MICROBIOLOGICAL PROFILE OF NEONATAL SEPTICAEMIA ALONG WITH AN OVERVIEW OF THE CLINICAL SCENARIO
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 4
Abstract
BACKGROUND Neonatal sepsis takes a big toll of neonatal deaths in developing countries. It is estimated that up to 20% of the neonates develop sepsis and approximately 1% die of sepsis related causes. In India, sepsis is one of the commonest causes of neonatal mortality contributing to 19% of all neonatal deaths. The present study was undertaken to study aerobic bacterial profile of neonatal septicaemia by automated blood culture systems. MATERIALS AND METHODS This observational study was conducted in the Microbiology Laboratory of a tertiary care centre over a period of one and a half years [January 2013 to June 2014]. Blood samples of neonates of both sexes were collected and processed. Detailed history recording and clinical examination was conducted on each patient and findings were recorded. RESULTS Total 157 blood samples, 99 [63.05%] from male and 58 [36.94%] from female patients were processed. Out of 157 blood samples, 70 i.e. 44.58% were flagged as positive by BacT/ ALERT 3D 60 system and 87 [55.41%] were negative. Within the neonatal age group, 52 [74.28%] neonates with positive blood cultures were of the age less than one week. Out of 70 culture positive cases 64 [91.42%] deliveries were conducted in the hospitals, rest 6 [8.57%] were home-based deliveries. Out of 70, 12 [17.14%] neonates were having history of febrile illness in the mother during gestation. And 17 [24.28%] neonates were found to have history of Prolonged Rupture of Membranes [PROM] during delivery. 43 [61.42%] of the 70 positive cases had not attained their gestational maturity. Out of 70 blood culture positive neonates, 44 [62.85%] were having early-onset sepsis. Rest 26 [37.14%] were suffering from late-onset sepsis. All 70 blood cultures were monobacterial. Out of 70 isolates, 35 [50%] isolates were Gram-positive cocci and 35 [50%] isolates were Gram-negative bacilli. Least susceptibility of E. coli isolates was observed to Cefepime [18.75%] and Ampicillin [12.50%]. CONCLUSION Culture positivity was found more in male neonates as compared to females. The male-to-female ratio being 1.69: 1. Highest blood culture positivity, i.e. 74.28% was found in neonates of age less than one week. 17.14% out of 70 babies with positive culture were having history of maternal pyrexia during gestation. 24.28% cases were found to have prolonged rupture of membranes during deliveries. 61.42% cases were preterm deliveries. 60% babies were having low birth weight. 62.85% cases were having early-onset sepsis and 37.14% were of late-onset sepsis.
Authors and Affiliations
Vaibhav Vitthalrao Rajhans, Sharmila Sanjay Raut, Sanjaykumar Rajaram More, Vimal Shriram Rathod, Vivek Madhukarrao Gujar
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