Current-proven neonatal sepsis in Indonesian tertiary neonatal intensive care unit: a hematological and microbiological profile

Abstract

Background and Objectives: Neonatal sepsis is the third leading cause of neonatal death in the world. The patterns of pathogens causing neonatal sepsis varies in many countries. This study was aimed to identify hematological and microbiological profile of culture-proven neonatal sepsis in Indonesian tertiary neonatal intensive care unit (NICU).
 Materials and Methods: Hospital based cross-sectional study was conducted in all inborn neonates that were suspected sepsis neonatal over a period of six months from April to September 2019. Complete blood count, c-reactive protein (CRP) and blood culture were examined before antibiotic administration. Statistical analysis were calculated based on Chi-Square’s Test and Mann-Whitney U test and p <0.05 considered significant.
 Results: One hundred four inborn neonates admitted to NICU and diagnosed with suspected neonatal sepsis were recruited. Culture-proven neonatal sepsis were confirmed in 52 (50%) neonates, 13 (25%) in early-onset neonatal sepsis (EONS) and 39 (75%) in late-onset neonatal sepsis (LONS). The most common abnormal hematological profile were anemia and thrombocytopenia, with amount of 61.5% and 75%, respectively. High CRP only detected in 36.4% and only 18.5% experienced leukopenia. Gram negative bacteria responsible in 75% from total isolated pathogens. Klebsiella pneumoniae accounted for 48.1% followed by coagulase negative staphylococci (CONS) for 17.3% and Enterobacter cloacae for 11.5%.
 Conclusion: Anemia and thrombocytopenia were the top two hematological profile of culture-proven neonatal sepsis. Most causes of culture-proven neonatal sepsis were Gram negative bacteria and the dominant pathogen was K. pneumoniae.

Diagnostic Values of Platelet to Lymphocyte Ratio and Neutrophil to Lymphocyte Ratio in the Early Diagnosis of Early-Onset Neonatal Sepsis in Full-term Newborns

“…In the present study, it has been found that hemoglobin and the platelet Counts in the septic group were statistically significantly decreased compared with the corresponding values in the control groups of infants. These results correlated with those of two recent studies [33,34] . In such cases, the low Hb level could be explained as a result of increased hemolysis of red blood cells caused by bacterial infection in blood [34] .…”

Clinical and bacteriological profile of neonatal sepsis: a prospective hospital-based study in a tertiary care hospital in eastern zone of West Bengal

“…14 In another study done in Indonesian tertiary neonatal care unit it was seen of all culture positive neonates 13 (25%) in early-onset neonatal sepsis (EONS) and 39 (75%) in late-onset neonatal sepsis (LONS). 15 More incidence of EONS in our study may be explained by more preterm neonate being affected than term neonate in this study.…”

Literature Review: Trombositopenia sebagai Deteksi Dini pada Pasien Sepsis Neonatorum

“…Penggunaan kultur darah sebagai pemeriksaan baku karena sepsis merupakan respon inflamasi sistemik terhadap infeksi sehingga dapat penegakan diagnosisnya melihat adanya bakteremia pada pasien dengan cara isolasi bakteri (27,28). Namun, sensitivitas dan spesifisitas kultur darah secara keseluruhan rendah, sebagian bergantung pada volume darah yang diambil, waktu pengambilan darah, pengobatan sebelumnya dengan antibiotik, dan keberadaan organisme yang hidup (6).…”