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BACKGROUND: Neonatal septicemia is a clinical syndrome characterized by signs and symptoms of infection with or without accompanying bacteremia in the first month of life. It is characterized by positive blood culture, thrombocytopenia and elevated C-reactive protein. Septic shock is the most dangerous complication of septicemia. Thrombocytopenia (platelet count < 150,000/µL) is one of the most common hematological problems in Neonatal Intensive Care Units (NICUs),. Thrombocytopenia in DIC occurs mainly due to consumption of certain coagulation factors and circulating platelets. There may be a possibility of immune mechanism & Bacteria or bacterial products leads to development of thrombocytopenia in septicemia. AIM: • Platelet count and their indices in neonatal sepsis in relation to specific organisms. • To identify organism involved in proven neonatal sepsis affecting platelet indices. MATERIALS AND METHODS: A Hospital-based cross-sectional study was conducted in the Department of Paediatrics, Santhiram medical college& general hospital for 12 months. RESULTS: A total of 50 neonates with blood culture positive for bacterial cases shows EOS(59%) was more common than LOS(41%). Out of 50 cases 57% cases had growth of gram negative organisms, 40% had growth of gram positive organisms and 3% had growth of fungal. Tachypnea(27%), Lethargy (20%) and refusal of feeds (8%) were the commonest clinical presentation followed by,Fever (6%), convulsions (5%) and jaundice (5%). 60% neonates had thrombocytopenia of varying severity. Staphylococcus aureus was the most common organism associated with thrombocytopenia (43.3%%). MPV was high in 85% of cases and PDW was high in 96% of cases.. CONCLUSION: The present study highlights the association of thrombocytopenia, mean platelet volume and platelet distribution width with causative organism in proven neonatal sepsis. Staphylococcus aureus was the most common organism causing thrombocytopenia in our NICU. [ABSTRACT FROM AUTHOR]

Objective: To explore the evaluation value of peripheral blood red blood cell distribution width (RDW), procalcitonin (PCT) and lactic acid for severity of neonatal septicemia (NS). Methods: A total of 132 children with NS admitted to the hospital were enrolled as the research objects between May 2019 and December 2022. According to neonatal critical illness score (NCIS), children were divided into non-critical group(>90 points, 94 cases) and critical group (70-90 points, 38 cases). The levels of peripheral blood RDW, PCT and lactic acid in the two groups were compared. The diagnostic value of the above three indexes for critical NS was evaluated by receiver operating characteristic (ROC) curves, and their correlation with disease severity was analyzed by Spearman analysis. Results: The proportion of gestational age <37 weeks in critical group was higher than that in non-critical group, while birth weight was lower than that in non-critical group (P<0.05). The levels of peripheral blood RDW, PCT and lactic acid in critical group were higher than those in non-critical group (P<0.05). The results of ROC curves analysis showed that area under the curve (AUC) values of RDW, PCT, lactic acid and combined detection for evaluating critical NS were 0.844, 0.645, 0.643 and 0.874, respectively(P<0.05). Spearman analysis showed that RDW, PCT and lactic acid were positively correlated with disease severity in NS children (P<0.05). Conclusion: The peripheral blood RDW, PCT and lactic acid are closely related to disease severity in NS children. Clinically, combined detection of the three indexes can be applied to evaluate disease severity in NS children. [ABSTRACT FROM AUTHOR]

Background: Neonatal septicemia is one of the primary causes of disease and death in low-income countries which makes early diagnosis an important factor to prevent microbial resistance and initiate antibiotic therapy. C-reactive protein is an essential biological indicator that might play an important role in the early detection of neonatal sepsis. Objective: The present study was conducted to determine the sensitivity and specificity of CRP against blood culture in the identification of neonatal sepsis. Methods: This study was carried out on 416 neonates identified with sepsis at the NICU and SICU of the National Institute of Child Health, Karachi, Pakistan for a span of 06 months from April 2022 to September 2022. The first blood sample for the evaluation of CRP and blood culture was drawn at the time of admission. The second sample of CRP and blood culture was drawn 72 hours after the first blood collection. The sensitivity and specificity of CRP were calculated on both occasions. Results: Of the total 416 neonates, 165(39.6 %) patients’ blood culture was positive and in 273 (65.9%) patients CRP was positive. The validation study of CRP in the diagnosis of neonatal septicemia reported sensitivity, specificity, positive predictive value, and negative predictive value to be 87.1%, 45.9%, 52.6%, and 83.7% 72 hours after the admission in comparison to 80.6%, 44.2%, 48.7%, and 77.6% at the time of admission. Conclusion: The high specificity and sensitivity of CRP against blood culture make it an important diagnostic modality that might play a helpful role in the diagnosis of neonatal sepsis.

Background: This study aimed to evaluate cord blood haematological parameters in pregnant mothers with high risk factors in predicting early onset neonatal sepsis. Methods: This is hospital based study done at Department of Obstetrics and Gynaecology, Siddhartha Medical College, Vijayawada. All examinations were done 24 hours after birth. Neonatal sepsis (NS) was characterized as a positive blood culture with symptoms of infection. All smears were examined by the pathologist blinded to the clinical findings. Platelet count & WBC, Differential leucocyte count, Nucleated RBC (for correction of leucocyte count), Neutrophil morphology for assessing degenerative changes.e A complete blood count, included TLC, platelet count, total neutrophil count (TNC). Absolute neutrophil counts (ANC) were calculated from the observed values. Results: Out of 100 high risk cases of neonatal septicaemia 56 culture positive cases 39 (69.64%) were males and 17 (30.36%) were females. Among the culture positive cases Klebsiella were the commonest isolates i.e, Klebsiella 23(41.07%), Staphylococci 12(21.43%), Pseudomonas6(10.71%), Enterobacter 5(8.93%), E.coli 4(7.14), Providencia 4(7.14%)And Acinetobacter 2(3.57%). 14. Haematological scoring system at score =2 was reliable since it had sensitivity & NPV of 100% but specificity and PPV of 54.7.A score of Haematological score of =5 had specificity and PPV of 100%. With increase in the score, the specificity and Positive predictive value increased. Among the different screening parameters assessed, total neutrophil count had highest sensitivity and Negative predictive value. Immature neutrophil count had highest Specificity and Positive predictive value. Conclusion: Neonatal septicemia is still a leading cause of mortality and morbidity in developing countries like India. Gram negative organisms are the predominant causative agents in neonatal septicemia with Klebsiella pneumonia leading the list. Blood culture is considered "Gold standard" for the diagnosis of septicemia in neonates. A hematological score of 0 and 1 suggested sepsis was unlikely, 2-3 - sepsis possible and score 4 and 5 indicated very likely. The study found that the higher the score the greater the certainty that sepsis occurs. [ABSTRACT FROM AUTHOR]

Objective. Neonatal respiratory infections continue to be a significant cause of illness and death in newborn infants. the aim was to determine the association of pneumonia in 60 neonates with septicemia and it is role in the morbidity and mortality of neonates in two Neonatal Intensive Care Units (NICU) in Al-Ramadi Teaching Hospital for Maternity and Children. Material and methods. All infants in this study were diagnosed with septicemia and were on empirical antimicrobial therapy. An early morning nasogastric tube (NG tube) was used to collect swallowed sputum by suction for culture and sensitivity. Outcomes. All neonates were diagnosed with septicemia. The positive bacterial blood culture was 28 (46.7%). The NG-tube culture revealed 100% fungal growth, 49 (81.6%) Candida albicans, Candida tropicalis 6 (10%) and Cryptococcus laurentii 5 (8.3 %). The NG-tube culture revealed 100% bacterial growth Staphylococcus aureus 8 (13.3%), Streptococcus pneumonia 5 (8.3), Klebsiella pneumonia 25 (41.6%), Klebsiella oxytoca 2 (3.3), Acinetobacter baumannii 12 (20%), Pseudomonas aeruginosa 3 (5%) and Pseudomonas putida 2 (3.3%). 42 (70%) of patients were received antifungal drug (fluconazole), 34 (80.9%) of them showed improvement, while 8 (19%) showed no improvement. 18 (30%) of patients received no medication, of which 3 (16.6%) showed improvement, while 15 (83.3%) showed no improvement. Conclusion. Bacterial pneumonia with mycotic co-infection in neonates with septicemia may lead to an increase in the mortality rate. During this study, using antimycotic medications led to a drop in the mortality rate to zero. [ABSTRACT FROM AUTHOR]

Introduction: Neonatal sepsis is a leading cause of morbidity & mortality in developing countries especially like India. As per involvement of different organisms, mortality rates differ among neonates. So, early detection of causing organism along with the identification of risk factors helps to prevent mortality among Neonates in India. Objectives: To study the risk factors associated with neonatal septicemia and its bacteriological profile at one of the tertiary care hospital of Gujarat. Method: The study was prospective observational research study in which purposive sampling technique was used to identify the 106 neonates blood culture positive to sepsis admitted in NICU of one of the tertiary care hospital in Gujarat in time period of 1 year from Nov 2021 to Oct 2022. Results: Out of 106 neonates, common factors associated with neonatal septicemia were gender, prematurity, law birth weight, gestational age & onset of septicemia. Meconium stained liquor, Pregnancy induced hypertension and Oligohydramnios were the commonest maternal risk factor associated with neonatal sepsis. Blood culture proven sepsis in neonatal septicemia was predominantly caused by Gram negative organism Klebsiella pneumonia. Conclusion: Neonatal septicemia is more common in preterm and low birth weight neonates. Early onset septicemia is more common which can be curtailed by clean vaginal deliveries. Prematurity and low birth remains the major presentation for admission in NICU followed by respiratory distress syndrome. Maternal risk factors like meconium stained liquor, pregnancy induced hypertension oligohydramnios, & leaking per -vaginal are associated With increase in the incidence of neonatal septicemia

Abstract Background Many aspects of microbial dissemination appear to vary with host cholesterol levels. Since neonatal septicemia remains a leading cause of newborn admissions and mortality in resource-limited settings, the contribution of abnormal cholesterol levels in maternal and/or newborn blood to the risk of neonatal septicemia and outcome requires elucidation. We aim to determine a relationship between maternal serum and neonatal cord blood cholesterol levels and neonatal septicemia. Methods This will be a mother-newborn pair cohort study. Approximately 353 pregnant women who are eligible and consent to participate in the study will have blood drawn for a lipid profile. Upon delivery, we will analyse the cord blood cholesterol of their newborns and follow them for 28 days to determine whether the infants develop clinical signs and symptoms suggestive of neonatal septicemia. Relative risk will be used to determine the association between cholesterol and newborn septicemia. Poisson regression will be used to estimate the relative risk (with 95% confidence intervals) of developing septicemia. Discussion Findings from our study will contribute evidence to support the inclusion of lipid profile screening for pregnant women and newborns. Our study will determine whether newborns with abnormal cholesterol or those born to mothers with abnormal cholesterol will require rigorous follow-up in neonatal clinics.

Background: The most significant cause of infant fatalities in the neighborhood is neonatal sepsis. Objective: To identify the typical bacterial infections linked to neonatal sepsis, as well as their pattern of antibiotic sensitivity. Materials and Methods: A total of 100 newborns admitted to the neonatology unit during the study period had their physical examinations and clinical characteristics. All infants were observed using conventional methods and the Kirby- Bauer disc diffusion method. Samples were also tested for standard antibiotic sensitivity. Results: The present study showed that out of 100 clinically suspected neonatal sepsis cases. 44% newborn sepsis patients with clinical suspicion and positive screening test results were confirmed by culture. The majority pathogen in the culture-positive cases was discovered to be Gram Negative 66% (n= 29); among them 62.06% (n=18) belonged to EONS and 37.93% (n=11) belonged to LONS. Klebsiella pneumoniae 46.15 % (n=12) was the most common isolate followed by Escherichia coli 23.06 %(n=6) whereas 34 % (n=15) were Gram Positive isolates. Out of 15 Gram-Positive isolates, 53.33% (n=8) were of EONS and 46.7 % (n=7) were of LONS. Staphylococcus aureus 19.23% (n=5) was the most common isolate followed by CoNS 7.69 %(n=2) and Enterococcus faecalis 3.85% (n=1). Conclusion: The timely diagnosis and prompt use of antibiotics according to standard policy is warranted to save newborns from septicemia. Knowing the bacterial infections that are widespread in NICUs and their antimicrobial susceptibility pattern can assist the doctor choose the right drugs for treating cases of suspected newborn sepsis in light of the developing bacterial resistance to commonly used antibiotics. [ABSTRACT FROM AUTHOR]

Neonatal septicemia is a major cause of infection and mortality in neonates. Neonatal sepsis is a type of neonatal infection, particularly bacteremia, diagnosed by the presence of microorganisms in blood via microbiological culture tests during the first 4 weeks of birth. Neonatal sepsis is classified into early bacterial neonatal septicemia (less than 72 h) and late bacterial neonatal septicemia (>72 h–28 d) according to age. Isolation of septicemia-causing bacteria from the blood of neonates and investigation of their antibiotic susceptibility pattern for disease management. This study was a retrospective analysis of blood cultures from neonates admitted to the NICU with symptoms of septicemia from June to December, 2019. All samples were processed according to standard microbiological procedures using the BACTEC 9050 automated culture system. Results were reported on the basis of microbial appearance on the culture media and microscopic examination using the Gram staining method, and authentication was performed using standard biochemical reactions. Of the 228 patients, 32.89% were positive for blood culture. Early bacteremia was detected in 64% of the patients, and late bacteremia was detected in 36% of the patients. The most effective drugs against the gram-positive bacteria were linezolid, vancomycin, and ciprofloxacin and against the gram-negative bacteria were tigecycline, imipenem, and amikacin. Coagulase-negative staphylococci and gram-negative organisms such as Klebsiella, Acinetobacter, and Staphylococcus aureus were the major cause of neonatal septicemia in this study, and almost all the isolates were resistant to different antibiotics. Overall, antimicrobial drug resistance was observed in all the positive blood culture samples.

Jinchun Li,1 Shiwen Xia,1 Yong Liu,1 Shasha Zhang,2 Zhengjiang Jin3 1Department of Neonatology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430070, China; 2Department of Pharmacy, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430070, China; 3Department of Clinical Laboratory, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430070, ChinaCorrespondence: Shiwen Xia, Tel +86 027-65395034, Fax +86 027-87163133, Email shiwenxia66@163.com; Xshiwen745@outlook.comPurpose: To evaluate the microorganisms involved in neonatal septicemia and its antibiotic susceptibility pattern and to further investigate the factors associated with the length of intensive care unit (ICU) stay in neonatal septicemia.Patients and Methods: A total of 297 infants with septicemia at neonatal ICU (NICU), Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology from 2016 to 2020 were enrolled. Identification of bacterial species was done using the standard positive blood culture. Data included demographics, signs at time of septicemia, laboratory values, patient sources, complications, microbiologic characteristics, and the duration of ICU stay. Univariate and multivariate gamma regression analyses were applied to determine the variables associated with ICU stay.Results: The result demonstrated that the main causative pathogens of neonatal septicemia in our hospital were Gram-positive bacteria, among which Staphylococcus epidermidis (100 isolates, 47.17%) was the main conditional pathogens; Escherichia coli (27 isolates, 49.09%) was most frequently isolated among Gram-negative pathogens. Gram-positive bacteria had higher susceptibility to vancomycin, tigecycline and linezolid. Escherichia coli was susceptive to piperacillin (27/27, 100.00%), cefotetan (27/27, 100.00%), meropenem and imipenem (27/27, 100.00%). Streptococcus agalactiae (95% CI: 0.140– 0.539), for patients who were transferred from other hospital (95% CI: 0.016 to 0.354), septicemia during hospitalization (95% CI: 0.411 to 0.825), the use of antibacterial drug during pregnancy (95% CI: 0.362 to 2.136), feeding intolerance (95% CI: 0.127 to 0.437), bradycardia (95% CI: 0.196 to 0.838), septicemia newborns have complications (95% CI: 0.063 to 0.291), the onset age (95% CI: 0.006 to 0.023), TRIPS score (95% CI: 0.005 to 0.016), and CRP level (95% CI: 0.002 to 0.005) were related to prolonged ICU stay days.Conclusion: This study summarized common pathogens and associated drug sensitivity, and factors influencing ICU stay length. Prevention and control policy in the NICU should be strengthened.Keywords: NICU, neonatal septicemia, microorganisms, antibiotic susceptibility

Introduction Neonatal sepsis is a major cause of neonatal mortality, the clinical outcome of which depends on early diagnosis and initiation of appropriate antibiotics. The emergence of multi-drug resistant strains has limited the choice of available antibiotics. Thus, antibiotic resistance pattern of pathogens is critical for both therapy and infection control. Objectives To find out prevalence neonatal septicemia at tertiary care level hospital To find out gender wise distribution of prevalence of neonatal septicemia at tertiary care level hospital To find out common associated factor, clinical symptoms of prevalence of neonatal septicemia at tertiary care level hospital To identify common bacterial pathogen responsible for neonatal septicemia at tertiary care level hospital To determine antibiotic susceptibility pattern of Bacterial pathogen responsible for neonatal septicemia Materials and Methods This observational study was conducted in the Microbiology department of Tertiary care level hospital affiliated with medical college. Venous blood collected aseptically before initiation of antibiotic therapy. For neonates 2 ml of blood & for older children 5 ml of blood was collected from peripheral vein with aseptic precaution. The blood culture bottles were sent to laboratory, where they incubated in BACTEC (FX40) if bottle was positive then it sub-culture were made on MacConkey & Blood agar & incubated in appropriate temperature & further identification was done according to standard guidelines.Antimicrobial susceptibility testing was done by Kirby-Bauer disc diffusion method and interpretation was done according to CLSI guidelines. Results Among 100 blood samples processed from clinically suspected neonatal septicemia cases, 28 (28 %) samples showed growth. Among 28 isolates, 15 were from early onset septicemia (EOS) and 13 were from Late Onset Septicemia (LOS). Among 28 culture positives, 20 (71.4%) were from males and 8(28.6%) were from females, thus showing a male preponderance. Gram-positive bacteria were responsible for most cases of neonatal sepsis. Coagulase negative staphylococci (CoNS) were the most frequent isolated pathogens in EOS and LOS, followed by Klebsiella pneumoniae, Staphylococcus aureus, Enterococcus spp and Escherichia coli. The antibiotic sensitivity showed that most of the Gram negative bacteria were highly resistant to the commonly used antibiotics like Ampicillin and Gentamicin. Conclusion Neonatal sepsis is a medical emergency and empirically treatment is started without microbiology report. If local microbiological databases are available with information regarding the commonly isolated organisms and their drug resistance patterns, it can help the clinicians in planning of therapy which in turn reduces neonatal mortality and morbidity.

Background: Many aspects of microbial dissemination appear to vary with host cholesterol levels. Since neonatal septicemia remains a leading cause of newborn admissions and mortality in resource-limited settings, the contribution of abnormal cholesterol levels in maternal and/or newborn blood to the risk of neonatal septicemia and outcome requires elucidation. We aim to determine a relationship between maternal serum and neonatal cord blood cholesterol levels and neonatal septicemia.Methods: This will be a mother-newborn pair cohort study. Approximately 353 pregnant women who are eligible and consent to participate in the study will have blood drawn for a lipid profile. Upon delivery, we will analyse the cord blood cholesterol of their newborns and follow them for 28 days to determine whether the infants develop clinical signs and symptoms suggestive of neonatal septicemia. Relative risk will be used to determine the association between cholesterol and newborn septicemia. Poisson regression will be used to estimate the relative risk (with 95% confidence intervals) of developing septicemia.Discussion: Findings from our study will contribute evidence to support the inclusion of lipid profile screening for pregnant women and newborns. Our study will determine whether newborns with abnormal cholesterol or those born to mothers with abnormal cholesterol will require rigorous follow-up in neonatal clinics. [ABSTRACT FROM AUTHOR]

Background: Neonatal sepsis is one of the major causes of morbidity and mortality in newborns, more so in the developing countries. Objectives: The aim of this article is to study the role of peripheral smear, to evaluate the usefulness of white blood cell (WBC) parameters, and to establish the sensitivity and specificity of each parameter for early diagnosis of neonatal septicemia. Materials and Methods: The prospective study is of 150 neonates admitted and fulfilling the inclusion criteria, over the period of June 2019 to December 2020, and tests were performed at the Department of Pathology in a tertiary medical college and hospital. Peripheral blood sample was obtained by venipuncture and the sepsis work-up included routine blood counts and blood culture. Total leucocytes counts were counted on an automated hematology analyzer. Leishman-stained peripheral blood smears were used for the study. Results: Based on the clinical findings and laboratory data, neonates were classified into three categories: sepsis (n = 70), probable infection (n = 50), and no infection (n = 30). The blood culture reports of confirmed sepsis cases reveal the commonest organism as Escherichia coli, followed by Klebsiella, Pseudomonas, and beta-hemolytic streptococci. Abnormal I:T ratio (≥0.2) shows highest sensitivity (90%) and specificity (95%). Conclusion: The peripheral smear study is found to be very useful in the early diagnosis of neonatal septicemia as it can be performed even in a small laboratory without any special equipment and within a short period of time. Among WBC parameters, the I:T ratio shows highest sensitivity and specificity.

Neonatal septicemia is a major cause of infection and mortality in neonates. Neonatal sepsis is a type of neonatal infection, particularly bacteremia, diagnosed by the presence of microorganisms in blood via microbiological culture tests during the first 4 weeks of birth. Neonatal sepsis is classified into early bacterial neonatal septicemia (less than 72 h) and late bacterial neonatal septicemia (>72 h–28 d) according to age. Isolation of septicemia-causing bacteria from the blood of neonates and investigation of their antibiotic susceptibility pattern for disease management. This study was a retrospective analysis of blood cultures from neonates admitted to the NICU with symptoms of septicemia from June to December, 2019. All samples were processed according to standard microbiological procedures using the BACTEC 9050 automated culture system. Results were reported on the basis of microbial appearance on the culture media and microscopic examination using the Gram staining method, and authentication was performed using standard biochemical reactions. Of the 228 patients, 32.89% were positive for blood culture. Early bacteremia was detected in 64% of the patients, and late bacteremia was detected in 36% of the patients. The most effective drugs against the gram-positive bacteria were linezolid, vancomycin, and ciprofloxacin and against the gram-negative bacteria were tigecycline, imipenem, and amikacin. Coagulase-negative staphylococci and gram-negative organisms such as Klebsiella, Acinetobacter, and Staphylococcus aureus were the major cause of neonatal septicemia in this study, and almost all the isolates were resistant to different antibiotics. Overall, antimicrobial drug resistance was observed in all the positive blood culture samples. [ABSTRACT FROM AUTHOR]

A surge of extended spectrum beta lactamase (ESBL)-producers is being witnessed in the neonatal intensive care units (NICUs). Hence, the present study was conducted to analyze both the bacteriological profile and clinical outcome of neonatal septicemia, and to identify the prevalence and sensitivity of the incriminated pathogens with emphasis on ESBL producers. We conducted this study in the NICU of a tertiary referral hospital over a one-year-period. All neonates with a clinical diagnosis of sepsis (371 participants) were enrolled. Blood cultures were performed, and subsequent cultures of various specimens were done according to clinical suspicion. Antibiotic susceptibility tests were carried out and the neonates were followed up until discharge. Out of the 371 neonates, 137 (37%) had positive blood culture results, of whom 49% died versus only 7.7% of neonates with a negative blood culture (P-value< 0.0001). Low birth weight, prematurity, and the duration of hospital stay were considered as positive blood culture risk factors. Meanwhile, among 85 cultures that yielded Gram-negative pathogens, 16 isolates were identified as ESBL producers with Klebsiella pneumoniae being the most frequently encountered isolate (19.7%). Of the neonates inflicted with ESBL-sepsis, 62.5% died versus 11.6% with non-ESBL sepsis. Judicious antibiotic stewardship together with infection control practices can hinder the spread of drug-resistant pathogens. This is especially compelling among the vulnerable population of the NICUs. Meanwhile, rapid diagnostic modalities and timely antibiotic susceptibility tests are of paramount importance to initiate appropriate therapy which can hugely impact the clinical prognosis.

Background: Neonatal sepsis is a major cause of morbidity and mortality worldwide and especially in developing countries. The incidence of neonatal septicemia varies widely between the developed world and developing countries. Methods: The data was collected from the records of the Department during period (February 2019-December 2020). incubated blood culture at 37°C for 7 days. Subcultures were done onto blood agar and MacConkey agar plates. Results: Clinical feature of neonatal septicemia as Fever 31(67%); Feeding difficulty 22 (48 %); both Jaundice and Lethargy as 9(19.5%); also, Diarrhea 7(15%); Skin rash 6(13%) and Meningitis 3(6.5%). so current results showed male with positive bacterial culture (69.5%) when compare with Female (30.5%), Among a total of 46 bacterial isolates recovered, 34 (74%) were Gramnegative isolates more than Gram-positive isolates 12 (26%), so among a total of 46 bacterial isolates recovered, E.coli were recovered from the cases as (24%) followed by both Klebsiella pneumoniae and Pseudomonas as (13.5%), So Citrobacter species and Proteus mirabilis as (8.5%), and Strep pneumonia and Staphylococcus aureus were recovered from a single case, Staphylococcus epidermedis (7 cases - 15%). Conclusions: Most clinical feature of neonatal septicemia as Fever; Feeding difficulty; and Jaundice and Lethargy, so the male with positive bacterial culture more than Female as well as gram negative bacteria is more common septicemia children with predominant of E.coli. [ABSTRACT FROM AUTHOR]

Background: Neonatal sepsis is one of the major causes of morbidity and mortality in newborns, more so in the developing countries. Objectives: The aim of this article is to study the role of peripheral smear, to evaluate the usefulness of white blood cell (WBC) parameters, and to establish the sensitivity and specificity of each parameter for early diagnosis of neonatal septicemia. Materials and Methods: The prospective study is of 150 neonates admitted and fulfilling the inclusion criteria, over the period of June 2019 to December 2020, and tests were performed at the Department of Pathology in a tertiary medical college and hospital. Peripheral blood sample was obtained by venipuncture and the sepsis work-up included routine blood counts and blood culture. Total leucocytes counts were counted on an automated hematology analyzer. Leishman-stained peripheral blood smears were used for the study. Results: Based on the clinical findings and laboratory data, neonates were classified into three categories: sepsis (n = 70), probable infection (n = 50), and no infection (n = 30). The blood culture reports of confirmed sepsis cases reveal the commonest organism as Escherichia coli, followed by Klebsiella, Pseudomonas, and beta-hemolytic streptococci. Abnormal I:T ratio (≥0.2) shows highest sensitivity (90%) and specificity (95%). Conclusion: The peripheral smear study is found to be very useful in the early diagnosis of neonatal septicemia as it can be performed even in a small laboratory without any special equipment and within a short period of time. Among WBC parameters, the I:T ratio shows highest sensitivity and specificity. [ABSTRACT FROM AUTHOR]

This is a prospective study aimed in identifying the latest aetiological factors of neonatal sepsis in Dr. Cipto General Hospital, Jakarta, and investigating the efficacy of antibiotics treatment especially with ceftriaxone. This study revealed that the present main causative microorganisms are as follows: Pseudomonas, Klebsiella and E. coli. The case fatality rates being: (1) Standard treatment with ampicillin and gentamycin: 80.9%, (2) S(andard treatment with consomittant ceftriaxone: 20%, (3) Ceftriaxone: 9,52%. It seems that in facing neonatal septicemia, the initial antibiotic should be the third generation cephalosporine. The second choice is chloramphenicol. However, the causative agent and the sensitivity test should be monitored regularly.

Background: Neonatal septicemia remains a significant healthcare challenge, particularly in resource-limited settings, with both early-onset neonatal septicemia (EONS) and late-onset neonatal septicemia (LONS) presentations contributing to morbidity and mortality. This study aimed to characterize the clinico-etiological profile and antibiotic susceptibility patterns of neonatal septicemia in a tertiary care setting in north India., Methodology: An analytical cross-sectional study was conducted from March 2021 to February 2022, encompassing neonates admitted to the Department of Pediatrics with suspected neonatal septicemia, confirmed by positive blood cultures., Results: A total of 96 neonates were included, predominantly male (71.9%). Gram-negative bacteria constituted 61.6% of isolates, and the most common organism isolated was non-lactose fermenter group (38.4%) followed by coagulase-negative staphylococci (CoNS) (33.4%). Non-lactose fermenter group bacteria were prominent in EONS cases (44.6%), while CoNS predominated in LONS cases (51.6%). Birthplace, birth weight, and perinatal score were significantly associated with both EONS and LONS. Linezolid exhibited high efficacy against gram-positive bacteria, while ciprofloxacin and meropenem demonstrated effectiveness against various gram-negative pathogens. Methicillin-resistant Staphylococcus aureus (MRSA) strains exhibited resistance to all the antibiotics used in the study except for linezolid., Conclusion: These findings underscore the importance of tailored empirical therapy guided by local epidemiological data to optimize clinical outcomes and mitigate antimicrobial resistance., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Ethics Committee, Indira Gandhi Medical College, Shimla issued approval HFW(MC-2)B(12)ETHICS/2021/14453 dated January 2021. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Sharma et al.)

Neonatal sepsis is one of the most common cause of death among neonates in the developing countries. Neonatal infections are estimated to cause 1.6 million deaths every year all over the world and 40 % of deaths occurring in the developing countries like India. To determine the bacteriological profile and antibiogram in neonatal septicemia cases. 99 different neonates, clinically diagnosed were included. Blood specimens for culture were drawn. Bacteria was identified, antibiogram was determined and ESBL test was done Out of 99 clinically suspected cases, 44 cases were culture positive whereas 55 were culture negative. Gram positive bacteria were the most common isolates (68.18%) followed by gram negative bacteria (31.82%). Among the Gram positive bacteria, MRCONS (50%) was the most common followed by MRSA (%). Among gram negative bacteria, Klebsiella (11.36%) was the most common followed by acinetobacter (9.09%), E.coli and Pseudomonas. 93.18% of the cases were EOS whereas 6.82% cases were LOS.92% of CONS were sensitive to linezolid, 84% to chloramphenicol, and 68% to amikacin. All isolates of Staphylococcus aureus were sensitive to linezolid and chloramphenicol. Most of the Gram negative bacteria were resistant to the most commonly used antibiotics.64.28% of Gram negative bacilli were ESBL producers of which Klebsiella was the commonest (44.44%). The increasing spread of different bacteria differing in resistance patterns demands for evidence based practice in neonatal septicemia.

A surge of extended spectrum beta lactamase (ESBL)-producers is being witnessed in the neonatal intensive care units (NICUs). Hence, the present study was conducted to analyze both the bacteriological profile and clinical outcome of neonatal septicemia, and to identify the prevalence and sensitivity of the incriminated pathogens with emphasis on ESBL producers. We conducted this study in the NICU of a tertiary referral hospital over a one-year-period. All neonates with a clinical diagnosis of sepsis (371 participants) were enrolled. Blood cultures were performed, and subsequent cultures of various specimens were done according to clinical suspicion. Antibiotic susceptibility tests were carried out and the neonates were followed up until discharge. Out of the 371 neonates, 137 (37%) had positive blood culture results, of whom 49% died versus only 7.7% of neonates with a negative blood culture (P-value< 0.0001). Low birth weight, prematurity, and the duration of hospital stay were considered as positive blood culture risk factors. Meanwhile, among 85 cultures that yielded Gram-negative pathogens, 16 isolates were identified as ESBL producers with Klebsiella pneumoniae being the most frequently encountered isolate (19.7%). Of the neonates inflicted with ESBL-sepsis, 62.5% died versus 11.6% with non-ESBL sepsis. Judicious antibiotic stewardship together with infection control practices can hinder the spread of drug-resistant pathogens. This is especially compelling among the vulnerable population of the NICUs. Meanwhile, rapid diagnostic modalities and timely antibiotic susceptibility tests are of paramount importance to initiate appropriate therapy which can hugely impact the clinical prognosis. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To explore the curative effects of vancomycin and cefotaxime combined with gamma globulin respectively in neonatal septicemia and their influences on PCT, CRP, and hs-CRP, so as to provide references for clinical treatment. PATIENTS AND METHODS: 181 patients with neonatal septicemia admitted to Huangshi Maternity and Child Health Hospital from April 2012 to August 2014 were selected as the study subjects. Patients treated with vancomycin combined with gamma globulin were selected as group A (96 cases) and those treated with cefotaxime combined with gamma globulin were selected as group B (85 cases). The improvement time of clinical symptoms (milk rejection, nervous system symptoms, body temperature), hospital stays, mortality, medicine curative effects, adverse reactions, complications, and levels of serum CRP, PCT, and hs-CRP of patients before and after treatment were compared between the two groups. RESULTS: The improvement time of clinical symptoms like body temperature, milk rejection, and neurological symptoms, as well as hospital stays in group A were lower than those in group B (p<0.05); the total effective rate of medicine curative effects in group B was better than that in group A (p<0.05); there was no significant difference in levels of serum CRP, PCT, and hs- CRP between the two groups before treatment (p>0.05); after treatment, levels of serum CRP, PCT, and hs-CRP in both groups decreased significantly, and levels of serum CRP, PCT, and hs-CRP in group B decreased more significantly than those in group A (p<0.05). CONCLUSIONS: Cefotaxime combined with gamma globulin in the treatment of patients with neonatal septicemia has short improvement time in clinical symptoms, high total effective rate of drugs, low mortality, fewer adverse reactions and complications, and can significantly reduce levels of serum CRP, PCT, and hs- CRP, which is worthy of further promotion and application in clinical practice. [ABSTRACT FROM AUTHOR]

Staphylococcus epidermidis strains play an important role in nosocomial infections, especially in the ones associated with biofilm formation on medical devices. The paper was aimed at analyzing the mechanisms of antibiotic resistance and confirming the biofilm-forming ability among S. epidermidis strains isolated from the blood of hospitalized newborns. Genetic analysis of resistance mechanism determinants included multiplex PCR detection of mecA, ermA, ermB, ermC, msrA, and mef genes. Biofilm analysis comprised phenotypic and genotypic methods including Christensen and Freeman methods and PCR detection of the icaADB gene complex. Among the tested S. epidermidis strains, 89% of the isolates were resistant to methicillin, 67%—to erythromycin, 53%—to clindamycin, 63%—to gentamicin, and 23%—to teicoplanin, while all the strains were susceptible to vancomycin and linezolid. The mecA gene was detected in 89% of the isolates, the ermC gene was the most common and present among 56% of the strains, while the msrA gene was observed in 11% isolates. Eighty-five percent of the strains were described as biofilm-positive by phenotypic methods and carried the icaADB gene cluster. Multidrug resistance and the biofilm-forming ability in most of the strains tested may contribute to antimicrobial therapy failure (p < 0.05).

Introduction: Neonatal sepsis is a leading cause of neonatal mortality and morbidity in the world. The objective of the current study was to detect the common causative microorganisms of neonatal sepsis and their antimicrobial resistance patterns in a rural secondary hospital in Tamil Nadu, India. Materials and Methods: Neonates (0–28 days) admitted to this newborn care unit from October 2013 to September 2015, with a diagnosis of probable sepsis were studied. All the enrolled babies had blood cultures taken and were followed up till final outcome, which was discharge or death, irrespective of culture result. Univariate analysis was performed for factors associated with culture positivity, generating odds ratios, and confidence intervals. Results: Among the 107 babies with a diagnosis of probable sepsis, 28 (26.2%) had shown bacteria in culture. The majority (94.4%) were of early-onset sepsis. The predominant organisms were Staphylococcus aureus (10/28) and Klebsiella (6/28). 100% of Gram-negative bacilli and 90% of Staphylococcus were resistant to Ampicillin. Gentamicin resistance among Gram-negative bacilli and Staphylococcus was 52.9% and 20%, respectively, while third-generation cephalosporin resistance was 31.2% and 20%, respectively. Among the neonates diagnosed as probable sepsis, idiopathic prematurity (P = 0.007) was found to have a statistically significant association with culture-positive sepsis. Conclusion: The culture positivity rate among the neonates with probable sepsis in the current study was 26%. An alarmingly high degree of antibiotic resistance observed calls for robust infection control practices and an urgent evaluation and development of individual and national antibiotic policies for neonatal sepsis.

Introduction: Antimicrobials are the mainstay treatment in neonatal septicemia (NS). National treatment guidelines for antimicrobial use in infectious diseases issued by the Government of India has paved the way for rationalizing antibiotic use, but it needs tailoring according to the prevalent local microbiota and individual patient's needs. A periodic surveillance of the microbial etiology and antibiotic use patterns in NS may be useful in rational selection of empirical antimicrobial therapy. Aims and Objectives: We observed the utilization pattern of antimicrobials and quantified the same in neonates admitted to neonatal intensive care unit (NICU) with septicemia along with the prospective follow-up of the clinical response to individual regimen. Materials and Methods: This hospital-based prospective observational study was conducted from January 2017 to June 2017 on 102 consecutive cases of NS admitted to NICU. Data regarding demographic parameters, antimicrobials used, and outcome were collected through a predesigned case record form. Antimicrobial usage was quantified as days of therapy (DOT) per 1000 patient days. Results: Common antimicrobials used in descending order of DOT were amikacin, colistin, and meropenem. Ampicillin, cefotaxime, and gentamicin were rarely found suitable for use based on the reported antibiograms. Piperacillin-tazobactam + amikacin regimen was the most commonly used empirical regimen. The case fatality rate was 4% in our study sample. Conclusion: Ampicillin, cefotaxime, and gentamicin had limited effectiveness in the majority of cases. Although there is a need of alignment with national treatment guidelines in NS, yet, the concurrent scope of periodic survey and research must be available for changeover to evidence-based local individualization of empirical antimicrobial therapy wherever required. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study aimed to investigate the predictive value of joint detection of serum amyloid A (SAA), plasma procalcitonin (PCT), and whole blood hypersensitive C-reactive protein (hs-CRP) in the diagnosis and efficacy of neonatal septicemia. PATIENTS AND METHODS: A total of 195 cases of neonatal septicemia patients admitted to our hospital from March 2013 to May 2017 were selected as observation group, and 100 healthy newborns in the same period were selected as control group. Before treatment, all newborns were detected with enzyme-linked immunosorbent assay (ELISA) for serum SAA, PCT, and hs-CRP three indicators respectively, and differences between expressions of PCT, HS-CRP, SAA in the serum of children (effective group) who improved after treatment and patients in ineffective group were observed. RESULTS: Three indexes of SAA, PCT, and hs-CRP in study group were significantly higher than those in control group before treatment, while three indexes of SAA, PCT, and hs-CRP in effective group were significantly lower than those in ineffective group after treatment, with statistical significance (p<0.05). By drawing the ROC curve, it was found that the AUC area, specificity, and sensitivity of joint detection were better than those of the single item detection. CONCLUSIONS: Joint detection of SAA, PCT, and hs-CRP has high diagnostic value in neonatal septicemia and is worthy of clinical application. [ABSTRACT FROM AUTHOR]

Objective: To explore the value of serum PCT content for evaluating inflammatory factor release and organ function injury in neonatal septicemia. Methods: 48 children who were diagnosed with neonatal septicemia in our hospital between March 2015 and May 2018 were selected as the septicemia group, and 50 healthy neonates delivered in our hospital during the same period were selected as the normal control group. The differences in PCT and inflammatory factor contents in serum as well as liver and kidney function index levels in peripheral blood were compared between the two groups. Pearson test was used to evaluate the correlation of serum PCT content with inflammatory factor release as well as liver and kidney function injury in children with neonatal septicemia. Results: The serum PCT content of septicemia group was significantly higher than that of normal control group; serum hypersensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), interleukin-8 (IL-8) and soluble intercellular adhesion molecule-1 (sICAM-1) contents were higher than those of normal control group; peripheral blood aspartate aminotransferase (AST), alanine aminotransferase (ALT), γ-glutamyl transpeptidase (γ-GGT) and alkaline phosphatase (ALP) levels were higher than those of normal control group; peripheral blood blood urea nitrogen (BUN), serum creatinine (Scr) and serum β2-microglobulin (β2-M) levels were higher than those of normal control group (P<0.05). Correlation analysis showed that serum PCT content in children with neonatal septicemia was directly correlated with the degree of inflammatory response as well as the degree of liver and kidney function injury (P<0.05). Conclusion: The serum PCT content abnormally increases in children with neonatal septicemia, and the specific content is consistent with the disease severity and has certain clinical value for the judgment of children's condition. [ABSTRACT FROM AUTHOR]

Human infection caused by Chromobacterium violaceum is rare but has got high fatality in septicemia. Nonpigmented strains of C. violaceum have been found similar in pathogenicity to pigmented strains. Pigment production is not an exclusive character of the genus Chromobacterium because around 9%–11% strains of C. violaceum are nonpigmented. Herewith, we report a nonpigmented strain of C. violaceum from a case of neonatal septicemia that was successfully treated with gentamicin plus imipenem.

Background and Objectives: Neonatal septicemia can be rapidly fatal if not treated promptly. A speedy laboratory diagnosis would improve the outcome. The BacT/ALERT 3D system (bioMerieux, Durham, North Carolina) is currently being used for laboratory diagnosis of blood stream infections. In the present study, a modified protocol was employed in which the broth was subcultured into two nutrient broth tubes and these tubes were used for biochemical tests and antimicrobial susceptibility testing to decrease the turnaround time. Materials and Methods: A prospective study was conducted in the Department of Microbiology, SDM College of Medical Sciences and Hospital, Dharwad from October 2010 to July 2012 after receiving clearance from the institutional ethics committee. Automated blood cultures of 250 neonates admitted to the Neonatal Intensive Care Unit (NICU), clinically diagnosed to have septicemia, were performed using BacT/ALERT 3D. Bottles flagged positive within 72 hours of loading were processed for identification and antibiotic susceptibility testing using a modified protocol. The results were assessed for time saved in reporting in comparison with standard protocol. Student’s t test was used for statistical analysis. Results: Of the 250 cases studied, 117 cases yielded a positive blood culture giving a yield of 46.8%. The number of cases yielding monomicrobial growth were 73, which were included for further analysis. Of the remaining samples, 133 did not show growth, 11 were polymicrobial while 33 samples were flagged positive after 72 hours. Candida spp. grew in 34 cases, Gram negative bacilli grew in 28 cases and Gram positive cocci grew in 11 cases. In four cases, 66 hours were saved, 60 and 54 hours were saved in 18 cases each, 48 hours were saved in 27 cases, and 24 hours were saved in 6 cases. Methicillin resistant Staphylococcus aureus and Klebsiella pneumoniae were the most common isolates among Gram positive cocci and Gram negative bacilli, respectively, while C. guilliermondii was the most common Candida isolate. All Gram positive isolates were susceptible to vancomycin and linezolid. Most of the Gram negative isolates were susceptible to imipenem. Conclusion: This method can be employed in peripheral laboratory settings where there is no complete automation. Modification in processing blood culture can provide speedy identification and sensitivity report in blood stream infections. Time saved in reporting would play a crucial role in improving morbidity and mortality rates in neonatal septicemia.

Introduction: Neonatal septicemia is a major cause of mortality and morbidity. Surviving neonates can have significant neurologic sequelae, septic shock or hypoxemia. The spectrum of bacteria that cause neonatal septicemia varies in different parts of the world. The management of these infections is being complicated by the emergence of antibiotic resistance. The aim of this study was to determine the etiology, clinical characteristics and outcome of neonatal septicemia cases. Materials and Methods: During a 1-year study, 257 clinically suspected cases of neonatal sepsis were enrolled and classified as early onset septicemia (EOS) and late onset septicemia (LOS) based on appearance of signs and symptoms, i.e. within or after 72 h, respectively. Blood culture was performed using BACTEC 9240, isolates were identified by standard techniques and antibiotic susceptibility was performed as per the CLSI guidelines. Risk factors associated with neonatal sepsis were recorded and analyzed with respect to culture-proven sepsis. Results: In both suspected and culture-proven sepsis cases, majority of the neonates were male, pre-term and low birth weight babies. The prevalence of EOS and LOS was 82.4% and 17.5%, respectively. Culture positivity was seen in 7.8% of the cases. In culture-proven septicemia, 55% neonates presented with EOS and 45% presented with LOS. Gram positive isolates were more as compared with Gram negative isolates. The most common isolates were S. aureus, S. epidermidis and E. coli. All Gram positive isolates were sensitive to vancomycin and linezolid, while carbapenems and polymyxin B were the most effective drugs in the Gram negative isolates. Mortality was higher in LOS as compared with EOS cases, and the difference was statistically significant. Conclusion: Gram positive pathogens were predominant in septicemia. Vancomycin and linezolid were the most effective antibiotics for Gram positive isolates and carbapenems for most effective Gram negative organisms.

Background: β-lactamases viz., extended spectrum β-lactamase (ESBL), AmpC, and metallo β-lactamase (MBL) production in Klebsiella pneumoniae has led to a serious concern about septicemic neonates in Neonatal Intensive Care Units due to high resistance against commonly used antimicrobials Purpose:To study the prevalence of ESBL, AmpC, and MBL production in K. pneumoniae isolates in neonatal septicemia, to check antimicrobial susceptibility to various drugs including tigecycline; and to assess burden of multiple drug resistance (MDR). Materials and Methods: Total 24 clinical isolates of K. pneumoniae isolated from 318 blood samples of suspected cases of neonatal septicemia were studied. Isolates were screened for ESBL, AmpC, and MBL production by Clinical and Laboratory Standards Institute (CLSI) disk method, AmpC cefoxitin screen, and imipenem, meropenem, ceftazidime disk screen respectively; and confirmation was done by CLSI phenotypic disk confirmatory test, AmpC sterile disk method, and imipenem ethylenediamine tetracetic acid double disk synergy test respectively. Antimicrobial susceptibility was determined by Kirby-Bauer's disk diffusion method. Efficacy of tigecycline was evaluated using United States Food and Drug Administration guidelines. Results: Of the 24 K. pneumoniae isolates, co-production of AmpC + MBL was found in more number of isolates (67%) (P < 0.0001) compared to single enzyme production (ESBL and MBL 8% both, AmpC 12.5%). Rate of resistance for penicillins and cephalosporins was highest. Susceptibility was more for imipenem, co-trimoxazole, and meropenem. Nonsusceptibility to tigecycline was low (21%). A total of 23 (96%) isolates were MDR. Conclusions: Routine detection of ESBL, AmpC, and MBL is required in laboratories. Carbapenems should be kept as a last resort drugs. Trend of tigecycline susceptibility has been noted in the study. Continued monitoring of susceptibility pattern is necessary to detect true burden of resistance for proper management.

Aim: To investigate the outbreak of Burkholderia cepacia complex (BCC), mortality, antimicrobial resistance and associated risk factors in the neonatal intensive care unit. Method: Eighteen blood culture samples from neonates and twenty swab samples from different neonatal intensive care unit surfaces were collected. The VITEK 2 was used to confirm the isolates and generate the antibiogram. PCR was used to identify bla NDM . Results: Eighteen samples tested positive for BCC, and 10/18 (55.5%) of the neonates died. 13/18 (72%) of the neonates had late-onset neonatal sepsis, and 10/18 (55%) had low birth weight. Resistance to minocycline and chloramphenicol was 100%, 72.2% to meropenem; 72.2% NDM gene was found in neonates and was 20% from the environment. Conclusion: Outbreak of NDM-producing BCC resulting in high neonatal mortality in NICU.

Background and Objectives: Neonatal septicemia can be rapidly fatal if not treated promptly. A speedy laboratory diagnosis would improve the outcome. The BacT/ALERT 3D system (bioMerieux, Durham, North Carolina) is currently being used for laboratory diagnosis of blood stream infections. In the present study, a modified protocol was employed in which the broth was subcultured into two nutrient broth tubes and these tubes were used for biochemical tests and antimicrobial susceptibility testing to decrease the turnaround time. Materials and Methods: A prospective study was conducted in the Department of Microbiology, SDM College of Medical Sciences and Hospital, Dharwad from October 2010 to July 2012 after receiving clearance from the institutional ethics committee. Automated blood cultures of 250 neonates admitted to the Neonatal Intensive Care Unit (NICU), clinically diagnosed to have septicemia, were performed using BacT/ALERT 3D. Bottles flagged positive within 72 hours of loading were processed for identification and antibiotic susceptibility testing using a modified protocol. The results were assessed for time saved in reporting in comparison with standard protocol. Student's t test was used for statistical analysis. Results: Of the 250 cases studied, 117 cases yielded a positive blood culture giving a yield of 46.8%. The number of cases yielding monomicrobial growth were 73, which were included for further analysis. Of the remaining samples, 133 did not show growth, 11 were polymicrobial while 33 samples were flagged positive after 72 hours. Candida spp. grew in 34 cases, Gram negative bacilli grew in 28 cases and Gram positive cocci grew in 11 cases. In four cases, 66 hours were saved, 60 and 54 hours were saved in 18 cases each, 48 hours were saved in 27 cases, and 24 hours were saved in 6 cases. Methicillin resistant Staphylococcus aureus and Klebsiella pneumoniae were the most common isolates among Gram positive cocci and Gram negative bacilli, respectively, while C. guilliermondii was the most common Candida isolate. All Gram positive isolates were susceptible to vancomycin and linezolid. Most of the Gram negative isolates were susceptible to imipenem. Conclusion: This method can be employed in peripheral laboratory settings where there is no complete automation. Modification in processing blood culture can provide speedy identification and sensitivity report in blood stream infections. Time saved in reporting would play a crucial role in improving morbidity and mortality rates in neonatal septicemia. [ABSTRACT FROM AUTHOR]

Neonatal sepsis is one of the most common cause of death among neonates in the developing countries. Neonatal infections are estimated to cause 1.6 million deaths every year all over the world and 40 % of deaths occurring in the developing countries like India. To determine the bacteriological profile and antibiogram in neonatal septicemia cases. 99 different neonates, clinically diagnosed were included. Blood specimens for culture were drawn. Bacteria was identified, antibiogram was determined and ESBL test was done Out of 99 clinically suspected cases, 44 cases were culture positive whereas 55 were culture negative. Gram positive bacteria were the most common isolates (68.18%) followed by gram negative bacteria (31.82%). Among the Gram positive bacteria, MRCONS (50%) was the most common followed by MRSA (%). Among gram negative bacteria, Klebsiella (11.36%) was the most common followed by acinetobacter (9.09%), E.coli and Pseudomonas. 93.18% of the cases were EOS whereas 6.82% cases were LOS.92% of CONS were sensitive to linezolid, 84% to chloramphenicol, and 68% to amikacin. All isolates of Staphylococcus aureus were sensitive to linezolid and chloramphenicol. Most of the Gram negative bacteria were resistant to the most commonly used antibiotics.64.28% of Gram negative bacilli were ESBL producers of which Klebsiella was the commonest (44.44%). The increasing spread of different bacteria differing in resistance patterns demands for evidence based practice in neonatal septicemia. [ABSTRACT FROM AUTHOR]

Introduction: In my study 100 neonates admitted to NICU in Sanjay Gandhi memorial hospital associated with shyam shah medical college with clinically suspicion were taken for comparison of I:T ratio, C- Reactive Protein and m-ESR for early diagnosis of neonatal septicemia. Material & Method: In this study I:T ratio was done by peripheral smear and auto analyzer, m-ESR was done by using capillary tube by micro ESR method and CRP was done by using CRP latex kit. Observation and result: Sensitivity of I:T ratio, m-ESR and CRP was 89.6%, 60.3% and 70.6% respectively, specificity is 73.8%, 73.8% and 78.5% respectively, positive predictive value 82.5%, 76% and 82% respectively and negative predictive value 83.7%, 57.4% and 66% respectively and result shows combination of these parameters helps in early diagnosis of neonatal septicemia. Conclusion : My study concluded that not a single parameter for detection of sepsis in neonates is very specific and blood culture takes a long time for diagnosis of septicemia, so combination of these parameters is more sensitive and specific for early detection of neonatal septicemia and it also helps clinician to institute proper antibiotic therapy and helps to avoid unnecessary exposure of neonates to antibiotic therapy and develop resistance. [ABSTRACT FROM AUTHOR]

Sphingomonas paucimobilis , a yellow-pigmented, aerobic, glucose nonfermenting, Gram-negative bacilli is a rare cause of human infection. It was first discovered as an infective agent in humans in 1977 and named Pseudomonas paucimobilis. It was renamed as S. paucimobilis in 1990 in accordance with phylogenetic data. S. paucimobilis is an aerobic bacterium found in soil and water; it is a rare cause of healthcare associated infections. S. paucimobilis can cause infections in healthy as well as immunocompromised individuals. At first, its colony looks like Gram-positive bacilli colony, so by mistake it is discarded as contaminants. S. paucimobilis is an emerging pathogen and it should not be discarded as contaminants. Here, we report a case of S. paucimobilis bacteremia in a neonate who presented with respiratory distress.

Neonatal septicemia is one of the leading causes of neonatal mortality and morbidity worldwide. Hence, the present study was undertaken to isolate the bacteria causing neonatal sepsis and determine their antibiotic susceptibility pattern. Fifty neonates suspected to have septicemia were screened for 2 months (July and August 2014). Out of 50 specimen, 15 (30%) were blood culture positive. Coagulase-negative staphylococci was the most common isolate (10, 66.6%), with 60% (6 isolates) methicillin resistance. In view of the increasing antibiotic resistance, periodic surveillance should be conducted to control the emergence and spread of antimicrobial resistance.

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.

The objective of this study was to isolate pathogenic bacteria in neo-natal septicaemia cases, and to know their antibiograms. Under aseptic precautions, blood was drawn from 140 neonates with sus-pected septicaemia and inoculated in brain heart infusion (BHI) broth. Isolates obtained were identified as per standard protocol and antibi-otic susceptibility was done by Kirby Bauer disc diffusion method (as per CLSI guidelines). A total number of 62 (44.2%) patients had positive blood cultures. The most common pathogens isolated were Klebsiella pneumoniae (n=22, 35%) followed by Staphylococcus aureus (n=15, 24.1%), Escherichia coli (n=14, 22.5%), CONS (n=7, 11.2%) and Pseudomonas aeruginosa (n=4, 6.4%). The Gram nega-tive organisms showed high resistance to commonly used antibiotics and were highly sensitive to Meropenem. The Gram positive bacteria showed high resistance to Ampicillin, Erythromycin and Amoxycillin; but they were highly susceptible to Linizolid and Vancomycin. As the Gram negative organisms were the most common isolates in neona-tal septicemia, their resistance pattern should be considered essen-tial for deciding the empirical treatment. Prompt treatment of neonatal sepsis with judicious use of appropriate antibiotics can minimize the morbidity and mortality, besides reducing the emergence of multi-drug resistant organisms in intensive care units (ICUs).

Neonatal septicemia is an important cause of morbidity and mortality. The present study was undertaken to determine the bacteriological profile and antimicrobial susceptibility pattern of prevalent pathogens isolated from the blood of septicemic neonates from Neonatal Intensive Care Unit (NICU). A total of 180 blood samples of septicemic neonates were studied bacteriologically. Antimicrobial susceptibility testing was done by the Kirby Bauer disc diffusion method in accordance to Clinical Laboratory Standards Institutes (CLSI) guidelines. 26.6% (48 out of 180) cases of septicemia could be confirmed by blood culture. Of these, 66.7% cases were of early onset septicemia (EOS) and 33.3% were of late onset septicemia (LOS). Klebsiella pneumoniae was the predominant pathogen (35.4%) among the Gram-negative pathogens and Staphylococcus aureus (22.9%) was the predominant Gram-positive pathogen. 28% of K. pneumoniae and E. coli isolates were extended spectrum beta-lactamase (ESBL) producers. 18.1% of the Staphylococcus isolates were methicillin-resistant S. aureus (MRSA). Multi-drug-resistance pattern was observed with all the isolates. Ciprofloxacin and aminoglycosides were the most effective drugs against Gram-positive and Gram-negative isolates. This study highlights the predominance of Gram-negative organisms in causing neonatal sepsis and emergence of multi-drug-resistant strains in our set up.

The incidence of fungal infection is increasing worldwide. Although fungal infection is common in adults, few cases have been reported in the neonatal population. We report a case of the preterm neonate of 34 weeks who developed respiratory distress on 2 nd day and was initiated on mechanical ventilation. Treatment was instituted for sepsis, but the patient continued to deteriorate. Two-dimensional echocardiography revealed a large right atrial mass, which eventually turned out to be fungal ball. Intense surgical and medical management led to a speedy recovery of the patient. We stress on the early use of echocardiography in atypical presentation of neonatal septicemia along with routine investigations to help in early recognition of source of infection. This can be of great value in initiating definitive management and improving survival rate in such patients.

Introduction: Neonatal sepsis is a leading cause of neonatal mortality and morbidity in the world. The objective of the current study was to detect the common causative microorganisms of neonatal sepsis and their antimicrobial resistance patterns in a rural secondary hospital in Tamil Nadu, India. Materials and Methods: Neonates (0-28 days) admitted to this newborn care unit from October 2013 to September 2015, with a diagnosis of probable sepsis were studied. All the enrolled babies had blood cultures taken and were followed up till final outcome, which was discharge or death, irrespective of culture result. Univariate analysis was performed for factors associated with culture positivity, generating odds ratios, and confidence intervals. Results: Among the 107 babies with a diagnosis of probable sepsis, 28 (26.2%) had shown bacteria in culture. The majority (94.4%) were of early-onset sepsis. The predominant organisms were Staphylococcus aureus (10/28) and Klebsiella (6/28). 100% of Gram-negative bacilli and 90% of Staphylococcus were resistant to Ampicillin. Gentamicin resistance among Gram-negative bacilli and Staphylococcus was 52.9% and 20%, respectively, while third-generation cephalosporin resistance was 31.2% and 20%, respectively. Among the neonates diagnosed as probable sepsis, idiopathic prematurity (P = 0.007) was found to have a statistically significant association with culture-positive sepsis. Conclusion: The culture positivity rate among the neonates with probable sepsis in the current study was 26%. An alarmingly high degree of antibiotic resistance observed calls for robust infection control practices and an urgent evaluation and development of individual and national antibiotic policies for neonatal sepsis. [ABSTRACT FROM AUTHOR]

We investigated an outbreak of Serratia marcescens (S. marcescens) in NICU of our hospital and are reporting the characteristics of this outbreak along with interventions leading to its resolution. In the month of September and November 2016, seven neonates were identified with blood cultures positive S. marcescens septicemia. To identify the source of the isolate surface swabs were taken from different environmental sources. All S. marcescens isolates were identified by Vitek automated identification system, API 20 E and their antibiogram pattern and further genotyping was done by pulse field gel electrophoresis. During surveillance, 25 blood cultures of newborns were analyzed, 32 environmental samples along with hand swabs of 10 healthcare workers (HCWs) were taken. Seven neonates had blood culture positive S. marcescens sepsis. Only one environmental source (water flasks) yielded S. marcescens with similar antibiogram suggesting the same strain which was further confirmed by pulse field gel electrophoresis. Timely delivery of culture and sensitivity results, good liaison and effective communication between neonatologist and microbiologist, targeted antimicrobial therapy helped in saving the life of six neonates suffering from S. marcescens septicemia. [ABSTRACT FROM AUTHOR]

In recent years, studies showed that there is a close relationship between oxidative stress and pathogenesis of the disease. The aim of the study is to determine the serum malondialdehyde (MDA) levels for lipid peroxidation status and serum glutathione peroxidase (GPx), superoxide dismutase (SOD), total bilirubin and albumin levels for antioxidant activities to find out the possible relationship between oxidative stress and septicemia in calves. The materials of this study are 40 septicemic and 13 healthy calves. No significant differences were observed for serum MDA and albumin levels between septicemic and healthy groups (p>0.05). Septicemic calves had significantly higher levels of GPx, SOD and total bilirubin as compared to the controls (p<0.001). The results obtained from this study suggest that septicemia in calves induced changes of antioxidant enzymes activity. The data obtained from this study indicates that oxidative stress might play important roles in the pathogenesis of septicemia in calves. [ABSTRACT FROM AUTHOR]

Background: Preterm premature rupture of membranes (PPROM) is closely associated with pathogenic microbiomes in the female reproductive tract, and can lead to neonatal septicemia. The current study aimed to investigate potential pathogenic microbiomes associated with neonatal septicemia based on DNA metagenome sequencing., Methods: In this study, a total of 7 pregnant women with PPROM presenting neonatal septicemia (experimental group) and 3 pregnant women with normal newborns (control group) were enrolled. Vaginal secretions at admission and before parturition as well as placental tissues after parturition were collected for DNA metagenome sequencing using whole genome shotgun method on the Illumina NovaSeq/HiSeq platform. Raw data were processed by BioBakery workflow, and MetaPhlAn4 was implemented for qualitative and quantitative analyses of microbiome. Lactobacillus crispatus, Gardneralla vaginalis, Fannyhessea vaginae and Streptococcus suis were specifically detected from the experimental group. The two groups were compared using Student's t-tests., Results: The indexes of Chao1 (P=0.00028/P=0.00072), abundance-based coverage estimator (ACE, P=0.00059/P=0.00026), Shannon (P=0.036/P=0.0065) and Simpson (P=0.007/P=0.041) in the experimental group were increased at admission and before parturition as compared with the control group. Several microbiomes, such as Lactobacillus crispatus, Gardneralla vaginalis, Fannyhessea vaginae and Streptococcus suis, were specifically detected in the experimental group. Notably, Gardnerella vaginalis and Streptococcus gallolyticus were identified from the vaginal secretions and placenta tissues of women with neonatal septicemia. Moreover, nucleic acid synthesis and carbohydrate metabolism-related pathways were enriched in the experimental group., Conclusion: This study enhanced the current understanding of the mechanisms underlying pathogenic microbiomes in PPROM-induced neonatal septicemia. The trial registry number is ChiCTR2300070666 (URL: https://www.chictr.org.cn/showproj.html?proj=195648)., Competing Interests: None., (AJTR Copyright © 2023.)