Clinical Profile of Neonatal Early Onset Sepsis: A Study on the Current Scenario

Clinical Profile of Neonatal Early Onset Sepsis

Keywords: Neonatal sepsis, clinical profile, risk factors

Abstract

Background: Neonatal early onset sepsis remains to be a challenge in India, owing to its variable presentation, diagnostic difficulty and high fatality. An attempt needs to be made to study its clinical profile for easy identification of such babies, with new antibiotic guidelines formulated based on current microorganisms isolated. The aim of the study is to study the clinical profile of early onset sepsis in neonates in terms of      the risk factors, clinical factors and etiology, and ascertain factors associated with definite sepsis. Subjects and Methods: This hospital based cross-sectional study enrolled neonates with suspected early onset sepsis. Those with congenital anomalies, surgical conditions, gestation <28 weeks and birth weight <1kg excluded. Subjects were subjected to sepsis screen and blood culture, and their perinatal history recorded. Blood culture positive babies were considered to have definite sepsis. Data was analysed using Chi square with SPSS 18. Results: Among 300 babies enrolled, 70 babies had definite sepsis. The most common organism isolated was Klebsiella (27.1%) and Staphylococcus hemolyticus (21.4%), most showing sensitivity to Ampicillin and Gentamicin. Respiratory distress was the commonest presentation (71.3%). A significant association with definite sepsis was seen with prematurity (p =0.0026) and low birth weight (p =0.0052), perinatal risk factors namely premature rupture  of membranes (p =0.004), foul smelling liquor (p=0.016) and birth asphyxia (p-value=0.02). 28.3% had positive sepsis screen, which was significant (p = 0.001). Conclusion: Early onset sepsis needs prompt identification and treatment initiation, possible with aid of sepsis screen and high index of suspicion with certain perinatal risk factors and gestational age and birth weight.

Downloads

Download data is not yet available.

References

Black RE, Cousens S, Johnson HL, Lawn JE, Rudan I, Bassani DG, et al. Global, regional, and national causes of child mortality in 2008: a systematic analysis. Lancet. 2010;375(9730):1969–1987. Available from: https://dx.doi.org/10.1016/s0140-6736(10)60549-1.

Bang AT, Bang RA, Baitule SB, Reddy MH, Deshmukh MD. Effect of home-based neonatal care and management of sepsis on neonatal mortality: field trial in rural India. Lancet. 1999;354(9194):1955–1961. Available from: https://dx.doi.org/10.1016/s0140-6736(99)03046-9.

Stoll BJ, Hansen NI, Sanchez PJ, Faix RG, Poindexter BB, Meurs KPV, et al. Early Onset Neonatal Sepsis: The Burden of Group B Streptococcal and E. coli Disease Continues. Pediatr. 2011;127(5):817–826. Available from: https://dx.doi.org/10.1542/peds.2010-2217.

Shane A, Sánchez PJ, Stoll BJ. Neonatal sepsis. Lancet. 2017;S0140-6736(17):31002–31006. Available from: https://doi.org/10.1016/S0140-6736.

Escobar GJ. The neonatal “sepsis work-up”: Personal reflections on the development of an evidence-based approach toward newborn infections in a managed care organization. Pediatrics. 1999;103(1 Suppl E):360–73.

Gerdes JS, Polin R. Early diagnosis and treatment of neonatal sepsis. Indian J Pediatr. 1998;65(1):63–78. Available from: https://dx.doi.org/10.1007/bf02849696.

Singh M, Narang A, Bhakoo ON. Predictive Perinatal Score in the Diagnosis of Neonatal Sepsis. J Trop Pediatr. 1994;40(6):365–368. Available from: https://dx.doi.org/10.1093/tropej/40.6.365.

Polinski C. The value of white blood cell count and differential in the prediction of neonatal sepsis. Neonatal Netw. 1996;15:13–23.

Silva OD, Ohlsson A, Kenyon C. Accuracy of leukocyte indices and C-reactive protein for diagnosis of neonatal sepsis. Pediatr Infect Dis J. 1995;14(5):362–366. Available from: https://dx.doi.org/10.1097/00006454-199505000-00005.

Fareedul H, Shamshad K, Prakash S. Clinical Profile and Risk factors in Neonatal Sepsis. IOSR-J Dent Med Sci

. 2017;13(12):44–47. Available from: https://dx.doi.org/10.9790/0853-131264447.

Murthy S, Godinho MA, Guddattu V, Lewis LES, Nair NS. Risk factors of neonatal sepsis in India: A systematic review and meta-analysis. PLOS One. 2019;14(4):e0215683– e0215683. Available from: https://dx.doi.org/10.1371/journal.pone.0215683.

Oddie S. Risk factors for early onset neonatal group B strepto- coccal sepsis: case-control study. BMJ. 2002;325(7359):308–308. Available from: https://dx.doi.org/10.1136/bmj.325.7359.308.

Shah GS, Budhathoki S, Das BK, Mandal RN. Risk factors in early neonatal sepsis. Kathmandu Univ Med J. 2006;4(2):187– 191.

Benitz WE, Gould JB, Druzin ML. Risk Factors for Early-onset Group B Streptococcal Sepsis: Estimation of Odds Ratios by Critical Literature Review. Pediatrics. 1999;103(6):e77–e77. Available from: https://dx.doi.org/10.1542/peds.103.6.e77.

Delhi Neonatal Infection Study (DeNIS) collabora- tion.Characterisation and antimicrobial resistance of sepsis pathogens in neonates born in tertiary care centres in Delhi, India: a cohort study. Lancet Glob Health. 2016;4:752–60. Available from: https://dx.doi.org/10.1016/S2214-109X(16)30148-6.

Jajoo M, Kapoor K, Garg LK, Manchanda V, Mittal SK. To study the incidence and risk factors of early onset neonatal sepsis in an out born neonatal intensive care unit of India. J Clin Neonatol. 2015;4(2):91–91. Available from: https://dx.doi.org/10.4103/2249-4847.154106.

Agarwal M, Chathurvedi P, Dey SK, Narang P. Coagulase negative staphylococcal septicemia in newborn. Indian Pediatr. 1990;27:163–169.

Chacko B, Sohi I. Early Onset Neonatal Sepsis. Indian J Pediatr. 2005;72(1):23–23. Available from: https://dx.doi.org/10.1007/BF02760574.

Pokhrel B, Koirala T, Shah G, Joshi S, Baral P. Bacteriological profile and antibiotic susceptibility of neonatal sepsis in neonatal intensive care unit of a tertiary hospital in Nepal. BMC Pediatr. 2018;18(1):208–208. Available from: https://dx.doi.org/10.1186/s12887-018-1176-x.

Basu R, Bandyopadhyay S. Study on Correlation between Sepsis Screening and Blood Culture in Neonatal Sepsis. IOSR-J Dent Med Sci. 2014;13(5):52–56. Available from: http://www.iosrjournals.org/.

Nandy M, Dutta S, Ganguly S, Dk P, Bandhopadhyay M. Changes in the Incidence and Spectrum of Neonatal Septicemia During a Fifteen-Year Period. Child New Born. 2007;11(1):3–6. Available from: https://dx.doi.org/10.1111/j.1651-2227.1985.tb10014.x.

Joshi SG, Ghole VS, Niphadkar KB. Neonatal gram-negative bacteremia. Indian J Pediatr. 2000;67(1):27–32. Available from: https://dx.doi.org/10.1007/bf02802632.

Vandana G, rao magar SL, Praveen D, devi BK, rani S, anil S. IOSR-J Dent Med Sci . 2017;16:11–17. Available from: https://dx.doi.org/10.9790/0853-1604091117.

Gupta I, Naskar P, Mitra G. Spectrum of Bacterial Infection and Antimicrobial Sensitivity Pattern in Neonatal Septicemia in a Peripheral Tertiary Care Hospital in West Bengal. Indian J Comm Med. 2016;3(9):34–38.

Buch A, Shrivastava, Kumar H, Jadhav P. Evaluation of hematological profile in early diagnosis of clinically suspected cases of neonatal sepsis. Int J Bams. 2011;1(1):1–06. Available from: http://www.cibtech.org/jms.htm.

Published
2020-07-09
How to Cite
Kiran C Pankaj, Ganguly, S., & Upadhyay, M. R. (2020). Clinical Profile of Neonatal Early Onset Sepsis: A Study on the Current Scenario. Asian Journal of Clinical Pediatrics and Neonatology, 8(2), 36- 41. https://doi.org/10.47009/ajcpn.2020.8.2.7