Clinical and Microbiological Profile of Neonatal Sepsis at a Tertiary Care Hospital in Dehradun, India
Introduction: Neonatal sepsis is the most common cause of neonatal mortality. It is responsible for 30-40% of neonatal deaths in developing countries. Due to the non-specific nature of presentation, neonatal sepsis is very difficult to diagnose, despite its high incidence. Blood culture is still...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Pvt. Ltd.
2021-01-01
|
| Series: | National Journal of Laboratory Medicine |
| Subjects: | |
| Online Access: | http://www.njlm.net/articles/PDF/2435/45878_CE[Ra1]_F(SHU)_PF1(AG_SHU)_PFA(SHU)_PB(AG_SHU)_PN(SHU).pdf |
| Summary: | Introduction: Neonatal sepsis is the most common cause of
neonatal mortality. It is responsible for 30-40% of neonatal
deaths in developing countries. Due to the non-specific nature
of presentation, neonatal sepsis is very difficult to diagnose,
despite its high incidence. Blood culture is still considered as
the gold standard for the diagnosis of neonatal septicaemia.
However, sensitivity and specificity of blood culture varies
considerably due to many factors, and the final diagnosis
of neonatal sepsis is based on a combination of clinical,
microbiological and haematological parameters.
Aim: To find sensitive clinical indicators for suspecting neonatal
sepsis and to ascertain the microbiological profile of neonatal
sepsis.
Materials and Methods: This six months (01st May 2017-
31st October 2017) prospective observational study was
conducted in the Department of Microbiology of Sri Guru
Ram Rai Institute of Medical and Health Sciences, Dehradun,
Uttarakhand, India, on 45 neonates admitted in the Neonatal
Intensive Care Unit (NICU). Half ml to 2 mL of blood was
drawn following strict aseptic precautions, before the start
of antibiotics. Microbial detection and identification were
by fully automated BACT/ALERT 3D and VITEK 2 systems,
respectively. The data was expressed in terms of frequency
and percentage, and statistical results were analysed with
help of Microsoft Excel.
Results: In this study, culture yielded positive results in a
relatively high proportion (60%) of suspected cases. Respiratory
distress, reduced movements, and poor feeding were very
frequently encountered in both suspected and confirmed cases
of neonatal sepsis. Fever was seen only in around half of all
neonates of suspected and confirmed neonatal sepsis. In this
study, bacteria were 81.48% of the isolates, whereas fungi were
18.51%. Although, as a group, gram-negative bacteria formed
the predominant group isolated in cases of neonatal sepsis,
yeasts like Candida species were the predominant isolate
(18.51%). In this study, isolation of gram-negative bacteria
(74.07%) predominated over gram-positive bacteria (7.4%).
Conclusion: Respiratory distress, reduced movements,
and poor feeding were sensitive indicators for suspecting
neonatal sepsis. Fever was a relatively uncommon finding in
this study. Candida species and Acinetobacter baumanii were
more frequently isolated. Automation can significantly help in
reducing mortality in neonatal sepsis. |
|---|---|
| ISSN: | 2277-8551 2455-6882 |