud Marashifard ◽  
Seyed Jabar Taghavi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Neonatal Sepsis ◽  
Late Onset ◽  
Clinical Manifestations ◽  
Diffusion Method ◽  
Laboratory Findings ◽  
Early Onset Sepsis ◽  
Southwest Of Iran ◽  
Susceptibility Patterns

Abstract Background: Neonatal sepsis is a serious worldwide problem causing significant rates of mortality and morbidity in newborns, especially in cases with delayed infection diagnosis and management. The present study aimed to evaluate the bacteriological profiles, antibiotic susceptibility patterns, risk factors, clinical manifestations, and laboratory findings in neonatal sepsis in southwest of Iran. Methods: In this descriptive-analytic study, 342 neonates with suspected sepsis admitted to the neonatal ward and NICU were included. Using standard protocols, blood samples were transported to the BACTEC blood culture system. Then, conventional biochemical tests were used for the identification of bacterial genera and species. The bacterial antimicrobial susceptibility patterns were determined usingagardisk diffusion method according to the CLSI guidelines. Demographic data, clinical findings, risk factors, mortality rates, and laboratory parameters were collected for each patient. Results: Forty-three (12.6%) cases were culture-positive, among whichCoNS, Staphylococcus aureus, Escherichia coli, Acinetobacter and Beta hemolytic streptococcus were the most prevalent. The prevalence of early-onset sepsis and late-onset sepsis were 53.5% and 46.5%, respectively. Significant differences between prematurity, very low birth weight, and invasive procedures were observedbetween neonates with and without sepsis. Teicoplanin and vancomycin were the most efficient antibiotics against Gram-positive bacteria, while amikacinwas more efficient against Gram-negative bacteria. Conclusion: Risk factors such as prematurity, abnormal birth weight, anemia, leukopenia, prolonged hospitalization, and invasive processes and cesarean section, can increase the incidence of neonatal sepsis.

scholarly journals Clinical, Bacteriological Profile & Outcome of Neonatal Sepsis in a Tertiary Care Hospital

2014 ◽  
Vol 26 (1) ◽  
pp. 18-21 ◽  
Author(s):  
Biplob Kumar Raha ◽  
Md Abdul Baki ◽  
Tahmina Begum ◽  
Nazmun Nahar ◽  
Nasim Jahan ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Klebsiella Pneumoniae ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Late Onset ◽  
Gram Negative ◽  
Common Pathogen ◽  
Late Onset Sepsis ◽  
Early Onset Sepsis

Neonatal sepsis is a major cause of mortality and morbidity in newborn, particularly in developing countries. The spectrum of bacteria which causes neonatal sepsis varies in different parts of the world. The organisms responsible for early onset and late onset sepsis are different. The objective of the study was undertaken to determine the pattern of bacterial isolates responsible for early and late onset neonatal sepsis based on the presence of one or more clinical signs, and its outcome. A cross- sectional prospective study was carried out in the special care baby unit (SCABU) from November 2008 to September 2009 under department of Paediatrics and Neonatology, BIRDEM General Hospital, Dhaka, Bangladesh. Organisms were isolated from 8.9% of collected blood samples. The male female ratio of culture proven sepsis was 1.7:1. Most of the culture proven septic neonates(71.88%) were preterm & 65.63% had low birth weight. The most frequent clinical presentations of patients with culture-proven sepsis were poor moro reflex (92.2%), feeding intolerance (90.6%), jaundice (87.5%), abdominal distention (76.6%), and lathergy (73.4%). The Gram positive and Gram negative bacteria accounted for 6 (9.4% ) and 58 (90.6%) of the isolates respectively. Around two third of the culture-proven septic neonates (70.3%) presented with early onset sepsis, while 29.7% presented with late onset sepsis. Klebsiella pneumoniae was the most common pathogen both in early onset (31.25%) and late onset (6.25%) sepsis. Serratia (18.75%) was the second most common pathogen in early onset sepsis. Total mortality rate was 9.38%. Preterm, low birth weight and Gram negative sepsis contributes majority of mortality. Gram negative organism especially Klebsiella pneumoniae contributed highest in early onset sepsis and neonatal death (6.25%) due to sepsis. DOI: http://dx.doi.org/10.3329/medtoday.v26i1.21306 Medicine Today 2014 Vol.26(1): 18-21

scholarly journals Forecasting the possibility of neonatal early onset sepsis based on perinatal risk factors

2020 ◽  
Vol 7 (7) ◽  
pp. 1534
Author(s):  
Kiran C. Pankaj ◽  
Sristi Ganguly ◽  
Manas R. Upadhyay
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Birth Weight ◽  
Blood Culture ◽  
Low Birth Weight ◽  
Early Onset ◽  
Birth Asphyxia ◽  
Perinatal Risk Factors ◽  
Perinatal Risk ◽  
Early Onset Sepsis

Background: Neonatal sepsis remains a leading cause of neonatal mortality and morbidity, diagnosis of which remains difficult due to variable presentations. With the increasing threat of antimicrobial resistance, it is important to identify perinatal risk factors which are associated with higher incidence of definite sepsis, to initiate empirical antibiotics, while awaiting blood culture reports.Methods: This was hospital based cross-sectional study done in SVPPGIP, Cuttack, Odisha during January 2019 to April 2019, enrolling all neonates  ≥37 weeks gestation and aged less than 72 hours, with suspected early onset sepsis. Neonates with TORCH infections, congenital anomalies, syndromic baby or with surgical conditions were excluded. After obtaining informed consent, blood culture was sent for all and their perinatal risk factors noted. Blood culture positive newborns were considered to have definite sepsis. Data was analysed with Chi-square test and percentages, using SPSS 18.Results: Among the 200 cases, incidence of definite sepsis was 26%. The most common risk factor was low birth weight and birth asphyxia. Majority (67%) had single or lesser risk factor and number of risk factors was significantly associated with definite sepsis. A significant association was seen between blood culture positivity with low birth weight (p=0.003), foul smelling liquor (p= 0.025), birth asphyxia (p 0.018) and premature rupture of membranes (p= 0.016). The combination of maternal fever and unclean vaginal examination was also significantly associated with the same.Conclusions: Protocols for initiating empiric antibiotics need to be formulated, taking into account the significant risk factors, in resource limited settings, to avoid resource and time wastage.

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.

scholarly journals A retrospective study of predisposing factors and outcome of persistant pulmonary hypertension among newborns at rural tertiary care centre

2020 ◽  
Vol 8 (1) ◽  
pp. 92
Author(s):  
B. C. Yelamali ◽  
Gangadhar S. Mirji ◽  
Mirnalini Rajput
Keyword(s):  
Risk Factors ◽  
Pulmonary Hypertension ◽  
Retrospective Study ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Birth Asphyxia ◽  
Male Gender ◽  
Predisposing Factors ◽  
Positive Pressure ◽  
Increased Risk

Background: Persistent pulmonary hypertension in newborns (PPHN) remains a significant cause of perinatal morbidity and mortality. Early recognition of factors that increase the risk of PPHN is of great importance in either to prevent or to treat PPHN optimally. Aim was to study the neonatal predisposing factors, profile and outcome of PPHN.Methods: This retrospective study was conducted in level III neonatal care unit, a rural referral centre of North Karnataka, India from January 2018 to April 2020.Results: During the study period a total of 50 infants with PPHN were identified with the incidence of 5.43/1000 live births. Mean gestation age (±SD) was 38.28±2.49 weeks and mean birth weight (±SD) was 2624±512 gm. The most noted risk factors were meconium aspiration syndrome (42%), birth asphyxia (16%), RDS (10%), positive pressure ventilation at birth (52%) and male gender (62%). Out of 50 infants with PPHN, high mortality was seen in low birth weight babies (66.6%). Use of sildenafil showed increased mortality (56.2%) whereas use of surfactant scored better with decreased mortality of 42.8%.Conclusions: Major risk factors for PPHN are MAS, birth asphyxia, RDS and low birth weight. Poor prognosis is seen in male gender, prematurity and CDH with increased risk of mortality. The use of systemic pulmonary vasodilators can be considered with caution and use of surfactant has a role in management of PPHN.

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