Pataskar Akangksha, Chandel Anuragsingh, Chauhan Varsha, Jain Manish
MGIMS, Sevagram, Maharashtra, India.
Department of Pediatrics, MGIMS, Sevagram, Maharashtra, India.
Clin Med Insights Pediatr. 2023 Aug 4;17:11795565231189595. doi: 10.1177/11795565231189595. eCollection 2023.
Neonatal sepsis has been a major cause of neonatal mortality and morbidity globally. Late onset sepsis is on the rise mostly due to better health care services and improved survival of premature neonates. Gram-negative sepsis has emerged as a major public health problem constituting significant morbidity and mortality. There is limited data on gram-negative late onset sepsis from the central part of India, therefore this study was conducted at a tertiary care center from rural part of India.
To determine the clinical profile and outcome among neonates with gram-negative late onset sepsis.
It is a retrospective analysis conducted among neonates with gram-negative late onset sepsis at a tertiary care center from central India.
All neonates below 28 days of age suspected to have late onset sepsis were enrolled in the study. The data for the period of January 2019 to December 2021 was collected and analyzed using software SPSS version 29. The outcome variables studied were discharge (good outcome) and death (poor outcome).
In the present study, overall prevalence of gram-negative late onset sepsis was 4.8%. Respiratory distress (52.2%), seizure (18.9%), jaundice (15.6%), and lethargy (15.6%) were common clinical symptoms among neonates with sepsis. The most common organism isolated was spp. (36.7%) followed by spp. (31.1%) and (17.8%). Low gestational age (n = 20 vs n = 7, = .002) and low birth weight (n = 33 vs n = 4, = .02) were associated with poor outcomes in neonates with gram negative LOS. The overall mortality rate was found to be 30% among neonates with gram negative sepsis.
The prevalence of gram-negative sepsis was found to be 4.8%. Factors associated with poor outcome in gram-negative sepsis were low birth weight, and prematurity. spp. was found to be a common cause of gram-negative LOS, therefore, the empiric antibiotic policy must provide coverage against these micro-organisms.
新生儿败血症一直是全球新生儿死亡和发病的主要原因。晚发性败血症呈上升趋势，主要是由于更好的医疗服务和早产儿存活率的提高。革兰氏阴性菌败血症已成为一个重大的公共卫生问题，导致显著的发病率和死亡率。来自印度中部地区的关于革兰氏阴性菌晚发性败血症的数据有限，因此本研究在印度农村地区的一家三级护理中心进行。
确定革兰氏阴性菌晚发性败血症新生儿的临床特征和预后。
这是一项对印度中部一家三级护理中心的革兰氏阴性菌晚发性败血症新生儿进行的回顾性分析。
所有疑似患有晚发性败血症的28日龄以下新生儿均纳入本研究。收集了2019年1月至2021年12月期间的数据，并使用SPSS 29版软件进行分析。研究的结局变量为出院（良好结局）和死亡（不良结局）。
在本研究中，革兰氏阴性菌晚发性败血症的总体患病率为4.8%。呼吸窘迫（52.2%）、惊厥（18.9%）、黄疸（15.6%）和嗜睡（15.6%）是败血症新生儿常见的临床症状。分离出的最常见病原体是 菌属（36.7%），其次是 菌属（31.1%）和 菌（17.8%）。低胎龄（n = 20 vs n = 7，P = 0.002）和低出生体重（n = 33 vs n = 4，P = 0.02）与革兰氏阴性菌晚发性败血症新生儿的不良结局相关。革兰氏阴性菌败血症新生儿中的总体死亡率为30%。
发现革兰氏阴性菌败血症的患病率为4.8%。革兰氏阴性菌败血症不良结局的相关因素为低出生体重和早产。 菌属被发现是革兰氏阴性菌晚发性败血症的常见病因，因此，经验性抗生素策略必须覆盖这些微生物。
