Showing 6 results for Sepsis
Gharahjeh, S, Nowzari, A, Azarhoush, R, Fuladi Nejad, M, Nematollahi, N, Aryaei, M, Mohammadi, R,
Volume 9, Issue 2 (7-2015)
Abstract
Background and Objective: Neonatal sepsis is a remarkable factor in mortality, morbidity, neonatal and perinatal complications. Group B Streptococcus (GBS) is the primary cause of invasive disease in infants and pregnant women. This study aimed to determine the relationship between antimicrobial resistance of the bacteria colonized in the vagina and rectum of pregnant women and early neonatal infection.
Material and Methods: In this prospective study conducted on 282 pregnant women, bacterial sensitivity to ampicillin, cefazolin, erythromycin, vancomycin, gentamicin, amikacin was measured. Furthermore, the relationship between rectal and vaginal colonization of mothers and early neonatal sepsis was evaluated.
Results: Of 98 positive rectal cultures, 49 (50%) were Gram-positive cocci and 49 (50%) E.coli. of 143 positive vaginal cultures, 136 (95.1%) were Gram-positive cocci, 7 (4.9%) were E.coli and two were positive GBS. We could find definitive neonatal sepsis. Significant correlation was found between a history of urinary tract infection and the mother's positive rectal culture (P =0. 03).
Conclusion: Clinical sepsis in neonates is correlated with positive rectal culture (P =0. 001) and the positive E.coli vaginal cultures is associated with suspected neonatal sepsis (P =0.007). Gram-positive cocci were resistance to ampicillin and gentamicin, and E.coli was resistant to ampicillin, erythromycin and vancomycin. Because of resistance to ampicillin, we recommend cefazolin due to its sensitivity to organisms and safety in pregnancy.
Sadaf Khursheed Baba, Abiroo Jan, Mohd Suhail Lone, Dalip K Kakru, Bashir Ahmad Fomda, Gulnaz Bashir, Nadeem Ahmad Bhat,
Volume 17, Issue 3 (5-2023)
Abstract
Background and objectives: Conventional culture and sensitivity methods take around 48 hours to generate antibiotic sensitivity results after a blood culture is flagged as positive by automated systems. However, it is imperative to initiate early targeted antibiotic therapy for effective management of sepsis and to reduce morbidity, mortality, and cost of treatment. This study aimed to evaluate the direct sensitivity test (DST) as a potential tool to obtain quicker antibiotic susceptibility results from positive BacT/ALERT blood culture vials and the VITEK-2 system (the reference method).
Methods: Blood culture bottles flagged as positive by BacT/ALERT were Gram-stained. Cultures with polymicrobial growth were excluded from the study. The isolates were then simultaneously cultured and processed for the DST using the disk diffusion method. Agreements or errors were interpreted according to the Clinical and Laboratory Standards Institute’s guidelines.
Results: Among 76 Gram-positive isolates, we observed 99.2% essential agreement between the DST and AST. The rate of minor and major errors was 4.04% and 1.18%, respectively. Among 75 Gram-negative isolates, we observed 98.99% essential agreement between the DST and AST. The rate of minor and major errors was 4% and 2%, respectively. No very major error was seen in either Gram-negative or -positive isolates.
Conclusions: The DST results are available earlier than the AST results, which can ultimately help in the early initiation of targeted antibiotic therapy.
Dr Neema Tiwari, Dr Richa Sharma, Dr Prachi Saxena,
Volume 19, Issue 3 (7-2025)
Abstract
Introduction
Nucleated red blood cells (nRBC) are immature erythrocytes whose production is thought to be driven primarily by the interplay of hypoxia and erythropoietin (EPO) synthesis..It is classified as early onset neonatal sepsis(occurring with first 24 hours of life)or late onset neonatal sepsis(occurring after 48-72 hour).
We planned the study with the aim of analysing the cause for presence of nRBCs in peripheral blood of neonates sent for routine workup in the hematology Lab of Dept of Pathology,SMSR,Sharda University
Material and Method
Retrograde analysis of 27 CBC and peripheral blood smears of neonates was done for a period of 1 month and clinical details, parameters for neonatal sepsis(NLR,PLR,LMR,IG) platelet counts and nRBC counts recorded and tabulated. For result tabulation we divided the neonatal samples into two groups 0-1 day and 2- 30 days
Results
The neonates had 17 males and 9 females. The markers for neonatal sepsis NLR ,LMR and IG were more in cases 2-30 days as compared to cases 0-1 day old. nRBCs were also raised in cases between 2-13 days old. We had 3 cases crossing nRBCs level of 200/100 WBC while 2 vases showed nRBC levels of 150/100 WBC.
Conclusion
We conclude that finding nRBCs in peripheral smear is an important indicator of neonatal stress(sepsis/jaundice/hypoxic sepsis).
Anuradha Saini , Anjali Sharma , Mukul Singh , Shaily Goyal , Maninder Narang , Sunil Ranga ,
Volume 19, Issue 3 (7-2025)
Abstract
Background: Sepsis stands as a leading cause of mortality among critically ill patients in intensive care units (ICUs). Bacterial infections, including sepsis, upregulate Neutrophilic cluster of differentiation 64 (nCD64) expression on activated polymorphonuclear leukocytes (PMNs). Prompt diagnosis of sepsis is crucial for initiating timely and targeted treatment. Consequently, a rapid laboratory test with high specificity for sepsis in adults would significantly aid therapeutic decision-making and help reduce the overuse of antibiotics.
Methods: This study enrolled 40 sepsis patients diagnosed according to the Sepsis-3 definition. For biomarker evaluation, 2 mL blood samples were collected from each patient in both ethylenediaminetetraacetic acid (EDTA) and plain vials. In addition, nCD64 was analyzed using flow cytometry, high-sensitivity C-reactive protein (hs-CRP) via nephelometry, and procalcitonin (PCT) using chemiluminescence.
Results: For sepsis prediction, nCD64 demonstrated a positive predictive value (PPV) of 92.68% and a negative predictive value (NPV) of 94.87%. A receiver operating characteristic (ROC) curve was generated to assess the diagnostic accuracy of nCD64 (≥ 1.8), hS-CRP (≥ 3 mg/L), and PCT (≥ 0.4 ng/mL). The area under the curve (AUC) for nCD64 was highest at 0.938 (95% confidence interval [CI] = 0.876-0.999), followed by hS-CRP at 0.888 (95% CI = 0.807-0.968) and PCT at 0.850 (95% CI = 0.759-0.941).
Conclusion: These findings strongly suggest that nCD64 determination is a valuable diagnostic tool for identifying infections in patients with septic syndrome. Its performance appears to be superior to that of hs-CRP and PCT.
Sahar Siddiqui , Mohd Suhail Lone , Umar Amin Qureshi , Rayees Khanday ,
Volume 19, Issue 3 (7-2025)
Abstract
Background: Staphylococcus aureus (S. aureus) is a virulent bacterium responsible for a spectrum of infections, from superficial dermatological issues to severe, life-threatening sepsis. The emergence of methicillin-resistant S. aureus (MRSA) strains, encompassing both hospital-acquired (HA) and community-acquired (CA) variants, presents significant challenges to effective treatment, especially in pediatric sepsis cases. This research endeavored to characterize S. aureus sepsis in pediatric patients, differentiate between cases caused by CA S. aureus (CA-SA) and HA S. aureus (HA-SA), and evaluate patterns of antibiotic resistance.
Methods: This study, conducted between January 2021 and December 2022 at the Postgraduate Department of Pediatrics, Children’s Hospital, Srinagar, Kashmir, J&K, investigated patients aged 1 month to 18 years with suspected S. aureus sepsis or disseminated disease. Standard methods (BacT Alert and Vitek II Compact) were employed for culturing various samples. Continuous data are presented as mean ± standard deviation (SD), while categorical variables are expressed as proportions.
Results: Out of 56 patients, CA-SA was observed in 66.1% of cases, while HA-SA accounted for the remaining 33.9%. The cohort primarily consisted of males (62.5%) and individuals residing in rural areas (71.43%). Localized musculoskeletal symptoms were a prominent feature, present in 91.9% of patients (P ≤ 0.05). Pleuropulmonary disease showed an association with HA-SA, whereas necrotizing soft tissue infections were linked to CA-SA. Common clinical manifestations included pneumonia and abscesses. Complications (such as septic shock, respiratory failure, and multi-organ dysfunction) were more frequently encountered in patients with HA-SA. Among 50 culture-confirmed cases, 96% were identified as methicillin-resistant S. aureus (MRSA). Survival rates differed between the two groups, with 94.6% for CA-SA patients and 89.5% for HA-SA patients.
Conclusion: The current study reveals a high prevalence of MRSA in pediatric sepsis, emphasizing the critical need for urgent antimicrobial stewardship. The observed distinct clinical profiles of CA-SA and HA-SA further underscore the necessity for tailored management strategies, particularly in resource-limited environments.
Shayosree Sarkar, Sonal Chavan, Geetika Agrawal, Heena Rahangdale, Sunanada Zodpey,
Volume 19, Issue 3 (7-2025)
Abstract
Background: Burkholderia cepacia complex is are opportunistic nosocomial pathogen that can cause severe infections in neonates, involving the respiratory tract, the urinary tract and bloodstream infections. Therefore, it can lead to outbreaks through different sources. This study was conducted with the aim of early detection and successful control of an outbreak caused by Burkholderia cepacia complex.
Methods: A cross-sectional study was conducted in a tertiary care hospital over a one-month period, July 2023. Blood culture samples of 11 neonate’s yielded growth of non-fermenting, oxidase-positive and motile, Gram-negative bacilli. Isolates were provisionally identified to be Burkholderia cepacia complex by conventional biochemical tests and antimicrobial susceptibility patterns. The increased, repeated, and continuous isolation of the same isolate raised the suspicion of an outbreak in the neonatal intensive care unit. Active surveillance was undertaken to trace the source and contain the bacteria. Identification of isolates was confirmed by VITEK 2 (BioMérieux, France) compact microbiology analyser.
Results: Surveillance revealed sources of Burkholderia cepacia complex for all 11 neonates. Sources of infection could be traced to intravenous catheters and cradles of the neonates and operation theatre beds, and instrument trolleys of the labour room where the babies were delivered. All the environmental isolates showed strain-relatedness of Burkholderia cepacia complex with the clinical isolates, along with a similar antibiotic susceptibility pattern. Timely interventions aided in the control of the outbreak.
Conclusion: This study presents the importance of the hospital infection control team in the management of an outbreak of Burkholderia cepacia complex in neonates.
