Clinical manifestation and laboratory findings in positive blood culture in neonatal septicemia

Document Type: Original Article

Authors

1 MASHHAD UNIVERSITY OF MEDICAL SCIENCES

2 Department of Pediatrics, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 Department of Microbiology, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Background/objective: Neonatal septicemia is one of the major causes of mortality in newborns. The aim of this study is to evaluate the clinical manifestations and laboratory findings in positive blood culture in neonatal septicemia.
Methods: In this retrospective study, we allocated 100 records positive blood culture of neonates suffering from septicemia. A questionnaire was completed for each patient consisting the age at admission, gender, weight at birth, admission time, type of delivery, pre- or post-term delivery and the clinical symptoms. Types of organism causing sepsis, and their resistance to antibiotics were evaluated and method for empirical treatment was recommended.
Results: Respiratory distress, cyanosis and lethargy were more common in the patients. The antibiogram showed Ampicillin resistance in 86% and Gentamycin resistance in 66% of studied records. Also, 36% cases of positive blood culture with gram-negative and 64% with gram-positive bacteria were observed. The most common bacteria in blood cultures were negative-coagulase Staphylococcus (%35), Staphylococcus Aureus (%24), Klebsiella (%18), respectively. Other bacteria were Enterobacter, Escherichia coli and Enterococcus (%5), Acinetobacter (%3), Pseudomonas aeruginosa and Negative-Gram Bacilli (%2) and Ceratia (%1). The most common effective antibiotics against bacterial growth in Antibiograms were Vancomycin, Cephalosporin, Amikacin, Co-trimoxazole and Gentamycin.
Conclusion: Since the most common bacteria in neonatal septicemia cases were negative-coagulase Staphylococcus, Staphylococcus Aureus, Klebsiella, the pediatricians must select the regiments that cover gram-negative bacteria for empirical antibiotic treatments.

Keywords


  1. Viswanathan R, Singh AK, Ghosh C, Dasgupta S, Mukherjee S, Basu S. Profile of neonatal septicaemia at a district-level sick newborn care unit. J Health Popul Nutr. 2012; 30(1):41-8.
  2. Kaistha N, Mehta M, Singla N, Garg R, Chander J. Neonatal septicemia isolates and resistance patterns in a tertiary care hospital of North India. J Infect Dev Ctries. 2009; 4(1):55-7.
  3. Mondal GP, Raghavan M, Vishnobhat B, Srinivasan S. Neonatal septicemia among inburn and out burn babies in a referral hospital. Indian J Pediatr. 1991; 58:529-33.
  4. Gupta BEl Amin E. Changing patterns of blood borne sepsis in special care baby unit, khoula hospital. Oman Med J. 2010; 25(2):100-3.
  5. Namavar Jahromi B, Salarian L, Shiravani Z. Maternal Risk Factors and Neonatal Outcome of the Admitted Patients for Preterm Spontaneous Uterine Contractions.  Iran Red Crescent Mel J. 2011; 13(12): 877-83.
  6. Al-Shamahy HASabrah AAAl-Robasi ABNaser SM. Types of Bacteria associated with Neonatal Sepsis in Al-Thawra University Hospital, Sana'a, Yemen, and their Antimicrobial Profile. Sultan Qaboos Univ Med J. 2012; 12(1):48-54.
  7. Haque KN, Khan MA, Kerry S, Stephenson J, Woods G. Pattern of culture-proven neonatal sepsis. A district general hospital in United Kingdom. Infect Control Hosp Epidemiol. 2004; 25:759-64.
  8. Paolucci MLandini MPSambri V. How can the microbiologist help in diagnosing neonatal sepsis?. Int J Pediatr. 2012; 2012:120139.
  9. Palazzi D, Klein J, Baker C. Bacterial sepsis and meningitis. In: Remington JS, Klein J, editors. Infectious Disease of the Fetus and Newborn Infants. 6th ed. Philadelphia: Elsevier Saunders; 2006.
10. Naderi-Nasab M, Farhat AS. Study of the bacterial agents in nosocomial and acquired infections based on the biood culture in neonatal intensive care unit of a hospital, north east of Iran. Saudi Med J. 2007; 28(5):723-726.

11. Gheibi Sh, Karamyar M, Khashabi J, Ilkhanizade B, Asgharisana F, Mahmoodzade H, et al. Coagulase negative staphylococcus ; the most common cause of neonatal septicemia in Urmia Iran. Iran J Pediatr. 2008; 18(3):237-243.

12. Hammoud MS, Al-Taiar A, Thalib L, Al-Sweih N, Pathan S, Isaacs D . Incidence, aetiology and resistance of late-onset neonatal sepsis: a five-year prospective study. J Paediatr Child Health. 2012; 48(7):604-9.

13. Mokaddas EM, Shetty SA, Abdullah AA, Rotimi VO. A 4-year prospective study of septicemia in pediatric surgical patients at a tertiary care teaching hospital in Kuwait. . J Pediatr Surg. 2011; 46(4):679-84.

14. Matloub HY, Matloub SY, Manna MJ. Comparative Study in Neonates with Septicemia Using Meropenem Versus Ceftriaxone Plus Vancomycin. The Iraqi Postgraduate Medical Journal. 2012; 11(2): 258-65.

15. Martin R, Fanaroof A, Walsh M. Neonatal prenatal medicine, disease of the fetus and infants.9th ed. Elsevier Mosbey; 2010.

16. Orrett FA, Shurland SM. Neonatal sepsis and mortality in a regional hospital in Trinidad: aetiology and risk factors. Ann Trop Paediatr. 2001; 21(1):20-5.

17. Jadba AE, Yazji ME. Naonatal septicemia  in Gaza city hospitals. Pak J Med Sci.2009; 25(2):226-231. 

18. Vander Ent CK, Jooston KF, Tielens AW, Gerards LJ. Diagnosis of infection in full-term infants born after prolonged status of ruptured membranes: clinical observation is sufficient. Ned Tijdschr Geneskd.1992; 36(38):1858-61. 

19. Zamora-Castorena S, Murguia-de-sierra MT. Five years experience with neonatal sepsis in a pediatric center. Rev Invest Clin.1998; 50(6):463-70.

20. Viswanathan R, Singh AK, Mukherjee S, Mukherjee R, Das P, Basu S. Aetiology and antimicrobial resistance of neonatal sepsis at a tertiary care centre in eastern India: a 3 year study. Indian J Pediatr. 2011; 78(4):409-12.