A Clinicomicrobial Association in Neonatal Septicemia
Neeraj Kumar Jain, Deepak Seth, Vibha Mangal
Department of Pediatrics, Himalayan Institute Hospital Trust, Rishikesh, India
Abstract


This prospective study was done in 167 neonates to analyze the clinical profile, etiological agents and radiological features for septicemia in neonates admitted at our center from June 2008 to January 2010. Common clinical manifestations were refusal to feeds in 102 (61%), respiratory distress in 89 (53%), lethargy in 66 (40%), convulsions in 49 (29%), abdominal distension in 38 (23%), hypothermia in 33 (20%), jaundice in 24 (14%) and hyperthermia in 8 (5%). Many patients in the study had more than 2 clinical features at the time of presentation. Blood culture was positive in 52 (27%) of babies of which 37 (34%) of preterm babies, and 15 (19%) of term babies which was statistically significant (p=0.004). Organisms grown on blood culture are E.coli in 12 (23%), Klebsiella pneumonia in 19 (37%), Acinetobacter species in 2 (4%), Staphylococcus aureus in 3 (6%), Citrobacter freundii in 1 (2%), Pseudomonas in 8 (15%), coagulase negative staphylococcus in 5 (10%) and yeast in 2 (4%). Common organisms causing pneumonia are Klebsiella and Staphylococcus aureus. Organisms associated with neonatal enterocolitis (NEC) are E.coli and Klebsiella. Septic arthritis is associated with bacteremia and organism associated is staphylococcus aureus.

Conclusion: Commonest infection associated with neonatal sepsis is pneumonia and neonatal sepsis is more common in preterms. Organisms involved seem to vary with organs affected.
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