A RETROSPECTIVE STUDY ON IMPORTANCE OF CRP AS A PREDICTOR AND TO ANALYSE THE EFFECTIVENESS OF ANTIBIOTICS IN THE TREATMENT OF NEONATAL SEPSIS AT SECONDARY CARE HOSPITAL OF TIRUPPUR
Abstract
Early diagnosis of sepsis in a neonate is often difficult because symptoms and signs are usually non-specific. A study was conducted to evaluate C-reactive protein (CRP) as a screening tool and the effectiveness of antibiotics in the treatment of neonatal sepsis. This retrospective study was conducted at NICU, Government District Headquarters Hospital, Tiruppur from December 2016 to June 2017, on total of 120 neonatal sepsis patients. Patients of Group I received Ampicillin + Gentamicin, Group II received Ampicillin + Gentamicin followed by Cefotaxime + Amikacin, Group III received Cefotaxime + Amikacin, Group IV received Ampicillin + Gentamicin followed by Piptaz followed by Amikacin + Ciprofloxacin and Group V received, Ampicillin + Gentamicin followed by Piptaz then by Amikacin + Meropenem and then by Ciprofloxacin. Chi-square test two side p-value & ONE WAY ANOVA followed by Tukey-Krammer Multiple Comparison Test is used for statistical analysis. Among study subjects, 18 (15%) and 102 (85%) had negative and positive CRP respectively. According to blood culture studies, 15 cases were culture positive, with the following organisms, Klebsiella pneumoniae (53.33%), Escherichia coli (20%), Staphylococcus aureus (20%) and Proteus marbilis (6.66%). Group II is an appropriate choice for empirical therapy of neonatal sepsis and was 46.96% of 66 patients. Group I, which is considered as First Line treatment was 33.33% of 66 patients.
Keywords:
Antibiotics, Blood culture, CRP, Neonatal sepsisDOI
https://doi.org/10.25004/IJPSDR.2018.100102References
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28. Dhale S, Valinjkar S, Anjutagi S, Narkhede V. The Study of in Vitro Sensitivity and Resistance Pattern of Antibiotics in Neonatal Septicemia in Tertiary Care Hospital. JMSCR. 2016; 04(08):11720-11729
29. Shah AJ, Mulla SA, Revdiwala SB. Neonatal sepsis: high antibiotic resistance of the bacterial pathogens in a neonatal intensive care unit of a tertiary care hospital. J Clin Neonatol. 2012; 1(2):72–5.
30. Ballot DE, Nana T, Sriruttan C, Cooper PA. Bacterial bloodstream infections in neonates in a developing country. ISRN Pediatr. 2012; 508-512.
31. Shah BA, Padbury JF. Neonatal sepsis An old problem with new insights. Virulence. 2014; 5(1): 170–178.
32. Zaidi AK, Huskins WC, Thaver D, Bhutta ZA, Abbas Z, Goldmann DA. Hospital-acquired Neonatal infections in developing countries. The Lancet. 2005; 365(9465):1175–88.
33. Viswanathan R, Singh AK, Ghosh C, Dasgupta S, Mukherjee S, Basu S. Profile of neonatal septicaemia at a district-level sick newborn care unit. J Healt Popul Nutr. 2012; 30(1):41-48.
34. Manucha V, Rusia U, Sikka M, Faridi MM, Madan N. Utility of haematological parameters and C-reactive protein in the detection of neonatal sepsis. J Paediatr Child Health. 2002; 38(5):459-64.
2. Naher HS, Khamael AB. Neonatal Sepsis: The Bacterial Causes and the Risk Factors. Int Res J Med Sci. 2013;1(6): 19-22.
3. Gandhi S, Ranjan KP, Ranjan N, Sapre N, Masani M. Incidence of neonatal sepsis in tertiary care hospital: An overview. Int J Med Sci Public Health. 2013; 2(3): 548-552.
4. Hornik CP, Fort P, Clark RH, Watt K, Benjamin DK Jr, Smith PB, et al. Early and late onset sepsis in very-low-birth-weight infants from a large group of neonatal intensive care units. Early Hum Dev. 2012 May;88 Suppl 2:S69-74.
5. Bedford Russell AR. Neonatal sepsis. Paediatr Child Health (Oxf). 2011; 21:265-9.
6. Lim WH, Lien R, Huang YC, Chiang MC, Fu RH, Chu SM, et al. Prevalence and pathogen distribution of neonatal sepsis among very-low-birth-weight infants. Pediatr Neonatol. 2012; 53:228-34.
7. Moreno MT, Vargas S, Poveda R, Sáez-Llorens X. Neonatal sepsis and meningitis in a developing Latin American country. Pediatr Infect Dis J. 1994; 13(6):516-520.
8. Tallur SS, Kasturi AV, Nadgir SD, Krishna BV. Clinico-bacteriological study of neonatal septicemia in Hubli. Indian J Paediatr. 2000; 67(3):169–174.
9. Karunasekera KA, Pathirana D. A preliminary study on neonatal septicaemia in a tertiary referral hospital paediatric unit. Ceylon Med J. 1999; 44(2):81–86.
10. Karthikeyan G, Premkumar K. Neonatal sepsis: Staphylococcus aureus as the predominant pathogen. Indian J Paediatr. 2001; 68(8):715–717.
11. Lim CT, Thong MK, Parasakthi N, Ngeow YF. Group B streptococcus: maternal carriage rate and early neonatal septicaemia. Ann Acad Med Singapore.1997; 26(4):421–425.
12. Mulholland EK, Ogunlesi OO, Adegbola RA, Weber M, Sam BE, Palmer A, et al. Etiology of serious infections in young Gambian infants. Paediatr Infect Dis J.1999; 18(10 Suppl):S35-41.
13. Bhutta ZA, Yusuf K. Early-onset neonatal sepsis in Pakistan: a case control of risk factors in a birth cohort. Am J Perinatol. 1997; 14(9):577–581.
14. Malik AS, Pennie RA. Early onset neonatal septicaemia in a level II nursery. Med J Malaysia. 1994; 49(1):17–23.
15. Muhe L, Tilahun M, Lulseged S, Kebede S, Enaro D, Ringertz S, et al. Etiology of pneumonia, sepsis and meningitis in infants younger than three months of age in Ethiopia. Paediatr Infect Dis J. 1999; 18(10 Suppl):S56-61.
16. Mathur NB, Agarwal HS, Maria A. Acute renal failure in neonatal sepsis. Indian J Pediatr. 2006; 73(6):499-502.
17. Black S, Kushner I, Samols D. C-reactive protein. Minireview. J BiolChem 2004; 279(47):48487-48490
18. Camacho-Gonzalez A, Spearman PW, Stoll BJ. Neonatal infectious diseases: evaluation of neonatal sepsis. Pediatr Clin North Am. 2013; 60(2):367–389.
19. Eisenfeld L, Ermocilla R, Wirtschafter D, Cassady G. Systemic bacterial infections in neonatal deaths. Am J Dis Child. 1983; 137(7):645-9.
20. Chu SM, Hsu JF, Lee CW, Lien R, Huang HR, Chiang MC, et al. Neurological Complications after Neonatal Bacteremia: The Clinical Characteristics, Risk Factors, and Outcomes. PLoS One. 2014 Nov 3; 9(11):e105294.
21. Eichenwald EC. Perinatally transmitted neonatal bacterial infections. Infect. Dis. Clin. North Am. 1997; 11(1):223-239.
22. Silver HM, Siler-Khodr T, Prihoda TJ, Gibbs RS. The effects of pH and osmolality on bacterial growth in amniotic fluid in a laboratory model. Am. J. Perinatol. 1992; 9(2):69-74.
23. Bergman N, Bercovici B, Sacks T. Antibacterial activity of human amniotic fluid. Am. J. Obstet. Gynecol. 1972; 114:520-523.
24. Carroll SG, Papaioannou S, Nicolaides KH. Assessment of fetal activity and amniotic fluid volume in the prediction of intrauterine infection in preterm prelabor amniorrhexis. Am. J. Obstet. Gynecol. 1995; 172(5):1427-1435.
25. Pyati SP, Pildes RS, Jacobs NM, Ramamurthy RS, Yeh TF, Raval DS, et al. Penicillin in infants weighing two kilograms or less with early-onset Group B streptococcal disease. N. Engl. J. Med. 1983; 308:1383-1389.
26. Klein JO, Marcy SM. Bacterial sepsis and meningitits. In Infectious Diseases of the Fetus and Newborn Infant. Editors: Remington JS, Klein JO. Philadelphia: WB Saunders Company, 1995, pp. 835-890.
27. http://www.newbornwhocc.org/pdf/sepsis_innewborn.pdf (Accessed on 31 august 2017).
28. Dhale S, Valinjkar S, Anjutagi S, Narkhede V. The Study of in Vitro Sensitivity and Resistance Pattern of Antibiotics in Neonatal Septicemia in Tertiary Care Hospital. JMSCR. 2016; 04(08):11720-11729
29. Shah AJ, Mulla SA, Revdiwala SB. Neonatal sepsis: high antibiotic resistance of the bacterial pathogens in a neonatal intensive care unit of a tertiary care hospital. J Clin Neonatol. 2012; 1(2):72–5.
30. Ballot DE, Nana T, Sriruttan C, Cooper PA. Bacterial bloodstream infections in neonates in a developing country. ISRN Pediatr. 2012; 508-512.
31. Shah BA, Padbury JF. Neonatal sepsis An old problem with new insights. Virulence. 2014; 5(1): 170–178.
32. Zaidi AK, Huskins WC, Thaver D, Bhutta ZA, Abbas Z, Goldmann DA. Hospital-acquired Neonatal infections in developing countries. The Lancet. 2005; 365(9465):1175–88.
33. Viswanathan R, Singh AK, Ghosh C, Dasgupta S, Mukherjee S, Basu S. Profile of neonatal septicaemia at a district-level sick newborn care unit. J Healt Popul Nutr. 2012; 30(1):41-48.
34. Manucha V, Rusia U, Sikka M, Faridi MM, Madan N. Utility of haematological parameters and C-reactive protein in the detection of neonatal sepsis. J Paediatr Child Health. 2002; 38(5):459-64.
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01-01-2018
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“A RETROSPECTIVE STUDY ON IMPORTANCE OF CRP AS A PREDICTOR AND TO ANALYSE THE EFFECTIVENESS OF ANTIBIOTICS IN THE TREATMENT OF NEONATAL SEPSIS AT SECONDARY CARE HOSPITAL OF TIRUPPUR”. International Journal of Pharmaceutical Sciences and Drug Research, vol. 10, no. 1, Jan. 2018, pp. 07-11, https://doi.org/10.25004/IJPSDR.2018.100102.
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How to Cite
“A RETROSPECTIVE STUDY ON IMPORTANCE OF CRP AS A PREDICTOR AND TO ANALYSE THE EFFECTIVENESS OF ANTIBIOTICS IN THE TREATMENT OF NEONATAL SEPSIS AT SECONDARY CARE HOSPITAL OF TIRUPPUR”. International Journal of Pharmaceutical Sciences and Drug Research, vol. 10, no. 1, Jan. 2018, pp. 07-11, https://doi.org/10.25004/IJPSDR.2018.100102.
