Showing 5 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.
Anuradha Saini, Anjali Sharma, Mukul Singh, Shaily Goyal, Maninder Narang, Sunil Ranga,
Volume 19, Issue 2 (3-2025)
Abstract
Background & objectives: Sepsis is one of the most common cause of mortality among patients who are critically ill and in Intensive Care Units(ICU). Bacterial infection or sepsis leads to an increase in Neutrophilic CD64(nCD64) expression on activated polymorphonuclear leukocytes(PMNs). Early diagnosing of sepsis is very important in order to start timely and specific treatment. The availability of a rapid laboratory test with high specificity for sepsis in adult patients could aid in therapeutic decision making and reduce unnecessary antibiotic use.
Methods: Sepsis patients diagnosed as per sepsis-3 definition were included in this study. 2 ml blood sample was collected in EDTA & plain vial each for evaluation of nCD64, Procalcitonin(PCT) & high sensitivity C-reactive protein(hS-CRP). The samples were run on Flow cytometer, Nephelometer and Chemiluminescence for nCD64, hS-CRP and PCT respectively.
Result: The Positive Predictive Value(PPV) of nCD64 for prediction of sepsis was 92.68% and the Negative Predictive value(NPV) was 94.87%. Receiver operating curve(ROC) was plotted for indicating the diagnostic accuracy of nCD64(≥1.8), hS-CRP(≥3 mg/L) and PCT(≥0.4 ng/mL). Area under the curve(AUC) for nCD64 was highest[0.938(95%CI=0.876-0.999)] followed by hS-CRP[0.888(95%CI=0.807-0.968)] and PCT [0.850(95%CI =0.759-0.941)].
Conclusion: These findings are suggestive of the possibility that nCD64 determination was a useful tool for diagnosing infection in patients with septic syndrome, with a performance superior to that of hS-CRP and PCT.
Sahar Siddiqui, Mohd Suhail Lone, Umer Qureshi, Rayees Khanday,
Volume 19, Issue 2 (3-2025)
Abstract
Background: Staphylococcus aureus (S. aureus) is a common pathogen that causes both community and hospital-acquired infections Objectives: To identify clinico-microbial profiles of S aureus acquired in the community and in the hospital. Methods This study was conducted from January 2021 to December 2022 in Postgraduate Department of Pediatrics Children Hospital Srinagar J&K on patients aged one month to 18 years suspected of having S. aureus sepsis or disseminated disease. Results: There were 56 patients identified with S aureus septicemia (SAS) over the study period; 37(66.10%) had community acquired S aureus sepsis (CASS) and 19(33.90%) hospital acquired S aureus sepsis (HASS). 35(62.50%) affected belonged to male gender; 40(71.43%) patients belonged to rural area. Localized musculoskeletal symptoms (91.90%) were the most commonpresentation P value < 0.05. Pleuropulmonary disease and necrotizing soft tissue disease were significantly associated with patients of HASS and CASS respectively. The common disease presentation was pneumonia followed by abscess. Septic shock, respiratory failure, multi organ dysfunction, etc were the common complications seen more often in HASS. Out of 50 patients who had SAS in cultures, 48 were Methicillin resistant S aureus (MRSA) and 2 were Methicillin sensitive S aureus (MSSA). The survival rate from CASS was 94.60% and from HASS was 89.50% Conclusions: CASS and HASS affects children, is multifocal, and has high morbidity associated. The sensitivity pattern of Staphylococcus aureus in our settings as well as globally has undergone a dramatic change with rise in proportion of Methicillin resistance and needs to been addressed urgently.
Shayosree Sarkar, Sonal Chavan, Geetika Agrawal, Heena Rahangdale, Sunanada Zodpey,
Volume 19, Issue 2 (3-2025)
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.
