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Profile of Neonatal Septicaemia at a District-level Sick Newborn Care Unit
Although sepsis is a major cause of morbidity and mortality among newborns in resource-poor countries, little data are available from rural areas on culture-proven sepsis. The aim of the present study was to provide information in this regard. The study reports results on the incidence and aetiology...
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Published in: | Journal of health, population and nutrition population and nutrition, 2012-03, Vol.30 (1), p.41-48 |
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Main Authors: | , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that cite this one |
Online Access: | Get full text |
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Summary: | Although sepsis is a major cause of morbidity and mortality among
newborns in resource-poor countries, little data are available from
rural areas on culture-proven sepsis. The aim of the present study was
to provide information in this regard. The study reports results on the
incidence and aetiology of neonatal sepsis cases admitted to a facility
in a rural area in eastern India. Blood culture was done for all
babies, with suspected clinical sepsis, who were admitted to the sick
newborn care unit at Suri where the study was conducted during March
2009-August 2010. A standard form was used for collecting
clinical and demographic data. In total, 216 neonatal blood culture
samples were processed, of which 100 (46.3%) grew potential pathogens.
Gram-negative infection was predominant (58/100 cases) mainly caused by
enteric Gram-negative bacteria. Klebsiella pneumoniae was the most
common Gram-negative isolate. The emergence of fungal infection was
observed, with 40% of the infection caused by yeast. Gram-negative
organisms exhibited 100% resistance to ampicillin, cefotaxime, and
gentamicin. Amikacin and co-trimoxazole showed 95% (n=57) resistance,
and ciprofloxacin showed 83.3% (n=50) resistance among the
Gram-negative bacteria. Carbapenem showed emerging resistance (n=4;
6.6%). Results of analysis of risk factors showed an extremely
significant association between gestation and sepsis and gender and
sepsis. Gastrointestinal symptoms were highly specific for fungal
infections. One-third of babies (n=29), who developed culture-positive
sepsis, died. Blood culture is an investigation which is frequently
unavailable in rural India. As a result, empirical antibiotic therapy
is commonly used. The present study attempted to provide data for
evidence-based antibiotic therapy given to sick newborns in such rural
units. The results suggest that there is a high rate of antibiotic
resistance in rural India. Urgent steps need to be taken to combat this
resistance. |
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ISSN: | 1606-0997 2072-1315 |
DOI: | 10.3329/jhpn.v30i1.11274 |