Klebsiella pneumoniae was the most common agent causing both early-onset and late-onset sepsis and significantly associated with sepsis in inborn babies. Amikacin should be used along with the third-generation cephalosporins for empirical treatment of gram-negative neonatal sepsis.
Introduction: During the last few decades, group B Streptococcus (GBS) has emerged as an important pathogen. The major reservoirs for GBS are the vagina and the peri-anal regions/rectum, and the colonization of these regions is a risk factor for subsequent infection in pregnant women and newborns. Methodology: A prospective study was performed to determine the prevalence of GBS colonization in the vagina and rectum of pregnant women and the antibiotic susceptibility pattern of the isolates. We also aimed to identify risk factors associated with GBS colonization. The vaginal and rectal swabs were inoculated in Todd-Hewitt broth and later subcultured on blood agar for isolation of GBS. Results: A total of 300 pregnant women were enrolled in the study. GBS strains were isolated from seven out of 300 patients, corresponding to a colonization rate of 2.3%. Of the seven patients carrying GBS, isolates were cultured only from vaginal swabs in two cases (28.6%), only from rectal swabs in two cases (28.6%) from both vaginal and rectal swabs in three cases (42.9%). Heavy colonization was present only in 42.9% (3/7) of antenatal women. None of the seven isolates were resistant to penicillin or clindamycin, while one isolate (14.3%) was resistant to erythromycin and five isolates (71.4%) were resistant to tetracycline. Multigravid women and those with previous spontaneous abortion were more frequently colonized by GBS. Conclusion: The GBS colonization rate in our study was low. No resistance to penicillin or clindamycin was seen, while the majority of the isolates were resistant to tetracycline.
The mortality rate was significantly high in neonates with a culture-proven sepsis compared to those with a negative blood culture. PROM >24 h, Apgar score <6 at 5 min, birth weight ≤1.5 kg and mechanical ventilation were independent risk factors for culture-proven sepsis, while lethargy, shock and birth weight ≤1.5 kg were independent predictors of mortality.
The prevalence of academic dishonesty is high. Academic integrity and ethics should be emphasized to the students which might help them in becoming professional and honest doctors.
Breathlessness, altered sensorium, leucocytosis, hypoalbuminemia, and hyponatremia predict severity in childhood scrub typhus. Presence of these factors should alert the treating physician regarding the need for intensive monitoring, treatment or referral.
A case of 7-day-old male neonate with cefotaxime-induced near-fatal anaphylaxis is being reported. Child was started on intravenous cefotaxime on day 3 of life in view of early-onset sepsis with pneumonia, following which there was clinical improvement. Child was then shifted out of intensive care to general ward for completion of antibiotic course. One day prior to the planned discharge, child suddenly developed poor sensorium, flaccidity, apnea, and cyanosis within seconds of receiving intravenous cefotaxime and was found to have bradypnea with bradycardia. Prompt resuscitation was carried out with artificial ventilation, adrenaline, and steroids. Spontaneous breathing reappeared and the clinical condition improved.
World health organization declared COVID-19 caused by SARS CoV-2 virus as a pandemic in early 2020. The target cells facilitating viral entry are ACE-2 receptor bearing cells like bronchial epithelial cells and pneumocytes. Children pose a less risk compared to adults in acquiring this disease and mortality in them is low due to protective pathogenesis. Children with COVID-19 are also at risk of developing unique immunological phenomena, known as multi-system inflammatory syndrome in children. MIS-C is considered to be hyperimmune state resulting from cytokine storm and circulating immune complexes. This mini-review reflects the most recent understanding of the pathogenesis in children with special emphasis on MIS-C.
Nebulised budesonide significantly improves PEFR levels and fitness for discharge at 2 h when compared to oral prednisolone in children between 5 and 12 y with acute severe asthma.
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