Evaluation of hypoglycemic status and causative factors in neonatal sepsis

Abstract

Background: Very few studies have been reported on hypoglycemic status, hematological parameters and causative organisms of neonatal sepsis in different regions of Bangladesh. Hence, present study was conducted in the Chittagong city of Bangladesh.Methods: The study was conducted on 106 neonates (0 to 28 days of age) in Chattagam Maa-Shishu O General Hospital, Bangladesh. The questionnaire was developed to get relevant information of the neonates. Blood from neonates were subjected to routine investigations like blood glucose, CRP, hematological parameters, blood culture and bacterial identification.Results: Among 106 neonates with sepsis, 68 presented early onset neonatal sepsis (EONS) and 38 presented late onset neonatal sepsis (LONS). Fifty-one neonates had low birth weight (2500 g or less), 18 had very low birth weight (1500 g or less) and 22 were preterm. The most prevalent clinical features were reluctant to feed (56), hyperthermia (31) and hypotonia (22). Thirty-three neonates had neutropenia (<54%) and 62 had higher neutrophil count (>62%). Biochemical analysis showed 52 had higher C-reactive protein levels. Investigation of hypoglycemic status revealed that there were different types of neonatal sepsis, i.e. 77 neonates were hypoglycemic (<45 gm/dl), and among them EONS and LONS were 59 and 18, respectively. Thirty-three neonates had positive blood culture for bacteria. Among them, Klebsiella spp. accounted for 10 of the total isolates followed by Acinetobacter spp. 8. The Gram-positive and negative bacteria were found in 7 and 26, respectively.Conclusions: Hypoglycemia was associated with neonatal sepsis as an exacerbating factor.

Determinants of neonatal hypoglycemia among neonates admitted at Hiwot Fana Comprehensive Specialized University Hospital, Eastern Ethiopia: A retrospective cross-sectional study

“…A similar study conducted in Bangladesh supports the current finding. 37 The possible justification could be that a neonate with sepsis becomes reluctant to eat which can cause hypoglycemia. Neonatal hypoglycemia is reported to be caused by sepsis in 9.6% of neonatal hypoglycemia cases.…”

What are the barriers preventing the screening and management of neonatal hypoglycaemia in low-resource settings, and how can they be overcome?

“…Additionally, of the LBW babies (n = 1015), 905 (89%) were admitted with sepsis, surprisingly the diagnosis of neonatal hypoglycaemia was reported 0–9% across the five hospitals [ 25 ]. This can be compared to hypoglycaemia diagnoses of 36–72% in babies with infections in other low-resource settings [ 33 – 35 ] providing evidence of countless unwell babies with unrecognised and untreated hypoglycaemia.…”

A Cross-Sectional Study of Blood Glucose Levels in Neonatal Sepsis and its Outcome in a Tertiary Care Hospital, Davangere

“…(2) https://ijpccr.com/ The reported incidence of neonatal sepsis varies from 7 to 38 per 1000 live births in Asia, from 6.5 to 23 per 1000 live births in Africa, and from 3.5 to 8.9 per 1000 live births in South America and the Caribbean. (3,4) By comparison, rates reported in the United States and Australasia range from 1.5 to 3.5 per 1000 for early-onset sepsis (EOS) and up to 6 per 1000 live births for late-onset sepsis (LOS), a total of 6-9 per 1000 for neonatal sepsis, and 0.3-3 per 1000 live births in Europe. (5,6) A number of organisms are associated with neonatal sepsis such as Klebsiella pneumoniae, Staphylococcus aureus, Group B Streptococcus (GBS), Escherichia coli, Pseudomonas aeruginosa, Acinetobacter spp and Enterobacter spp etc.…”