Neonatal Sepsis in a Tertiary Care Hospital in South India: Bacteriological Profile and Antibiotic Sensitivity Pattern

Zakariya, Bambala Puthattayil; Bhat, Vishnu; Harish, Belgode Narasimha; Babu, Thirunavukkarasu Arun; Joseph, Noyal Mariya

doi:10.1007/s12098-010-0314-8

Cited by 95 publications

(112 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The prevalence of A. baumannii bacteremia in neonates has been reported to be 0.2%-6.9% [2][3][4][5]. Fourteen percent of early-onset sepsis (EOS) [6] and 9% of late-onset sepsis (LOS) in newborns has been reported to be due to A. baumannii species [7].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for carbapenem-resistant Acinetobacter baumanii blood stream infections in a neonatal intensive care unit, Delhi, India

Kumar

Randhawa

Nirupam

et al. 2014

J Infect Dev Ctries

View full text Add to dashboard Cite

Introduction: Carbapenem-resistant Acinetobacter baumannii (CRAB) infection is being increasingly observed and is associated with significant morbidity and mortality in newborns. In this study, we determined the epidemiology, risk factors, and outcomes of blood stream infection (BSI) caused by CRAB in neonates. Methodology: The clinical charts of neonates who developed Acinetobacter baumannii BSI in the period between 1 January 2010 and 31 December 2012 were reviewed. Results: During the study period, 65 neonates developed Acinetobacter baumannii BSI; 33 were CRAB at an incidence of 0.50 case per 1,000 patient-days. Compared with carbapenem-sensitive Acinetobacter baumannii (CSAB), patients with CRAB BSI had significantly higher prior antimicrobial use, longer duration of ventilation, and late isolation of organisms. Feeding with expressed breast milk was protective. All isolates of Acinetobacter baumenii were sensitive to colistin and tigecycline. The all-cause mortality rates were 27.3% in CRAB and 9.4% in CSAB BSI, respectively (p = 0.074). Conclusions: Neonatal BSI caused by CRAB was not common but caused high mortality. Feeding with breast milk was protective. Lack of effective antibiotics was the major challenge in treating these patients.

show abstract

Section: Introductionmentioning

confidence: 99%

Risk factors for carbapenem-resistant Acinetobacter baumanii blood stream infections in a neonatal intensive care unit, Delhi, India

Kumar

Randhawa

Nirupam

et al. 2014

J Infect Dev Ctries

View full text Add to dashboard Cite

show abstract

“…4,19,22 In developed countries, the predominant bacteria in EONS is group B Streptococcus; 2 in our study; it was isolated in three occasions.…”

Section: Discussionmentioning

confidence: 49%

“…Such interventions may be of little access or nonexistent in low-resource countries, thus favoring a different epidemiological scene. 4,8,9 Viswanathan, et al identified that 71.7% of Gram-negative bacteria, while 81.8% were E S B L p r o d u c e r s . 10 I n o u r s t u d y , 4 0 % o f Enterobacteriaceae isolated from LONS cases were ESBL producers (n: 30), while only 6.5% of Enterobacteriaceae isolated from EONS corresponded to this type (p < 0.001).…”

Section: Discussionmentioning

confidence: 99%

“…Given amikacin's low rate of resistance and the fact that it does not induce chromosomal beta-lactamases, it should be used instead of cephalosporins as empirical management of neonatal sepsis, and treatment should be modified based on antibiogram results. 4 Of all nosocomial LONS, 34.7% were caused by Staphylococcus spp. The conditions that favor these infections include prematurity, invasive procedures, such as central venous lines or mechanical ventilation, and an immature immune system.…”

Section: Discussionmentioning

confidence: 99%

“…2 E a r l y -o n s e t n e o n a t a l s e p s i s (EONS) refers to the presence of a confirmed infection in the blood or cerebrospinal fluid (CSF) of patients younger than 72 hours of life, and late-onset neonatal sepsis (LONS) refers to the onset of such infection between 72 hours and 90 days old. 2,4 Information on etiologic agents is heterogeneous. While in developed countries the most common cause of EONS is group B Streptococcus, its main cause in developing countries are Enterobacteriaceae.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Etiology and antimicrobial resistance patterns in early and late neonatal sepsis in a Neonatal Intensive Care Unit

2015

Arch Argent Pediat

View full text Add to dashboard Cite

Introduction.Neonatal sepsis is one of the main causes of death among newborn infants. Empirical antimicrobial treatment is based on epidemiological information and antimicrobial susceptibility tests. The objective of this study was to describe etiologic agents and their antimicrobial susceptibility among newborn infants with early-onset neonatal sepsis (EONS) or late-onset neonatal sepsis (LONS) at a Neonatal Intensive Care Unit. Methods.Cross-sectional study conducted at a tertiary referral hospital in Western Mexico. Determination of antimicrobial resistance of microorganisms isolated in blood or cerebrospinal fluid of patients with EONS or nosocomial LONS. Results.Yeasts and bacteria were isolated from 235 cultures corresponding to 67 events of EONS and 166 events of LONS. Of all isolates, the most common bacteria were Enterobacteriaceae (51.5%), followed by Streptococcus spp. in EONS, and by Staphylococcus spp. in LONS. Of all nosocomial Enterobacteriaceae, 40% were extended spectrum beta-lactamase producing bacteria. Among Staphylococcus species, resistance to oxacillin was recorded in 65.5%. Among Enterobacteriaceae (n: 121), resistance to amikacin, piperacillin-tazobactam, and meropenem was below 3%. Non-fermenting bacteria did not show resistance to amikacin, ciprofloxacin or cefepime; however, the number of isolates was scarce. Conclusions.The most commonly identified bacteria in EONS were Enterobacteriaceae (67.6%) and Streptococcus spp. (17.6%), and Enterobacteriaceae (44.9%) and Staphylococcus spp. (34.7%) in LONS. Forty percent of nosocomial Enterobacteriaceae were extended spectrum beta-lactamase producing bacteria, and 65.5% of Staphylococcus spp. showed resistance to oxacillin.

show abstract

Cerebral blood flow velocity in early-onset neonatal sepsis and its clinical significance

et al. 2012

View full text Add to dashboard Cite

Chorioamnionitis is a known risk factor for neurological damage in newborns. The present study aimed at assessing the changes in cerebral blood flow velocity (CBFV) in early-onset neonatal sepsis (EONS) and determining its predictive value as well as prognostic significance. Inborn neonates with antenatal risk factors for chorioamnionitis were followed up for development of EONS, diagnosed by presence of clinical signs along with positive blood culture and/or elevated interleukin-6 (IL-6) concentrations (≥50 pg/mL) in umbilical cord blood. Comparison group was formed by asymptomatic neonates who had risk factors for chorioamnionitis but did not develop EONS and cord blood IL-6 concentrations were <50 pg/mL. CBFV (resistance and pulsatility indices, peak systolic flow velocity, and vascular diameter) of internal carotid, vertebral, and middle cerebral arteries was assessed by transcranial Doppler ultrasonography within 24 h of birth. The babies were kept under clinical and radiological follow-up for a minimum period of 6 months. Data were analyzed by SPSS 16.0. Final study group contained 55 neonates with sepsis and 35 asymptomatic control neonates. Blood culture was positive in 27 babies of the sepsis group with a preponderance of Gram-negative bacterial isolation. Significantly lower resistance, vasodilatation, and higher blood flow were noted in all the cerebral arteries of the sepsis group. Increase in CBFV was correlated with elevated IL-6 concentrations. CBFV parameters showed significant predictive accuracy as early diagnostic markers of EONS. Among the sepsis group, 14 patients showed signs of intracranial hemorrhage during the hospital stay of which four expired and six showed signs of ventricular dilatation during follow-up. These patients had significantly higher CBFV compared to those who survived. Assessment of CBFV at early hours of birth can be adopted as an additional bedside, non-invasive investigation with immediate diagnostic and late prognostic significance.

show abstract

Neonatal Sepsis in a Tertiary Care Hospital in South India: Bacteriological Profile and Antibiotic Sensitivity Pattern

Abstract: 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.

Cited by 95 publications

References 11 publications

Risk factors for carbapenem-resistant Acinetobacter baumanii blood stream infections in a neonatal intensive care unit, Delhi, India

Risk factors for carbapenem-resistant Acinetobacter baumanii blood stream infections in a neonatal intensive care unit, Delhi, India

Etiology and antimicrobial resistance patterns in early and late neonatal sepsis in a Neonatal Intensive Care Unit

Cerebral blood flow velocity in early-onset neonatal sepsis and its clinical significance

Contact Info

Product

Resources

About