IJCRR - vol 06 issue 03, February, 2014
A COMPARATIVE STUDY OF EARLY ONSET VERSUS LATE ONSET NEONATAL SEPSIS WITH SPECIAL REFERENCE TO BACTERIOLOGICAL, DEMOGRAPHIC AND CLINICAL PROFILE
Author: Kuhu Pal, Arnab Kumar Samanta, Ritesh Singh
Introduction: Neonatal sepsis is classically divided into early onset sepsis (EOS) and late onset sepsis (LOS) depending upon the time of onset of sepsis. Aims: To determine the differences in bacteriological, demographic and clinical profile between EOS and LOS, if any. Setting and Design: A prospective study was carried out in a tertiary care centre of Eastern India from March 2011 to February 2012. Methods: Neonates with less than 28 days age, associated with a clinical diagnosis of sepsis were included in the study. Blood was collected aseptically for culture and isolates were identified in conventional way and antibiotic sensitivity test was done by Kirby Bauer disc diffusion method. Epidemiological parameters, clinical features were compared in the light of culture report. Statistical analysis used: Chi square test, ANOVA and multivariate regression analysis. Results: Out of 230 clinically suspected septic neonates, 72.6% of neonates presented with EOS and 27.4% with LOS. None of the bacteria except Klebsiella sp. was significantly associated with EOS (P=0.043). Almost identical result was observed between EOS and LOS, when demographic parameters including gender, birth weight, gestational age, mode of delivery, outcome and clinical presentation were compared. Caesarean section was significantly associated with increased morbidity in cases of EOS (multivariate P value 0.018). Conclusion: There was no statistically significant difference in epidemiological, clinical and bacteriological profile between EOS and LOS except a few. So it is better to judge the two groups of neonatal sepsis as one and universal.
Keywords: Demography, Early onset sepsis, Late onset sepsis, Microbiological spectrum
Kuhu Pal, Arnab Kumar Samanta, Ritesh Singh. A COMPARATIVE STUDY OF EARLY ONSET VERSUS LATE ONSET NEONATAL SEPSIS WITH SPECIAL REFERENCE TO BACTERIOLOGICAL, DEMOGRAPHIC AND CLINICAL PROFILE International Journal of Current Research and Review. vol 06 issue 03, February, 07-15
1. Klein Jo. Bacterial Sepsis and Meningitis. In: Remington JS, Klein Jo.eds. Infectious diseases of fetus and newborn and infants. 5 theds. W B Saunders Co. Philadelphia; 2001:943-984.
2. Guha D.K, Saili A. Guha R, Aggarwal A. Common Infections in the Newborn. In: Neonatology – Principles and Practice. Guha D.K; 3rd eds. Jaypee Brothers Medical Publishers (P) Ltd. New Delhi, India; 2005: 654 – 672.
3. Stoll BJ. Infection of the Neonatal Infant. In Nelson’s Text Book of Paediatrics; Behrman RE, Kleigman RM, Jenson HB. 18theds; WB Saunders Co.2006; 794-811.
4. A.K. Zaidi, W.C. Huskins, D. Thaver et al., Hospital acquired neonatal infections in developing countries, Lancet 2005; 365 : 1175–1188.
5. Sundaram V, Kumar P and Narang A. Bacterial profile of early versus late onset neonatal sepsis in a North Indian tertiary care centre: Heading towards a change. Journal of Pediatric Infectious Diseases 2009; (4): 241– 245
6. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial disk susceptibility tests. Approved standard M2- A10. Wayne, PA: Clinical and Laboratory Standards Institute; 2009
7. Shah M. N. and. Desai P. B. Clinical and bacteriological profiles of blood culture positive sepsis in newborns.IntJ. of Pharm. and Life Sci. 2011; 2(9):1041-1045
8. Hafsa A, Fakruddin M, Hakim MA, Sharma JD. Neonatal bacteremia in a neonatal intensive care unit: analysis of causative organisms and antimicrobial susceptibility. Bangladesh Journal of Medical Science 2011; 10 (3) ;187-194
9. Shrestha NJ, Subedi KU, Rai GK. Bacteriological Profi le of Neonatal Sepsis: A Hospital Based Study. J Nepal Paedtr Soc 2011;31(1):1-5.
10. Kuruvilla A K, Pillai S, Jesudason M and Jana A K. Bacterial profile of sepsis in a Neonatal Unit in South India. Indian Pediatrics 1998; 35:851-858
1. Jia-Horng Jiang, Nan-Chang Chiu, Fu-Yang Huang, Hsin-An Kao, Chyong-Hsin Hsu, Han-Yang Hung et al . Neonatal sepsis in the neonatal intensive care unit: characteristics of early versus late onset. J Microbiol Immunol Infect 2004;37:301-306
12. Motara F, Ballot DE, Perovic O. Epidemiology of neonatal sepsis at Johannesburg hospital. The Southern African journal of Epidemiology and Infection 2005;3: 90-93
13. Viswanathan R, Singh Arun K, Ghosh C, Dasgupta S, MukherjeeS,and Basu S. Profile of Neonatal Septicaemia at a District-level Sick Newborn Care Unit. J Health Popul Nutr 2012;30(1):41-48
14. Pal K, Samanta A K. Bacteriological profile and antimicrobial resistance pattern in early onset neonatal sepsis: challenge to the physician. Int J Cur Res Rev 2013; 5 (6):51- 58
15. Yilmaz N O, Agus N, Helvaci M, Kose S, Ozer E, and Sahbudak Z. Change in Pathogens Causing Late-onset Sepsis in Neonatal Intensive Care Unit in Izmir, Turkey. Iranian Journal of Pediatrics 2010; 20 (4): 451-458
16. Joseph CJ, Wee Bin Lian W B, Yeo C L. Nosocomial Infections (Late Onset Sepsis) in the Neonatal Intensive Care Unit (NICU). Proceedings of Singapore Healthcare 2012; 21(4): 238-244
17. Afsharpaiman S,Torkaman M, Saburi A,Farzaampur A, Amirsalari S, Kavehmanesh Z. Trends in incidence of neonatal sepsis and antibiotic susceptibility of causative agents of two neonatal intensive care units in Tehran.I.R. Iran. Journal of Clinical Neonatology. 2012;1(3):124-130.
8. Khinchi Y. R, Kumar A, Yadav S. Profile of Neonatal sepsis. Journal of college of Medical Sciences-Nepal, 2010; 6 (2): 1-6
19. Mosayebi Z, Movahedian AH, Soori T. Clinical and bacteriological chartacteristics of neonatal sepsis in an intensive care unit of Kashan, Iran: A 2 years descriptive study. Arch Pediatr Infect Dis. 2013;1(2):61-64
20. Signore C.Klebanoff M. Neonatal morbidity and mortality after elective caesarean delivery. Clin Perinatol 2008; 35: 361-371