Early onset neonatal sepsis

Chacko, Betty; Sohi, Inderpreet

doi:10.1007/bf02760574

Cited by 140 publications

(137 citation statements)

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“…Group B streptococcus has been reported uncommonly as a cause of earlyonset sepsis in India. 15,18 The incidence of late onset sepsis secondary to CoNS is less common in developing countries, as also seen in our study. 15,19 The lower rates of infection at our centers could be secondary to less-invasive device use.…”

Section: Discussionsupporting

confidence: 85%

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Organism-specific platelet response and factors affecting survival in thrombocytopenic very low birth weight babies with sepsis

Bhat

Kawoosa

et al. 2009

J Perinatol

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Objective: To study organism-specific platelet response and factors affecting survival in thrombocytopenic very low birth weight (VLBW) babies with sepsis.Study Design: Very low birth weight babies (birth weight <1500 g) admitted to a single level-three intensive care unit from January 2000 to December 2005 were prospectively evaluated for sepsis by rapid screen test, blood counts and blood culture. In thrombocytopenic babies, organismspecific platelet response and its effect on various platelet parameters were evaluated. In addition, morbidity, mortality and factors affecting survival were studied.Result: Sepsis was diagnosed in 230 of 620 (37%) patients. Grampositive sepsis occurred in 20% (46/230), Gram-negative in 71% (164/ 230) and fungal in 8.6% (20/230) of patients. Thrombocytopenia was observed in 67% (155/230) of babies. The frequency and duration of thrombocytopenia were more with Gram-negative and fungal infections. The incidence of persistent bacteremia, multiorgan failure and death was more in thrombocytopenic neonates (P<0.01). The incidence of multiorgan failure and death was directly related to the duration of thrombocytopenia. On multiple logistic regression analysis, poor prognostic factors include a high SNAP score at admission, a severe drop in platelet count at onset of sepsis, a low platelet nadir, a prolonged duration of thrombocytopenia, a need for platelet transfusion, less number of days off ventilation and a prolonged stay in the hospital. Conclusion:In thrombocytopenic VLBW babies with sepsis, organismspecific platelet response is seen. In addition, persistent bacteremia, multiorgan failure and death are more in these babies, and survival decreases with the increased severity and duration of thrombocytopenia, with prolonged ventilation and increased need for platelet transfusions

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Section: Discussionsupporting

confidence: 85%

“…15,18 A similar pattern of Gram-negative organisms in neonates with early-onset sepsis is reported by Stoll et al 25 Mortality in neonates with early-onset/perinatal sepsis was more (57%) than in neonates with postnatal/nosocomial sepsis (39%).…”

Section: Discussionsupporting

confidence: 66%

Organism-specific platelet response and factors affecting survival in thrombocytopenic very low birth weight babies with sepsis

Bhat

Kawoosa

et al. 2009

J Perinatol

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“…The culture positive rate was 54.1% which is comparable to culture positive rate of 43% observed by Chackoo et al, 59.8% by Khatua et al 1,16 This difference in positivity of blood culture is because blood culture positivity depends on many factors like specimen collection, blood volume and the number and timing of blood culture.…”

Section: Discussionsupporting

confidence: 52%

“…Chacko et al, Sharma et al and Choudhary et al reported incidence of septicemia as 37.2/1000 live births, 33.7/1000 and 51/1000 live births respectively. 1,14,15 In present study, as per Table 1, lethargy was most common clinical feature in current study (76.1%) followed by refusal to feed (75.2%), respiratory distress (66.1%), hypothermia (38.5%), hyperthermia (28.4%), abdominal distension (11.9%), jaundice (10.1%), convulsions (10.1%), apnea (7.3%), irritability (3.7%), vomiting (2.8%), sclerema (1.8%) and diarrhea (1.8%). Kathua et al 16 reported refusal to feed as common clinical presentation (92%) followed by lethargy (74%), diarrhea (74%), abdominal distension (60.1%), hypothermia (46.8%), jaundice (38%), vomiting (30.4%), hyperthermia (24.8%), respiratory distress (24%), sclerema (17.4%), apnea (13%) and convulsions (10.8%).…”

Section: Discussionmentioning

confidence: 99%

Prospective study to evaluate the risk factors associated with mortality in neonatal septicemia

Khurana

Malik

Narang

et al. 2017

Int J Contemp Pediatr

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Background: Neonatal sepsis is a clinical syndrome of bacteremia characterized by systemic signs and symptoms of infection in the first month of life. Neonatal sepsis refers to infection occuring within the neonatal period i.e. first 28 days of life for a term baby and up to 4 weeks beyond the expected date of delivery in a preterm baby. Neonatal sepsis is one of the major cause of neonatal morbidity and mortality.Methods: The present study is a prospective observational study conducted in the neonatal intensive care unit (NICU) of Sri Guru Ram Das Institute of Medical Sciences and Research (SGRDIMSAR), Sri Amritsar over a period of one year from January 2015 to January 2016. Aim of the study is to know the incidence of neonatal sepsis, to study bacteriology of neonatal septicemia and to evaluate the risk factors associated with mortality in neonatal sepsis in our hospital.Results: During the study period (January 2015 to January 2016), 727 neonates were admitted in NICU of SGRDIMSAR, Sri Amritsar. Out of them, 109 neonates were diagnosed as having septicemia. Incidence of neonatal sepsis in our hospital in this study is 149.9/1000 neonatal admissions. 59 (54.1%) neonates had positive blood culture. Out of 109 septic neonates, 50 died and 59 survived. Mortality observed in the present study is 45.9%.Conclusions: It is concluded from present study that the main factors associated with neonatal mortality are low birth weight, prematurity, positive blood culture, neutropenia and prolonged prothrombin time. Some of the risk factors like low birth weight and prematurity are preventable by proper antenatal check ups and measures can be taken for safe and hygienic delivery. Babies with risk factors should be monitored closely for early detection of sepsis and the neonates with sepsis having abnormal laboratory parameters should be subjected to appropriate therapeutic intervention in order to decrease the mortality.

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“…[9][10][11] Our results differed from that of Betty Chacko et al who observed an equal proportion of cases among both males and females, because their study involved only early onset septicemia cases. 12 The male preponderance in neonatal septicemia may be linked to the X-linked immuno-regulatory gene factor resulting in the host's susceptibility to infections in males. 13 Maximum culture positive cases were seen in neonates more than 1 week of age 41.6% and Late onset septicemia 87.5% as compared to neonates aged less than 1 week 41.6% and early onset septicemia 12.5% in the present study.…”

Section: Discussionmentioning

confidence: 99%