A survey of infection control practices in the delivery room and nursery to investigate and control the high rate of neonatal sepsis: an experience at a secondary care hospital (original) (raw)
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2015
Objective: Sepsis is an important cause of neonatal morbidity and mortality especially in developing countries where identification of the organisms and treatment is often unsatisfactory. The aim of the study was to assess the clinical presentation, and bacteriological profile of neonatal infections. Methods: We carried out a prospective analytic study in the Pediatric Hospital in New Delhi over 1 year period from December 2009 to November 2010. On the basis of history and/or clinical findings and biochemical investigations, 560 neonates out of a total of 2240 admissions were investigated and managed for neonatal infection. Results: During the study period, out of total 2240 admissions, sepsis was diagnosed in 560 (25%) neonates. Among these 560 neonates 80 near term and term neonates with weight appropriate for gestational age had at least one episode of positive blood culture. Other 480 neonates had clinical features as well as biochemical evidences of sepsis but there blood cultu...
Journal of Evolution of Medical and Dental Sciences
BACKGROUND Neonatal sepsis is one of the commonest causes of morbidity and mortality in neonates in India compared to the developed countries. It is one of the four leading causes of morbidity and mortality in India among the neonates due to delivery and postnatal follow up in an unhealthy environment and low socioeconomic state leading to maternal infection and premature delivery. It is absolutely necessary to diagnose early neonatal sepsis and its cause using clinical signs and rapid diagnostic method so that no time is wasted in starting appropriate treatment. MATERIALS AND METHODS A hospital-based study carried out in the Department of Neonatology over the period from 15 June 2013 to 15 May 2014. Setting-A teaching, research and tertiary care hospital at Srinagar, Kashmir, North India. Participants-All the neonates, inborn or out-born with at least one of the following anamnestic or clinical criteria as developed by the French National Agency for Accreditation and Health, were included in study. Procedure: Variables recorded were-presenting risk factors, symptoms, clinical signs, baseline laboratory tests, blood, urine and CSF cultures and sensitivities. RESULTS 100 neonates were included in the study. The most common symptoms of neonatal sepsis were general (62%) followed by respiratory (54%). 32% neonates were having fever and 34% hypothermia. Klebsiella was most common gram-negative organism (36.84) grown and CONS most common gram-positive organism (13.5%) among culture positive sepsis. CONCLUSION Neonatal sepsis is a major cause of morbidity and mortality in neonates in Kashmir India despite recent improvements in the health care system. Clinical manifestations are nonspecific and varied and early diagnosis is must to prevent morbidity and mortality. Gram negative neonatal sepsis is most common.
The Medical Journal of Cairo University, 2019
Background: Neonatal sepsis is considered a major cause of morbidity and mortality among neonates worldwide. Premature infants are more susceptible to sepsis. Diagnosis and management of sepsis are great challenges facing neonatologists in NICUs. Aim of Study: The aim of this study was to evaluate the incidence of neonatal sepsis at neonatal Intensive Care Unit in Tanta University Hospital. The study was carried out on all admitted neonates with clinical signs and symptoms of sepsis at the time of admission or who developed sepsis during their hospital stay.
Neonatal sepsis has been identified by World Health Organisation (WHO) as one of the major causes of high morbidity and mortality in neonates [1]. It is a clinical syndrome characterised by systemic signs of circulatory compromise which is usually as a result of the invasion of the blood stream by bacteria during the first month of life [2], [3]. In Ghana where most people are in the middle or low-income range and cannot afford the cost of a blood culture investigation and considering the fact that it takes a minimum of five days for one to receive a blood culture report, there is usually the approach of empirical management of most cases of neonatal sepsis in the hospital. A request is made for blood cultures usually after treatment failure. The incidence of neonatal sepsis in the Korle-Bu Teaching Hospital is very high and this is likely due to the occurrence of predisposing factors and lack of essential facilities for optimal hygiene in most of the primary health facilities from where the patients are referred. OBJECTIVE: The aim of this study was to evaluate the empirical management of neonatal sepsis at the Children's Department of Korle –Bu Teaching Hospital (KBTH). METHODOLOGY: A prospective cohort study method was used. Patients diagnosed with Neonatal sepsis were identified from the admissions and discharge records. All neonates admitted to the pediatric ward with sepsis during the period was selected and followed up over the study period (15th November, 2015 – 15th December, 2015. There was no intervention made to the management approach to the subjects during the study. All the necessary data was taken from the patients' folders and the care givers (Clinical staff and parents of the patient) where possible. The data was collected using a specially designed data collection tool which captured data on the following; Patient characteristics, Septic screen, Case fatality, Sensitivity patterns and Pattern of antibiotic usage. The results were analysed using SPSS for Microsoft version 20 and Excel spreadsheet and presented as bar charts, pie charts and percentages. FINDINGS: A total of 271 neonates were admitted at the study site during the period. A third of all neonatal admissions during the period were diagnosed with neonatal sepsis. 55.4% of the cases were males and the rest females. More than half of the neonates diagnosed with neonatal sepsis had septic screen conducted on them. Most of the cases (58.33%) were screened for C-reactive protein whilst less than half (40.2%) of the septic screen was for organism culture. Over half of the samples sent for organism culture yielded no growth. 48.27% yielded growth out of which only 35.71% were microorganisms. Most of the cousative organisms were gram-negative microorganisms. The case fatality rate of neonatal sepsis for the period was 4.17%. E-coli infection was confirmed as a cause of more than a third of death from Neonatal Sepsis. Almost all (95.83%) of the neonates diagnosed with neonatal sepsis were given empirical antibiotics. Only 4.17% of the cases had their antibiotics changed in accordance with their culture and sensitivity results. CONCLUSION: Neonatal sepsis diagnosis at the department was usually of early onset and empirical treatment used for its management appeared effective. Most of the subjects did South American Journal of Clinical Research Volume 3, Issue 1, 2016 2 not have septic screen done making it impossible for microbial sensitivity and resistance patterns to be studied.
Birat Journal of Health Sciences, 2018
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 givi...
Journal of Medical Science And clinical Research, 2017
Introduction-Neonatal sepsis is a major cause of neonatal mortality and morbidity. For proper management knowledge of the pattern of etiological agents and their sensitivity pattern is crucial. The aim of this study was to determine the aetiology and their sensitivity of neonatal septicemia cases. Materials and Method-It was a retrospective survey study. During 1 year period blood samples were sent for culture sensitivity. Samples were drawn from sick neonates or those having risk factors for developing sepsis. Blood culture was performed using BACTEC 9240, isolates were identified by standard techniques and antibiotic susceptibility was performed as per the CLSI guidelines. Results-Total 147 samples were sent for blood culture,29 (19.7%) came out positive. Escherichia coli was the most common organism causing sepsis. All Gram positive organisms were sensitive to Vancomycin where for Gram-negative organisms, Colistin and Meropenem mostly effective. Conclusion-Gram negative organisms were most commonly associated with neonatal sepsis. Commonly used antibiotics like Amoxycillin, Cefotaxime, Amikacin were ineffective to control sepsis
Neonatal Sepsis -a Clinico-Etiological profile at a tertiary care center in south India
International Journal of Medical Sciences, 2020
Background: Neonatal sepsis is a common problem in most of the neonatal intensive care units. It contributes to significant mortality and morbidity among the neonates. Sepsis if properly treated can result in significant reduction in the neonatal mortality. Methodology: This study was a prospective observational study conducted at Government Kilpauk Medical college Hospital between October 2010 and October 2012.The aim of the study was to determine the clinical and etiological pattern of sepsis in our unit. Results: A total of 207 neonates were included in the study of which 88 neonates had culture positivity.34 neonates were early onset sepsis and 54 were late onset sepsis. The clinical presentation was nonspecific in most of the neonates while others had respiratory, gastrointestinal and Central nervous system symptoms. Klebsiella was the most common organism in our study followed by E. coli and Pseudomonas. Among the Gram-positive organisms Staphylococcus aureus. Conclusion: Early identification and interventions like careful selection of antibiotics based on the clinical and etiological pattern of organisms in neonatal sepsis is essential to prevent mortality and morbidity.
Journal of Pharmaceutical Research International
Background: The drug resistance and pathogens are different in various Hospitals of any country. Very high resistance pattern is observed nowadays to the frequently used antibiotics. The important observation has been noted that most of the doctors do not obtain blood cultures before start of the antibiotics, which becomes competent source of resistance. For the same purpose, this study has been done to find out the responsible microbes causing ailment and their susceptibility towards antibiotics to plan early and effective management. Materials and Methods: A number of 100 new borns admitted in the NICU CMC Children Hospital Larkana with signs and symptoms of sepsis were included in this research work. The study will help in provision of a comprehensive record on microorganisms causing sepsis in the neonates and their antibiotic sensitivity. The epidemiology and presence of neonatal sepsis in particular area makes it more easy and convenient to implement the rationale of empirical ...
Microbiological study of neonatal sepsis in a tertiary care hospital of western Uttar Pradesh, India
International Journal of Research in Medical Sciences, 2016
Background: Neonatal sepsis is a clinical syndrome characterized by systemic signs of infection and accompanied by bacteraemia in the first month of life. Neonatal sepsis is among the three most common illnesses among newborns, and second most common cause of neonatal mortality especially among preterm and low birth weight babies. Aim of the study was to identify the common bacterial pathogens associated with neonatal sepsis and their antibiotic susceptibility pattern. Methods: Total 120 blood samples collected aseptically (from January 2015 to April 2015) and cultured in automated machine Versa TREKTM automated microbial detection system. Significant bacterial colonies are seen on streak lines which were observed by their diameter, opaqueness, flatness, regular or irregular margins etc. Any growth was subjected for identification by appropriate biochemical tests. Antibiotic susceptibility testing was done. Results: Out of one hundred twenty (120) samples, eighty (66.67%) samples were found positive for bacterial infection. In which 22 (27.50%) E.coli, 14 (17.50%) Klebsiella pneumonia, 10 (12.50%) pseudomonas, 17 (21.25%) Staphylococcus aureus, 6 (7.50%) coagulase negative staphylococci (CoNS) and 11(13.75%) Enterococcous sp. was identified. Conclusions: The blood culture positivity rate was 66.67%. E. coli, Klebsiella spp, and Staphylococcus aureus was the commonest agent.
2017
Objective: The main objective of study is to determine the etiology and antimicrobial patterns of neonatal sepsis. Place and Duration of Study: Postgraduate Medical Institute , Lahore and duration of study was 6 months (1st July’ 14 -31st Dec’ 14). Materials and Methods: 95 positive blood cultures with clinical signs and symptoms were included in this study in PGMI, Lahore. The blood cultures were taken before the start of antimicrobial therapy. Blood culture reports were assessed for identification by standard methods. Antimicrobial susceptibility testing was carried out by Modified Kirby Bauer disk diffusion method on Mueller Hinton agar using CLSI protocols. Results: Out of the 450 blood samples, 95 (21.1%) were culture positive. Among 95 positive blood cultures, Gram negative organisms were recovered from 56 (58.9%) followed by Gram positive organisms 36 (37.8%) whereas only 3(3.1%) blood cultures were positive for Candida spp. Among Gram negative organisms (n= 56) Pseudomonas s...