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...
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JCDR Research and Publications Pvt. Ltd.
2021-01-01
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| Series: | National Journal of Laboratory Medicine |
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| author | Manish Kumar Tiwari Himanshu Bhim Khatri |
| author_facet | Manish Kumar Tiwari Himanshu Bhim Khatri |
| author_sort | Manish Kumar Tiwari |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-14T20:23:52Z |
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| series | National Journal of Laboratory Medicine |
| spelling | doaj.art-6c834612a4c34ee6b6f43446f487d42c2022-12-21T22:48:40ZengJCDR Research and Publications Pvt. Ltd.National Journal of Laboratory Medicine2277-85512455-68822021-01-01101MO01MO0410.7860/NJLM/2021/45878:2435Clinical and Microbiological Profile of Neonatal Sepsis at a Tertiary Care Hospital in Dehradun, IndiaManish Kumar Tiwari0Himanshu Bhim Khatri1Tutor, Department of Microbiology, Saraswati Medical College, Unnao, Uttar Pradesh, India.Assistant Professor, Department of Microbiology, Saraswati Medical College, Unnao, Uttar Pradesh, 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 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.http://www.njlm.net/articles/PDF/2435/45878_CE[Ra1]_F(SHU)_PF1(AG_SHU)_PFA(SHU)_PB(AG_SHU)_PN(SHU).pdfearly onset sepsislate onset sepsissepticaemiasystemic inflammatory response syndrome |
| spellingShingle | Manish Kumar Tiwari Himanshu Bhim Khatri Clinical and Microbiological Profile of Neonatal Sepsis at a Tertiary Care Hospital in Dehradun, India National Journal of Laboratory Medicine early onset sepsis late onset sepsis septicaemia systemic inflammatory response syndrome |
| title | Clinical and Microbiological Profile of Neonatal Sepsis at a Tertiary Care Hospital in Dehradun, India |
| title_full | Clinical and Microbiological Profile of Neonatal Sepsis at a Tertiary Care Hospital in Dehradun, India |
| title_fullStr | Clinical and Microbiological Profile of Neonatal Sepsis at a Tertiary Care Hospital in Dehradun, India |
| title_full_unstemmed | Clinical and Microbiological Profile of Neonatal Sepsis at a Tertiary Care Hospital in Dehradun, India |
| title_short | Clinical and Microbiological Profile of Neonatal Sepsis at a Tertiary Care Hospital in Dehradun, India |
| title_sort | clinical and microbiological profile of neonatal sepsis at a tertiary care hospital in dehradun india |
| topic | early onset sepsis late onset sepsis septicaemia systemic inflammatory response syndrome |
| url | http://www.njlm.net/articles/PDF/2435/45878_CE[Ra1]_F(SHU)_PF1(AG_SHU)_PFA(SHU)_PB(AG_SHU)_PN(SHU).pdf |
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