Neonatal Sepsis

Neonatal sepsis is one of the most prevalent infections today, claiming the lives of almost one million newborns in developing countries. Our objective is to determine the bacteria that cause sepsis in newborns in Egyptian hospitals, as well as to discover their resistance profiles, allowing for the selection of appropriate drug combinations against multidrug resistant (MDR) bacteria. Nine hundred and eighty-nine blood samples were collected from neonates in Al Demerdash and Ain Shams University Specialized Hospital from March 2019 to March 20121 according to the standard protocols. Bacterial identification and antimicrobial susceptibility test AST were performed using VITEK® 2 system. The results revealed that 51.4 % of patients had positive blood cultures, with 60.3 % females and 39.7 %. Males. Sepsis with late onset was detected in 95% of positive cases, while sepsis with early onset was observed in only 5% of the total positive cases. According to the Original Research Article

BACKGROUND: Neonatal sepsis ranks third as a leading cause of infant mortality worldwide. It is also a major cause of mortality in both developed and developing countries. Despite considerable burden of disease, few data exist on precise incidence and etiology of onset neonatal sepsis in sub-Saharan Africa. This study addresses this gap.
OBJECTIVES: To Estimate Prevalence of Neonatal Sepsis and to determine maternal, neonatal and environmental risk factors contribute to neonatal sepsis in Mogadishu Hospitals.
METHODS: This was a hospital based prospective cross sectional study conducted at selected Mogadishu hospitals in Banadir region. A total of 286 neonates were recorded from February to august 2016. Were performed from newborn babies (n=286, age: 0-28 days) admitted to the hospitals with/without a clinical diagnosis of neonatal sepsis.
RESULTS: Of the 286 out of 172 (60.1%) are Male, were 114 (39.9%) of neonate are Female. resulting in an overall male is common than female. The age of neonates the commonest one is age between 1-7 days (84.6%), were age 8-28 days is (15.4%). Out of the 286 neonates were 102 (35.7%) Prolonged rapture of membrane. The most prevalence clinical features of sepsis were difficult feeding (19.2%), fever (12.9%), and lethargy (5.9%). In the other hand this study found 286 respondents out of 241 (84.3%) are delivered in a Hospital, were 42 (14.7%) of respondents are delivered TBA, were 3 (1%) is delivered Private clinic, and were most who attended during delivery out of 152 (53.1%) are Doctors, were 99 (34.6%) of respondents are Midwife, were 23 (8%) is Nurse, were 10 (3.5%) is mother/relative and were 2 (0.7%) is friend/neighbor. II
CONCLUSION AND RECOMMENDATIONS:
This study set out to look at the estimate prevalence of neonatal sepsis in Mogadishu hospitals in selected hospitals (Banadir, SOS and DEVA), was most our study establish place of delivery is hospitals, in other hand most common that attended delivery is Doctor and were most ages of children are 1-7 days in male gender are commonest gender that attended this study. To describe the varied pathogens causing neonatal sepsis as well as their changing antibiotic susceptibility profile is important. There are a number of important gaps in our knowledge or in Somalia, and there is an urgent need for studies looking at simple and sustainable interventions to reduce the burden of neonatal sepsis and causative organisms
Key words: neonatal sepsis, neonate, pediatric, prevalence of sepsis, Mogadishu.

1. PENGERTIAN Sepsis merupakan respon tubuh terhadap infeksi yang menyebar melalui darah dan jaringan lain. Sepsis neonatorum adalah infeksi bakteri pada aliran darah pada bayi selama empat minggu pertama kehidupan. Insiden sepsis bervariasi yaitu antara 1 dalam 500 atau 1 dalam 600 kelahiran hidup (Bobak, 2005). Sepsis adalah istilah yang digunakan untuk menggambarkan respons sistemik terhadap infeksi pada bayi baru lahir (Behrman, 2000). Sepsis adalah sindrom yang dikarekteristikkan oleh tanda-tanda klinis dan gejala-gejala infeksi yang parah yang dapat berkembang kearah septikemia dan syok septik (Dongoes, 2000) Sepsis neonatorum adalah semua infeksi pada bayi pada 28 hari pertama sejak dilahirkan. Infeksi dapat menyebar secara nenyeluruh atau terlokasi hanya pada satu orga saja (seperti paru-paru dengan pneumonia). Infeksi pada sepsis bisa didapatkan pada saat sebelum persalinan (intrauterine sepsis) atau setelah persalinan (extrauterine sepsis) dan dapat disebabkan karena virus (herpes, rubella), bakteri (streptococcus B), dan fungi atau jamur (candida) meskipun jarang ditemui. (John Mersch, MD, FAAP, 2009). Sepsis Neonatorum adalah suatu infeksi bakteri berat yang menyebar ke seluruh tubuh bayi baru lahir. Suatu sindroma respon inflamasi janin/FIRS disertai gejala klinis infeksi yang diakibatkan adanya kuman di dalam darah pada neonatus. Sepsis terjadi pada kurang dari 1% bayi baru lahir tetapi merupakan penyebab daro 30% kematian pada bayi baru lahir. Infeksi bakteri 5 kali lebih sering terjadi pada bayi baru lahir yang berat badannya kurang dari 2,75 kg dan 2 kali lebih sering menyerang bayi laki-laki.

frecuentes fueron: Staphylococcus epidermidis (38,3%), Staphylococcus aureus (12%), Klebsiella sp (10%), Alcaligenes fecalis (4,6%), Acinetobacter sp (4%) y Pseudomonas aeruginosa (4%). S. epidermidis mostró sensibilidad de 100% a vancomicina, 90% a cefotaxima, 50% a amikacina y ampicilina y 37% a oxacilina. Klebsiella mostró sensibilidad de 100% a ciprofloxacina e imipenen, 44% a ceftriaxona, 20% a ceftazidima y 14% a ampicilina;

The most frequent cause of mortality in neonates is infections which include sepsis, meningitis, pneumonia,
diarrhea and tetanus. Approximately 1.6 million deaths due to neonatal infections occur annually in
developing countries. The causes of sepsis vary from one geographic area to another. Thus, it is important
to create a database for the Philippines regarding the etiologies of neonatal sepsis.
Objectives: The study was undertaken to determine the most common bacterial pathogens of neonatal
sepsis in the Philippines and the antibiotic sensitivity patterns of these pathogens.
Methods: A multicenter surveillance and chart review was conducted in five hospital sites for a period of
six months- from July to December 2006. All neonates less than or equal to 28 days who had positive
cultures from a sterile site and or had fulfilled the SIRS criteria as defined by the International Pediatric
Sepsis Consensus Conference in the presence of suspected or proven infection were included in the study.
Results: A total of 289 neonates fulfilled the criteria of sepsis. More than 61% of the patients had early
onset neonatal sepsis. The most common site of infection was the lungs, (57%), followed by sepsis without
an obvious site of infection (35%).
In 50% of patients, an organism was identified; gram-negative bacteria were the dominant bacteria found
(Pseudomonas, Burkholderia, Klebsiella) which comprised 94% of the bacteria isolated. Resistance patterns
varied among the different urban study centers. The Pseudomonas and Burkholderia isolates from the
Philippine General Hospital (PGH) were sensitive to ceftazidime. All Klebsiella isolates from St. Louis
University (SLU) were resistant to third generation cephalosporins. In contrast, Klebsiella isolates from
PGH and Davao were sensitive to third generation cephalosporins but resistant to piperacillin-tazobactam.
The overall mortality rate was 11%. Ampicillin and an aminoglycoside were the most common regimens
used but were only successful in less than 50% of cases.
Conclusion: Gram-negative organisms comprised the majority of the neonatal infections, with
Pseudomonas and Burkholderia being the most prevalent. Resistance patterns differed among the different
centers. Continuing surveillance of infections is still needed in order choose the most appropriate empiric
therapy for each center.

Morganella morganii is an opportunistic gram-negative bacterium, resistant to ampicillin, and scarcely involved in early-onset neonatal sepsis.Case report. – After a premature rupture of the membranes, a pregnant patient received prophylactic amoxicillin per os. She developed chorioamnionitis. Her infant was diagnosed with early-onset sepsis. Maternal and baby’s blood cultures grew M. morganii. Both the mother and the infant were successfully

Neonatal infections and sepsis occur most frequently in calves with failure of passive transfer. If the invading bacteria are not rapidly controlled, they can set up focal infections, such as in growth plates, joints, or meninges, or generalized sepsis may occur. If not successfully treated, sepsis can lead to a systemic inflammatory response, multiple organ dysfunction syndromes, septic shock, and death. Treatments are based on selecting an appropriate antimicrobial drug and dosage, supportive therapy, fluid therapy, nonsteroidal anti-inflammatory drugs, and plasma transfusion. Preventing the failure of passive transfer through good colostrum management is essential.

To evaluate effects of polymyxin B direct hemoperfusion (PMX-DHP) on a neonatal sepsis cecal ligation and perforation (CLP) model, in 24 anesthetized and mechanically ventilated 3-d-old piglets, 16 were assigned to CLP and an arteriovenous extracorporeal ...

OBJECTIVE: The objective of this study was to determine the frequency and clinical significance of a systemic inflammatory response as defined by an elevated plasma interleukin-6 concentration in fetuses with preterm labor or preterm premature rupture of membranes.STUDY DESIGN: Amniocenteses and cordocenteses were performed in 157 patients with preterm labor and preterm premature rupture of membranes. Written informed consent and multi-institutional review board approvals were obtained. Amniotic fluid was cultured for aerobic and anaerobic bacteria, as well as mycoplasmas. Amniotic fluid and fetal plasma interleukin-6 concentrations were measured with a sensitive and specific immunoassay. Statistical analyses included contingency tables, receiver operating characteristic curve analysis, and multiple logistic regression.RESULTS: One hundred five patients with preterm labor and 52 patients with preterm premature rupture of membranes were included in this study. The overall prevalence of severe neonatal morbidity (defined as the presence of respiratory distress syndrome, suspected or proved neonatal sepsis, pneumonia, bronchopulmonary dysplasia. intraventricular hemorrhage, periventricular leukomalacia, or necrotizing enterocolitis) among survivors was 34.8% (54/155). Neonates in whom severe neonatal morbidity developed had higher concentrations of fetal plasma interleukin-6 than fetuses without development of severe neonatal morbidity (median 14.0 pg/mL, range 0.5 to 900 vs median 5.2 pg/mL, range 0.3 to 900, respectively; P < .005). Multivariate analysis was performed to explore the relationship between the presence of a systemic fetal inflammatory response and subsequent neonatal outcome. To preserve a meaningful temporal relationship between the results of fetal plasma interleukin-6 concentrations and the occurrence of severe neonatal morbidity, the analysis was restricted to 73 fetuses delivered within 7 days of cordocentesis who survived. The prevalence of severe neonatal morbidity in this subset of patients was 53.4% (39/73). A fetal plasma interleukin-6 cutoff value of 11 pg/mL was used to define the presence of a systemic inflammatory response. The prevalence of a fetal plasma interleukin-6 level >11 pg/mL was 49.3% (36/73). Fetuses with fetal plasma interleukin-6 concentrations >11 pg/mL had a higher rate of severe neonatal morbidity than did those with fetal plasma interleukin-6 levels ≤11 pg/mL (77.8% [28/36] vs 29.7% [11/37], respectively; P < .001). Stepwise logistic regression analysis demonstrated that the fetal plasma interleukin-6 concentration was an independent predictor of the occurrence of severe neonatal morbidity (odds ratio 4.3, 95% confidence interval 1 to 18.5) when adjusted for gestational age at delivery, the cause of preterm delivery (preterm labor or preterm premature rupture of membranes), clinical chorioamnionitis, the cordocentesis-to-delivery interval, amniotic fluid culture, and anmiotic fluid interleukin-6 results.CONCLUSION: A systemic fetal inflammatory response, as determined by an elevated fetal plasma interleukin-6 value, is an independent risk factor for the occurrence of severe neonatal morbidity. (Am J Obstet Gynecol 1998;179:194-202.)

We aimed to investigate the role of procalcitonin in the diagnosis and follow-up of neonatal sepsis, and to compare it with C-reactive protein (CRP) in this context. Between April and October 2002, a total of 67 neonates were randomly recruited into the study and were divided into four groups as: those with highly probable sepsis (group 1), probable sepsis (group 2), possible sepsis (group 3), and no sepsis (group 4; controls). When the initial procalcitonin levels of the groups were compared, the results were statistically significant (p &lt; 0.05) except for the comparison between groups 3 and 4 (p &gt; 0.05). When the initial CRP levels were compared between the groups, the levels measured in groups 1 and 2 were significantly higher than the levels measured in groups 3 and 4 (p &lt; 0.05). In addition, the decreasing levels in procalcitonin were statistically more significant than the decreasing levels in CRP in showing the response to antibiotic treatment (p &lt; 0.01 and p &lt;...

La Sepsis Neonatal actualmente se ha convertido en una de las principales causas de morbilidad y mortalidad neonatal, pasando a ser un significante desafío en salud pública a nivel mundial. La Sepsis Neonatal es un síndrome clínico de infección hematógena con respuesta sistémica a una posible infección, con o sin localización en diferentes sitios del organismo, con hemocultivo positivo o no, que se produce dentro de las primeras cuatro semanas de vida. Para el 2016 en Ecuador, la sepsis neonatal se situó en el lugar 42 dentro de las 50 primeras causas de morbilidad. El objetivo fundamental de la presente investigación es compendiar lo concerniente a los cuidados de enfermería en pacientes con sepsis neonatal atendidos en hospitales en Ecuador. La investigación se realizó bajo una metodología de tipo documental bibliográfica, bajo la modalidad de revisión.

Invasive Group A Streptococcus disease is a severe and sometimes life-threatening infection with only few cases reported in literature. We describe the case of a 49-day-old male infant with invasive Group A Streptococcus infection characterized by acute otitis media and development of septicemia within a probably community-acquired cluster. The causative agent resulted to be a rare emm-89 genotype of Streptococcus pyogenes. Group A Streptococcus must be considered responsible for sepsis in newborns and young infants.

Background. Neonatal sepsis is a significant cause of morbidity and mortality in developing countries, accounting for a large proportion of
neonatal deaths annually. Every year, 4 million neonates die, and one-third of these deaths is attributed directly to neonatal sepsis.
Objectives. To determine the prevalence of neonatal sepsis, characterise and identify causative organisms and identify possible risk factors.
Specific objectives were to determine the aetiological agents responsible for neonatal sepsis at Lagos University Teaching Hospital and also to identify the risk factors responsible for the development of neonatal sepsis.
Methods. Venous blood pairs were collected from clinically septic admitted neonates and inoculated into BACTEC Peds Plus (BD, USA)
bottles aerobically in the BACTEC 9050 system. Organisms were identified using the Microbact 12A/E system and biochemicals. A
structured questionnaire was used to collect data for risk factors, which were analysed with the SPSS version 17.
Results. Of 250 neonates who were sampled, 85 (34%) had pathogens recovered from their bloodstream, with Klebsiella pneumoniae the
predominant organism. Risk factors for sepsis were being delivered outside the hospital (p=0.01), and by frequent changes in antibiotics (p=0.00).
Conclusion. The burden of neonatal sepsis is still high in our environment as evidenced by our isolation rate of 34%. A concerted effort needs to be made to reduce this.

Objective: To determine whether the use of disposable clean delivery kits (CDKs) is effective in reducing neo-natal tetanus (NNT) infection, regardless of the skills of birth attendants in resource-poor settings. Methods: A secondary analysis was conducted on data from a matched case–control study in Karachi, Pakistan, involving 140 NNT cases and 280 controls between 1998 and 2001. Conditional logistic regression was performed to assess the independent effect on NNT of CDKs and skilled birth attendants (SBAs). Results: After adjustment for socioeconomic factors, both CDKs (adjusted matched odds ratio [mOR] 2.0; 95% confidence interval [CI], 1.3–3.1) and SBAs (adjusted mOR 1.7; 95% CI, 1.1–2.7) were independently associated with NNT. The association with CDKs remained significant when additionally adjusted for SBAs (mOR 2.0; 95% CI, 1.0–3.9; P= 0.05). The population attributable risk for lack of CDK use was 24% in the study setting. Conclusion: In the context of resource-poor settings in low-income countries with poor coverage of tetanus toxoid immunization, the use of CDKs seems to be an effective strategy for reducing NNT infection, irrespective of the skill levels of birth attendants. Approximately one-quarter of NNT cases could be prevented in low-income populations with the use of CDKs.

Background Sepsis is one of the most common causes of neonatal deaths globally. Most sepsis-related deaths occur in low-income and middle-income countries, where the epidemiology of neonatal sepsis remains poorly understood. Most of these countries lack proper surveillance networks, hampering accurate assessment of the burden of sepsis, implementation of preventive measures, and investment in research. We report results of neonates born in hospital from a multicentre collaboration on neonatal sepsis.

Human enteroviruses (family Picornaviridae) are the major cause of aseptic meningitis and also cause a wide range of other acute illnesses, including neonatal sepsis-like disease, acute flaccid paralysis, and acute hemorrhagic conjunctivitis. The neutralization assay is usually used for enterovirus typing, but it is labor- intensive and time-consuming and standardized antisera are in limited supply. We have developed a molecular

Early-onset sepsis (EOS) is the major cause of neonatal morbidity and mortality. Maternal group B Streptococcus (GBS) screening and intrapartum antibiotic prophylaxis (IAP) were implemented in our hospital in 2004. Our aim was to evaluate the effectiveness of the program and changes in pathogens and antibiotic susceptibility. The medical charts of mothers and infants with EOS between January 2001 and November 2008 were retrospectively reviewed. EOS was defined as sepsis occurring within 72 hours of birth. Data were pooled and compared for January 2001 through September 2004 (Period 1, without GBS screening) and October 2004 through November 2008 (Period 2, with GBS screening and IAP). The GBS screening rate increased from 10.11% in 2004 to 65% in 2008 and the IAP rate increased from 40% in 2004 to 90% in 2008. The most common EOS pathogen in Period 1 was GBS (45.4%), which decreased to 20% in Period 2 (p=0.081; trend p=0.009). The percentage of EOS because of Escherichia coli in Per...

La sepsis de inicio temprano es una infección bacteriana invasiva de la sangre y/o el líquido cerebroespinal, que ocurre en las primeras horas después del nacimiento. La causa primaria de la enfermedad es la infección ascendente de las bacterias que colonizan el tracto genital y uterino de la madre, siendo la flora gastrointestinal y genitourinaria los factores etiológicos más comunes.

Los pacientes generalmente inician con datos clínicos inespecíficos, y cuando estos se presentan son similares a otros síndromes inflamatorios de origen no infeccioso; la mayoría de los pacientes se recuperan con solo tratamiento de apoyo, con o sin terapia antimicrobiana. Aunque en países industrializados la prevalencia de los casos de sepsis puede ir desde el 1.5 por cada 1,000 recién nacidos (Estados Unidos), en nuestro país esta prevalencia se eleva desde 15 a 30 por cada 1,000 nacidos vivos; lo cual lo identifica como un problema importante al encontrarse muy por encima de lo que se puede lograr en reducción de esta patología.