Bacteria Causing Early Onset Sepsis in Neonates Admitted in Neonatal Intensive Care Unit of a Military Hospital in Muzaffarabad, Azad Kashmir Pakistan
DOI:
https://doi.org/10.36570/jduhs.2023.2.1843Keywords:
Early Onset of Sepsis, Escherichia Coli, Neonates, Pakistan, Staphylococcus AureusAbstract
Objective: To determine the burden of early onset of sepsis (EOS) in suspected neonates and to assess the most common causative agents of EOS in these neonates.
Methods: This prospective cross-sectional study was conducted at H.H. Sheikh Khalifa Bin Zayed Al Nahyan Hospital/Combined Military Hospital, Muzaffarabad, Pakistan from January 2020 to June 2021. All neonates admitted in Neonatal Intensive Care Unit (NICU) during first 3 days of life with suspicion of sepsis, based on maternal history or neonatal clinical examination were enrolled. EOS was defined based on the presence of clinical sepsis developed within 72 hours of life or if positive blood/cerebrospinal fluid (CSF) cultures were detected . This information along with the bacteria causing EOS was noted.
Results: Of 109 suspected neonates for EOS, positive blood culture for EOS was observed in 26 (23.9%) neonates. Risk of EOS was 7 times higher among neonates with total leucocyte count (TLC) ≥30,000 per mm as compared to neonates with < 30,000 per mm of TLC (aOR 7.19, 95% CI 2.12 to 24.31, p-value 0.002). Gram positive was the most common bacterial isolates, i.e., 15 (57.69%) whereas gram negative was observed in 11 (42.31%) neonates. Of 15 neonates with gram positive bacteria, all had staphylococcus aureus, i.e., 15 (100%) whereas of 11 neonates with gram negative bacteria, Escherichia coli was observed in majority of the neonates, i.e., 7 (63.64%).
Conclusion: In our study cohort, a significant occurrence of EOS we observed. Specifically, gram-positive organism (staphylococcus aureus) was the predominant cause of sepsis.
Downloads
References
Ahn HM, Park EA, Cho SJ, Kim YJ, Park HS. The associa-tion of histological chorioamnionitis and antenatal steroids on neonatal outcome in preterm infants born at less than thirty-four weeks' gestation. Neonatology 2012; 102:259-64. doi:10.1159/000339577
Puopolo KM, Draper D, Wi S, Newman TB, Zupancic J, Lieber-man E, et al. Estimating the probability of neonatal early-onset infection on the basis of maternal risk factors. Pediatrics 2011; 128:1155-63.
doi:10.1542/peds.2010-3464
Pappas A, Kendrick DE, Shankaran S, Stoll BJ, Bell EF, Laptook AR, et al. Eunice kennedy shriver national institute of child health and human development neonatal research network. Chorioamnionitis and early childhood outcomes among extremely low-gestational-age neonates. JAMA Pediatr 2014; 168:137-47. doi:10.1001/jamapediatrics
Schrag SJ, Farley MM, Petit S, Reingold A, Weston EJ, Pondo T et al. Epidemiology of Invasive early-onset neonatal sepsis, 2005 to 2014. Pediatrics 2016; 138:e20162013.
doi:10.1542/peds.2016-2013
Lawn JE, Blencowe H, Oza S, You D, Lee AC, Waiswa P, et al. Lancet every newborn study group. Every newborn: progress, priorities, and potential beyond survival. Lancet 2014; 384:189-205.
doi:10.1016/S0140-6736(14)60496-7
Verani JR, McGee L, Schrag SJ. Division of bacterial diseases, national center for immunization and respiratory diseases, centers for disease control and prevention (CDC). Prevention of perinatal group B streptococcal disease–revised guidelines from CDC, 2010. MMWR Recomm Rep 2010; 59:1–36.
Puopolo KM, Benitz WE, Zaoutis TE. Committee on fetus and newborn; Committee on infectious diseases. Management of neonates born at #34 6/7 weeks' gestation with suspected or proven early-onset bacterial sepsis. Pediatrics 2018; 142:1-10.
Weissman SJ, Stoll B. Ampicillin and gentamicin in infa-nts with suspected sepsis: long live Amp and Gent-but for how long? JAMA Pediatr 2021; 175:131–2.
Rathore H, Rahman AJ, Salman M, Nasir M, Sherali. Frequency of early-onset neonatal sepsis following prolonged rupture of membranes. Cureus 2020; 12:e6864.
doi:10.7759/cureus.6864
Ahmed M, Yasrab M, Khushdil A, Qamar K, Ahmed Z. Neonatal sepsis in a tertiary care hospital: bacte-riological profile and its antibicrobial sensitivity. PAFMJ 2018; 68:1654-8.
Atif M, Zia R, Malik I, Ahmad N, Sarwar S. Treatment outcomes, antibiotic use and its resistance pattern among neonatal sepsis patients attending Bahawal Victoria Hospital, Pakistan. PloS One 2021; 16:e0244866.
Akbarian-Rad Z, Riahi SM, Abdollahi A, Sabbagh P, Ebrahim-pour S, Javanian M, et al. Neonatal sepsis in Iran: A systematic review and meta-analysis on national prevalence and causative pathogens. PLoS One 2020; 15:e0227570.
doi:10.1371/journal.pone.0227570
Nyma Z, Rahman M, Hasan SM, Roby NU, Khanam F, Ala-m ME, et al. Prevalence and associated risk factors of sepsis among neonates admitted into neonatal intensive care units of public hospitals in Dhaka. Cureus 2020; 12:e7461.
doi:10.7759/cureus.7461
Salsabila K, Toha NM, Rundjan L, Pattanittum P, Sirikarn P, Rohsiswatmo R, et al. Early-onset neonatal sepsis and antibiotic use in Indonesia: a descriptive, cross-sectional study. BMC Public Health 2022; 22:1–12.
doi:10.1186/s12889-022-13343-1
Swarnkar K, Swarnkar M. A study of early onset neonatal sep-sis with special reference to sepsis screening parameters in a tertiary care centre of rural India. Int J Infect Dis 2012; 10:1–8.
Xiao T, Chen LP, Liu H, Xie S, Luo Y, Wu DC. The analysis of etiology and risk factors for 192 cases of neonatal sepsis. Biomed Res Int 2017; 2017:8617076.
doi:10.1155/2017/8617076
Adatara P, Afaya A, Salia SM, Afaya RA, Konlan KD, Agyabeng-Fandoh E, et al. Risk Factors Associated with Neonatal Sepsis: A Case Study at a Specialist Hospital in Ghana. Sci World J 2019; 2019:9369051.
doi:10.1155/2019/9369051
Adatara P, Afaya A, Salia SM, Afaya RA, Kuug AK, Agbi-nku E, et al. Risk factors for neonatal sepsis: a retrospective case-control study among neonates who were delivered by caesarean section at the trauma and specialist hospital, Winneba, Ghana. Biomed Res Int 2018; 2018:6153501.
doi:10.1155/2018/6153501
Akalu TY, Gebremichael B, Desta KW, Aynalem YA, Shiferaw WS, Alamneh YM. Predictors of neonatal sepsis in public referral hospitals, Northwest Ethiopia: A case control study. PLoS One 2020; 15:e0234472.
doi:10.1371/journal.pone.0234472
Shaw CK, Shaw P, Thapalial A. Neonatal sepsis bacterial isola-tes and antibiotic susceptibility patterns at a NICU in a tertiary care hospital in western Nepal: a retrospective analysis. Kathmandu Univ Med J 2007; 5:153-60.
Shaikh MH, Gul R, Hussain W, Hemandas H, Memon A. Spect-rum and Antimicrobial Susceptibility Pattern of Micro-Organisms Associated With Neonatal Sepsis in a Hospital in Karachi, Pakistan. Cureus 2020; 12:e10924.
doi:10.7759/cureus.10924
Mudassar S, Nawaz J, Ali M, Rana M, Mahmood F, Iqbal S. Neonatal sepsis: frequency and antibiogram profiling of bacterial isolates in a tertiary teaching hospital Lahore, Pakistan. Int J Contemp Med 2019; 6:14-8.
doi:10.21276/ijcmr.2019.6.10.50
Shane AL, Sanchez PJ, Stoll BJ. Neonatal sepsis. Lancet 2017; 390:1770-80. doi:10.1016/S0140-6736(17)31002-4
Lorthe E, Quere M, Kayem G. Prolonged latency after preterm premature rupture of membranes: an independent risk factor for neonatal sepsis? Am J Obstet Gynecol 2017; 216:84.
doi:10.1016/j.ajog.2016.08.022
Murthy S, Godinho MA, Guddattu V, Lewis LE, Nair NS. Risk factors of neonatal sepsis in India: A systematic review and meta-analysis. PloS One 2019; 14:e0215683.
doi:10.1371/journal.pone.0215683
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Bareerah Haidry, Naheem Ahmed, Tayyaba Saddique, Maryam Abbasi, Momina Shafique, Nuzhat Rasheed
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Articles published in the Journal of Dow University of Health Sciences are distributed under the terms of the Creative Commons Attribution Non-Commercial License https://creativecommons.org/ licenses/by-nc/4.0/. This license permits use, distribution and reproduction in any medium; provided the original work is properly cited and initial publication in this journal. 
