Introduction: Neonatal sepsis is a major cause of morbidity and mortality most remarkable in the third world nations. Early diagnosis and subsequent therapy for the infected infants may play a vital role in lowering such mortality and morbidity rates. Aim: To study the clinical profile of neonatal sepsis in a tertiary care hospital and to correlate the findings with quantitative C-reactive protein (CRP) and Interleukin-6 (IL-6). Settings and Design: A total of 296 neonates admitted in neonatal intensive care unit (NICU) with clinical signs and symptoms suggestive of sepsis were studied. Based on their age the study population was divided into early onset sepsis (EOS): age group less 72 hours and late onset sepsis (LOS): age group more than 72 hours. Also healthy neonates who had no signs and symptoms of sepsis were taken as control for the study. Material and Methods: Blood culture was carried out using BacT/ Alert-3D automated system. Quantitative CRP by nephelometry and IL-6 by ELISA was done in all culture positive cases and controls. Correlation of detection of cases of sepsis by quantitative CRP and IL-6 with blood culture was carried out. Statistical analysis: Statistical parameters such as sensitivity, specificity, predictive values, accuracy and significance levels were calculated Results: In EOS the sensitivity and negative predictive value (NPV) of IL-6 was 62.32% and 33.33% respectively as compared to sensitivity of 27.5% and NPV of 26.47% of CRP. Conclusions: IL-6 is a good marker for early onset sepsis than CRP detecting a greater number of sepsis cases.
Background: Sepsis is one of the most common cause of neonatal deaths globally more so in low and middle-income countries. The key to management is high degree of clinical suspicion and prompt initiation of empirical antibiotic therapy pending investigations’ results. Knowledge of one’s own NICU flora and antimicrobial susceptibility pattern guides in choosing correct antibiotic therapy to pediatrician. If this data is standard and comparable across different sites, then it also helps in formulating regional and National treatment guidelines. Present study was therefore undertaken to study microbial flora of present NICU and analyze their antimicrobial susceptibility pattern and formulate antimicrobial policy.Methods: Data of blood culture isolates sent from suspected cases of neonatal sepsis received from January 2017 to July 2018 was analysed by “WHONET”.Results: One hundred ninety-three non-repeat isolates were obtained from 992 blood culture samples. Coagulase negative Staphylococcus and K. pneumoniae were the most common isolates. Non albicans Candida were responsible for majority of fungal infection. There was an outbreak of C. pelliculosa for six months. Most of the bacteria were multidrug resistant (MDR). However, except one all other Candida isolates were sensitive to antifungal drugs.Conclusions: WHO guidelines suggest use of penicillin and gentamicin for neonatal sepsis. But in present study, they were not found useful, instead amikacin, netilmicin and piperacillin-tazobactam were found useful and changes were made in antibiotic policy. Authors therefore recommend regular monitoring of antimicrobial susceptibility pattern followed by necessary changes in antibiotic policy for reasonable empirical therapy.
Shewanella putrefaciens rarely causes human infection. These are mostly found in environment and food stuffs. Shewanella are often found in mixed culture. It has been implicated in cellulitis, otitis media, and septicemia. It may be found in respiratory tract, urine, feces, and pleural fluid. There is no definite guideline for therapeutic option. In general, these are susceptible to various antimicrobial agents but are often resistant to penicillin and cephalothin. We report a rare case of bacteremia by S. putrefaciens in a patient of head injury with polytrauma after a road traffic accident.
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