Background: Multidrug resistant Acinetobacter infection has emerged as an important pathogen in neonatal sepsis in the recent years causing morbidity as well as mortality. Methods: Neonates admitted with sepsis in NICU from Jan 2014 to Dec.2014 were retrospectively analysed to find out the incidence, clinical features, antibiotic sensitivity pattern and the risk factors associated with mortality in culture positive Acinetobacter sepsis. Results: Incidence of neonatal sepsis was 11.3% (26/230).Neonatal sepsis caused by Acinetobacter spp was 5.65% (13/230). Pure growth of Acinetobacter was obtained in 13 and all of them were multidrug resistant. Resistance to Meropenem was 50%.Out of 13, six were early onset and seven were late onset sepsis. The major signs were poor perfusion (9/13), hypotension (9/13) and respiratory distress (13/13). Mortality due to Acinetobacter neonatal sepsis was 76.92% (10/13 ).The major risk factors associated with death in Acinetobacter sepsis were female sex, prematurity (<30 weeks) , birth weight less than 1500 gm and normal deliveries. Conclusion: Multidrug resistant Acinetobacter infection is fatal, particularly in premature and very low birth weight neonates.
Haemophagocytic lymphohistiocytosis (HLH) is a potentially fatal, hyper inflammatory condition which is caused by a highly stimulated but ineffective immune response. We are presenting here, a case of HLH which occurred in a 45 day infant. Presence of lung cavity and a lytic bone lesion in the skull, as was seen in this case, have not been reported in HLH in the literature. This raises a possibility of a simultaneous occurrence of HLH and Langerhans cell histiocytosis. In a child who presents with septicaemia but does not respond to treatment, the possibility of HLH needs to be considered.
Background: Very low birth weight babies with respiratory complications are the commonest reason for admission in NICU. We wanted to identify maternal risk factors associated with it and ways to prevent it. The objective of the current study was to study the prevalence of maternal risk factors, morbidity and mortality in VLBW babies admitted in tertiary care hospital NICU.Methods: Cross sectional observational study performed on all very low birth weight (VLBW) neonates admitted in neonatal intensive care unit of tertiary care hospital attached with Smt. Kashibai Navale medical college, Pune from January 2019 to March 2020.Results: In our study VLBW babies were 2.2% (78/3545). Mean gestational age was 31.15±3.21 weeks; mean birth weight was 1226.24±250.95 grams. Small for gestational age (SGA) babies were 41% and 96% were preterm. Maternal risk factors were present in 61.53% of deliveries, commonest were anaemia in 30.06 % and preeclampsia in 24.35%. Resuscitation at birth was required in 30.76% babies. Morbidity profile showed respiratory distress syndrome in 46.15%, neonatal sepsis in 19.23% and patent ductus arteriosus in 16.66% babies. Overall survival was 74.35%. Prematurity and its complications like RDS requiring surfactant therapy and mechanical ventilation were significant contributors for mortality but only 23.07% mothers were found to have received antenatal steroids in the hospital .Conclusions: Anaemia and preeclampsia were commonly found risk factors present in 61.53% of mothers of VLBW babies. Use of antenatal steroids in mothers should be made compulsory to decrease mortality in VLBW preterm newborns.
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