scholarly journals A ten-year review of neonatal bloodstream infections in a tertiary private hospital in Kenya

2011 ◽  
Vol 5 (11) ◽  
pp. 799-803 ◽  
Author(s):  
Ruchika Kohli-Kochhar ◽  
Geoffrey Omuse ◽  
Gunturu Revathi
Keyword(s):  
Developing Countries ◽  
Neonatal Sepsis ◽  
Late Onset ◽  
Group B Streptococcus ◽  
Bloodstream Infections ◽  
Empiric Therapy ◽  
Gram Positive ◽  
Late Onset Sepsis ◽  
Group B ◽  
The Right

Introduction: Neonatal mortality in developing countries is usually due to an infectious cause.  The gold standard of investigation in developing countries is a positive blood culture.  It is important to know the aetiology of neonatal bloodstream infections so that empiric treatment can be effective.  Methodology: We conducted a retrospective clinical audit over ten years between January 2000 until December 2009, looking at the aetiology of both early and late onset neonatal sepsis.  We analysed data from 152 (23%) patient isolates out of 662 suspected cases of neonatal sepsis.  Results: Our study revealed that Gram-positive organisms were the predominant cause of both early and late onset sepsis; the common isolates were Staphylococcus epidermidis (34%) and Staphylococcus aureus (27%).  There were no isolates of group B Streptococcus.  Candida species was isolated only in patients with late onset sepsis (6.9%).  Bacterial isolates were relatively sensitive to the commonly used first- and second-line empiric antibiotics. Conclusion: Gram-positive organisms remain the major cause of neonatal bloodstream infections in our setup.  The findings of this study will guide clinicians in prescribing the right empiric therapy in cases of suspected neonatal sepsis before the definitive culture results are obtained.

scholarly journals Neonatal Sepsis: Clinical Considerations

2017 ◽  
Vol 07 (01) ◽  
pp. e54-e59 ◽  
Author(s):  
S. Blatt ◽  
M. Schroth
Keyword(s):  
Neonatal Sepsis ◽  
Late Onset ◽  
Rapid Development ◽  
Group B Streptococcus ◽  
Neonatal Morbidity ◽  
Screening Tests ◽  
Late Onset Sepsis ◽  
Early Onset Sepsis ◽  
Clinical Considerations ◽  
Group B

AbstractUnspecific symptoms and rapid development of sepsis up to septic shock from systemic inflammatory response syndrome (SIRS) are well-known, important issues in neonatology. A common cause is the infection by Streptococcus agalactiae (Group B Streptococcus [GBS]) or Escherichia coli, which contributes significantly to neonatal morbidity and mortality. Whereas early-onset sepsis is normally derived from mother during birth, late-onset sepsis can be transmitted by the environment. Management of neonatal sepsis includes the maintenance of cardiovascular and pulmonary function besides antibiotic therapy. Due to the fact that until today, there are no reliable screening tests for detecting early sepsis, clinical assessment is considered to be of utmost importance.

Recurrent neonatal group B streptococcus cellulitis and adenitis syndrome with late-onset sepsis

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Alex Guri ◽  
Eric Scheier ◽  
Uri Balla ◽  
Mikhael Chigrinsky ◽  
Eli Shapiro
Keyword(s):  
Emergency Department ◽  
Late Onset ◽  
Group B Streptococcus ◽  
Complete Recovery ◽  
Blood Cultures ◽  
Case Presentation ◽  
Late Onset Sepsis ◽  
Neonatal Group ◽  
Group B ◽  
The Right

AbstractObjectivesGroup-B streptococcus (GBS) continues to be a significant cause of late-onset neonatal illness. Rarely does it present as cellulitis-adenitis syndrome, and rarely does the infection recur in the same infant after complete recovery.Case presentationHere we report a case of recurrent late-onset cellulitis-adenitis GBS syndrome in a term 12-day-old neonate. The infant presented with fever and cellulitis of the right neck. Full sepsis workup was normal and the infant recovered completely with antibiotics. Three days after the completion of antibiotics the patient returned to the emergency department due to fever, toxic appearance and rapidly spreading cellulitis, and adenitis on the left side of the neck. Blood culture revealed GBS. The patient was re-admitted to the hospital and successfully treated with a prolonged course of antibiotics.ConclusionsThis case highlights the importance of treating neonatal cellulitis with fever as bacteremia, and reminds us of the rare possibility of recurrent invasive GBS disease. Moreover, this case illustrates that GBS cellulitis-adenitis syndrome is possibly underdiagnosed in mild cases. Physicians should be aware that neonatal cellulitis can precede the appearance of severe sepsis. Neonates with fever and cellulitis without a clear external port of entry should undergo a complete sepsis workup and receive antibiotic treatment appropriate for bacteremia, even if the blood cultures are negative. Although the recurrence of GBS sepsis is rare, physicians should be aware of this possibility in order to treat the infection early.

scholarly journals Neonatal Group B streptococcal osteomyelitis and suppurative arthritis: A case report

2021 ◽  
Vol 35 ◽  
pp. 117-120
Author(s):  
Ashwath Duraiswamy ◽  
Veerappan Somu
Keyword(s):  
Neonatal Sepsis ◽  
Late Onset ◽  
Group B Streptococcus ◽  
Neonatal Morbidity ◽  
Sternoclavicular Joint ◽  
Unusual Site ◽  
Late Onset Sepsis ◽  
Focal Infection ◽  
Neonatal Group ◽  
Group B

Neonatal sepsis contributes significantly to neonatal morbidity and mortality. Group B streptococcus (GBS) is not a frequent cause of neonatal sepsis in India. Late onset sepsis by GBS presenting as focal infection like osteomyelitis is seen in only 3% of the total GBS sepsis profile in neonates. Here, we report a rare case of neonatal osteomyelitis with septic arthritis caused by GBS at an unusual site, the clavicle and sternoclavicular joint.

Linezolid

2009 ◽  
Vol 28 (3) ◽  
pp. 187-192
Author(s):  
Susan Givens Bell
Keyword(s):  
Very Low Birth Weight ◽  
Late Onset ◽  
Group B Streptococcus ◽  
Neonatal Infection ◽  
Research Network ◽  
Coagulase Negative Staphylococcus ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
Late Onset Sepsis ◽  
Group B

THE MOST RECENT DATA FROM THE National Institute of Child Health and Human Development Neonatal Research Network revealed that in late-onset sepsis events in very low birth weight neonates proven by blood culture, 70 percent were caused by Gram-positive organisms. Coagulase-negative staphylococci accounted for 68 percent of these Gram-positive infections, and Staphylococcus aureus, Enterococcus species, and Group B Streptococcus were isolated in the remainder.1Staphylococcus epidermidis continues to be the most common coagulase-negative Staphylococcus species isolated in culture, and S. capitis, S. warneri, S. haemolyticus and S. hominis have also been implicated in neonatal infection.

Group B streptococcus sepsis in an infant presented with cellulitis of soft tissue of neck

2021 ◽  
Vol 14 (8) ◽  
pp. e241683
Author(s):  
Muhammad Moazzam Gulzar ◽  
Andrea Roman ◽  
Rizwan Gul ◽  
Nagabathula Ramesh
Keyword(s):  
Soft Tissue ◽  
Lymph Nodes ◽  
Late Onset ◽  
Group B Streptococcus ◽  
Late Onset Sepsis ◽  
Intravenous Antibiotics ◽  
Early Onset Sepsis ◽  
History Of ◽  
Group B ◽  
Tissue Oedema

We report a case of cellulitis of the soft tissue of the neck with group B streptococcus (GBS) sepsis in a 4-week-old baby boy presented with a 1-day history of fever, irritability and feed refusal. While in the hospital, a left-sided submandibular swelling extending to preauricular area started emerging, which progressed dramatically. Ultrasound scan of the neck confirmed inflammation of the underlying soft tissue while revealing multiple enlarged lymph nodes without any abscess formation and overlying soft tissue oedema. Blood cultures were flagged positive at 9 hours for GBS. The infant was treated with intravenous antibiotics for 2 weeks. GBS is considered a common cause of early-onset sepsis in neonates. However, it can also lead to late-onset sepsis in infancy with variable presentations. In our case, GBS sepsis manifested with cellulitis of the soft tissue of the neck along with swelling of local lymph nodes.

scholarly journals Bacterial Isolates of Early Onset Neonatal Sepsis and Their Antibiotic Susceptibility Pattern

2018 ◽  
Vol 17 (1) ◽  
pp. 3-8 ◽  
Author(s):  
Md Abdul Mannan ◽  
Shahed Iqbal ◽  
SM Rezaul Karim ◽  
Talim Uddin Ahmed ◽  
Md Hakimul Haque Khan ◽  
...  
Keyword(s):  
Neonatal Sepsis ◽  
Early Onset ◽  
Late Onset ◽  
Gram Positive ◽  
Gram Negative ◽  
E Coli ◽  
Late Onset Sepsis ◽  
Early Onset Sepsis ◽  
Sensitivity Pattern ◽  
Rule Out

Background: Neonatal infections are the commonest cause of neonatal mortality along with perinatal asphyxia and consequence of Prematurity and Low Birth Weight (LBW) in Bangladesh. Early Onset Neonatal Sepsis (EONS) is neonatal sepsis occurring within the first 72 hours of birth and it is much more fulminant and has a higher mortality than Late Onset Sepsis (LOS). Sepsis in neonate remains a significant cause of mortality and morbidity in developing countries. Changing bacterial flora and emergence of resistant strains adds to the problem. Thus, neonatal sepsis requires accurate and timely clinical and laboratory diagnosis and proper management for better outcome. The organisms responsible for Early Onset Sepsis (EOS) are different than Late Onset Sepsis (LOS). In this study an attempt has been made to know the positivity rate of EOS and profile of bacteria responsible for EOS and determine the antimicrobial sensitivity pattern that were investigated for rule out sepsis. Methods: This was a prospective observation single centre study over a period of nine months (January to September, 2017) conducted on neonates born at Ad-din Medical College Hospital (AMCH), Dhaka and subsequently admitted in Neonatal Intensive Care Unit (NICU) within 72 hours of birth that were investigated for rule out sepsis. Dual blood sample for cultures from separate area along with essential investigations were sent by collecting samples under aseptic precautions. Empirical antimicrobial therapy was started according to antimicrobial guidelines in the NICU. The blood cultures test were carried out by BD BACTEC automated blood culture system and susceptibility testing was done for all blood culture isolates according to the criteria of the National Committee for Clinical Laboratory Standards by disk diffusion method. Results: A total of 700 neonates were investigated to rule out sepsis and 5.43% neonates were found with culture proven sepsis in the study. The gram positive bacteria accounted for 71% and gram negative 29% of the total isolates. Out of total 38 isolates, Coagulase-Negative Staphylococci (CONS) (68.4%) was the commonest followed by Acinetobacter (18.4%) and E. coli (7.9%) was common culture isolates. Among the gram positive, CONS (96.3%) was commonest isolate and in gram negative Acinetobacter (63.6%) was the most prevalent bacteria followed by E.coli (27.3%). Gram positive isolate, especially CONS (68.4%) was the major culprit for the early onset sepsis. Among the commonly used antibiotics, the susceptibilities were remarkably low to Amikacin (16%) in comparison to Ampicillin (42%) Cefotaxime (45%) and moderately high to Gentamicin (58%) for both gram positive & gram negative isolates. All (100%) gram positive isolates were resistant to Amikacin. Majority of the gram positive showed low susceptibilities to Meropenem (22%) Ciprofloxacin (41%) Ampicillin (48%) & Oxacillin (48%) in comparison to Cefotaxime (52%) Levofloxacin (55%) Gentamicin (70%), Linezolid (70%) and Vancomycin (74%). 50% of Coagulase Negative Staphylococcus (CONS) were resistant to Methicillin/Oxacillin. The sensitivity pattern of majority of gram negative isolates showed high level of resistance to Piperacillin+Tazobacterm (9%) and Ampicillin (27%) Gentamicin (27%) Cefotaxime (27%) less sensitive to Ciprofloxacin (45%); moderately high to Levofloxacin (54%) & Amikacin (54%) and highly sensitive to Imipenem/Meropenem (73%) & Colistin (91%). Gentamicin (58%) and Levofloxacin (55%) were showed marginal superiority compared to Ampicillin (42%) and Cefotaxime (45%) for effective coverage of both. Conclusion: Present study indicated that gram positive species especially CONS continue to be the predominant causative organism followed by Acinetobacter and E. coli in gram negative species. The antibiotic susceptibility profile suggested that for a given cohort empiric (initial) choice of Ampicillin and Gentamicin in EOS. Routine bacterial surveillance and their sensitivity patterns must be an essential component of neonatal care Chatt Maa Shi Hosp Med Coll J; Vol.17 (1); Jan 2018; Page 3-8

scholarly journals Neonatal Case of Late-onset Sepsis Involving Group B Streptococcus Type Ib

2013 ◽  
Vol 80 (5) ◽  
pp. 384-386 ◽  
Author(s):  
Sakae Kumasaka ◽  
Yoshio Shima ◽  
Makiko Mine ◽  
Mizue Nakajima ◽  
Makoto Migita
Keyword(s):  
Late Onset ◽  
Group B Streptococcus ◽  
Late Onset Sepsis ◽  
Group B

scholarly journals Bacteriological profile and antimicrobial sensitivity pattern in neonatal sepsis: a study from North India

2017 ◽  
Vol 5 (4) ◽  
pp. 1541 ◽  
Author(s):  
Poonam Dalal ◽  
Geeta Gathwala ◽  
Mohit Gupta ◽  
Jasbir Singh
Keyword(s):  
Blood Culture ◽  
Neonatal Sepsis ◽  
Late Onset ◽  
Microbial Flora ◽  
Gram Positive ◽  
Gram Negative ◽  
Antimicrobial Sensitivity ◽  
Late Onset Sepsis ◽  
Early Onset Sepsis ◽  
Sensitivity Pattern

Background: Neonatal sepsis is a leading cause of neonatal mortality and continues to be a formidable problem for neonatologists and pediatricians world over.  Knowledge of microbial flora and their susceptibility will help us to decide empirical treatment for the neonatal sepsis. The objective of this study was to determine the bacteriological flora prevalent in NICU and the antimicrobial sensitivity pattern.Methods: The blood culture reports of all the neonates with culture proven neonatal sepsis during the period July 2010 to September 2013 were reviewed retrospectively. A retrospective review in tertiary care teaching medical college. The data was entered in Excel sheets and percentages of various outcomes were calculated.Results: A total of 28,927 babies were born during the study period and 336 among them had positive blood culture. The incidence of neonatal sepsis was 11.62 per 1,000 live births. Three hundred fifty- six microbes were isolated, out of which 50% presented as early onset sepsis and remaining as late onset sepsis. Pseudomonas aeruginosa was the most common organism encountered in both early (43.82%) and late onset sepsis (51.35%). Gram negative bacilli were sensitive to carbapenems (92%) followed by piperacillin-tazobactam (90%) whereas linezolid (90%) was most sensitive antimicrobial for gram positive cocci.Conclusions: Pseudomonas was most commonly isolated in both early and late onset sepsis.  Gram negative bacilli were most sensitive to piperacillin-tazobactam and the carbapenems whereas linezolid and vancomycin were most effective against the gram-positive cocci. Resistance to third generation cephalosporins was rampant. Continuous surveillance for microbial flora, their antibiotic susceptibility, rational use of antibiotics and the strategy of antibiotic cycling may be of help to curtail emerging antimicrobial resistance.

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