{"title":"Gram-negative Late Onset Neonatal Sepsis in a Tertiary Care Center From Central India: A Retrospective Analysis.","authors":"Akangksha Pataskar, Anuragsingh Chandel, Varsha Chauhan, Manish Jain","doi":"10.1177/11795565231189595","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Neonatal sepsis has been a major cause of neonatal mortality and morbidity globally. Late onset sepsis is on the rise mostly due to better health care services and improved survival of premature neonates. Gram-negative sepsis has emerged as a major public health problem constituting significant morbidity and mortality. There is limited data on gram-negative late onset sepsis from the central part of India, therefore this study was conducted at a tertiary care center from rural part of India.</p><p><strong>Objectives: </strong>To determine the clinical profile and outcome among neonates with gram-negative late onset sepsis.</p><p><strong>Design: </strong>It is a retrospective analysis conducted among neonates with gram-negative late onset sepsis at a tertiary care center from central India.</p><p><strong>Methods: </strong>All neonates below 28 days of age suspected to have late onset sepsis were enrolled in the study. The data for the period of January 2019 to December 2021 was collected and analyzed using software SPSS version 29. The outcome variables studied were discharge (good outcome) and death (poor outcome).</p><p><strong>Results: </strong>In the present study, overall prevalence of gram-negative late onset sepsis was 4.8%. Respiratory distress (52.2%), seizure (18.9%), jaundice (15.6%), and lethargy (15.6%) were common clinical symptoms among neonates with sepsis. The most common organism isolated was <i>Klebsiella</i> spp. (36.7%) followed by <i>Acinetobacter</i> spp. (31.1%) and <i>E. coli</i> (17.8%). Low gestational age (n = 20 vs n = 7, <i>P</i> = .002) and low birth weight (n = 33 vs n = 4, <i>P</i> = .02) were associated with poor outcomes in neonates with gram negative LOS. The overall mortality rate was found to be 30% among neonates with gram negative sepsis.</p><p><strong>Conclusion: </strong>The prevalence of gram-negative sepsis was found to be 4.8%. Factors associated with poor outcome in gram-negative sepsis were low birth weight, and prematurity. <i>Klebsiella</i> spp. was found to be a common cause of gram-negative LOS, therefore, the empiric antibiotic policy must provide coverage against these micro-organisms.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":null,"pages":null},"PeriodicalIF":1.7000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1c/1d/10.1177_11795565231189595.PMC10403979.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Medicine Insights-Pediatrics","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/11795565231189595","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Neonatal sepsis has been a major cause of neonatal mortality and morbidity globally. Late onset sepsis is on the rise mostly due to better health care services and improved survival of premature neonates. Gram-negative sepsis has emerged as a major public health problem constituting significant morbidity and mortality. There is limited data on gram-negative late onset sepsis from the central part of India, therefore this study was conducted at a tertiary care center from rural part of India.
Objectives: To determine the clinical profile and outcome among neonates with gram-negative late onset sepsis.
Design: It is a retrospective analysis conducted among neonates with gram-negative late onset sepsis at a tertiary care center from central India.
Methods: All neonates below 28 days of age suspected to have late onset sepsis were enrolled in the study. The data for the period of January 2019 to December 2021 was collected and analyzed using software SPSS version 29. The outcome variables studied were discharge (good outcome) and death (poor outcome).
Results: In the present study, overall prevalence of gram-negative late onset sepsis was 4.8%. Respiratory distress (52.2%), seizure (18.9%), jaundice (15.6%), and lethargy (15.6%) were common clinical symptoms among neonates with sepsis. The most common organism isolated was Klebsiella spp. (36.7%) followed by Acinetobacter spp. (31.1%) and E. coli (17.8%). Low gestational age (n = 20 vs n = 7, P = .002) and low birth weight (n = 33 vs n = 4, P = .02) were associated with poor outcomes in neonates with gram negative LOS. The overall mortality rate was found to be 30% among neonates with gram negative sepsis.
Conclusion: The prevalence of gram-negative sepsis was found to be 4.8%. Factors associated with poor outcome in gram-negative sepsis were low birth weight, and prematurity. Klebsiella spp. was found to be a common cause of gram-negative LOS, therefore, the empiric antibiotic policy must provide coverage against these micro-organisms.
背景:新生儿败血症已成为全球新生儿死亡和发病的主要原因。由于卫生保健服务的改善和早产儿存活率的提高,迟发性败血症正在上升。革兰氏阴性败血症已成为一个主要的公共卫生问题,造成了严重的发病率和死亡率。关于印度中部地区革兰氏阴性晚发败血症的数据有限,因此本研究是在印度农村地区的三级保健中心进行的。目的:探讨革兰氏阴性晚发型脓毒症新生儿的临床特点和预后。设计:对印度中部一家三级保健中心的革兰氏阴性迟发性败血症新生儿进行回顾性分析。方法:所有28日龄以下疑为晚发型脓毒症的新生儿均被纳入研究。收集2019年1月至2021年12月的数据,使用SPSS 29版软件进行分析。研究的结果变量为出院(好结果)和死亡(差结果)。结果:在本研究中,革兰氏阴性晚发型脓毒症的总体患病率为4.8%。呼吸窘迫(52.2%)、癫痫发作(18.9%)、黄疸(15.6%)和嗜睡(15.6%)是新生儿败血症的常见临床症状。检出最多的细菌是克雷伯氏菌(36.7%),其次是不动杆菌(31.1%)和大肠杆菌(17.8%)。低胎龄(n = 20 vs n = 7, P = 0.002)和低出生体重(n = 33 vs n = 4, P = 0.02)与革兰氏阴性LOS新生儿预后不良相关。发现革兰氏阴性脓毒症新生儿的总死亡率为30%。结论:革兰氏阴性脓毒症患病率为4.8%。与革兰氏阴性脓毒症预后不良相关的因素是低出生体重和早产。克雷伯氏杆菌被发现是革兰氏阴性LOS的常见原因,因此,经验性抗生素政策必须提供针对这些微生物的覆盖。