Clinico-epidemiological spectrum of early onset neonatal sepsis in neonates admitted in NICU of a tertiary care institute

Background: Neonatal' sepsis' is' a' clinical syndrome' characterized by signs and symptoms' of' infection' with' or' without' accompanying' bacteremia' in' the' first' month' of' life. Neonatal' sepsis' may' be' classified' into' two' groups : early onset' sepsis and' late onset' sepsis . Early onset neonatal sepsis' is' generally' associated' with' the' acquisition' of' microorganisms' from' the' mother' and' usually' presents' with' respiratory' distress' and' pneumonia.Methods: The study included one hundred' term' neonates with early onset neonatal sepsis. A septic screen including total leukocyte count, absolute neutrophil count, blood smear evaluation, blood cultures and C-reactive protein (CRP) were performed in all neonates with suspected sepsis to corroborate early onset sepsis diagnosis. Epidemiological parameters including gender of the neonate, mode of delivery, rural/urban residence were recorded in addition to clinical profile.Results: Respiratory distress was the most common presentation in the form of tachypnea, seen in 63 (63.0%) neonates. In present study, Staphylococcus aureus was the most common organism isolated followed by Staphylococcus epidermidis, Staphylococcus hominis, Acinetobacter baumannii and Klebsiella pneumonae.Conclusions: Early onset neonatal sepsis' was seen more in males. Among the gram-positive Staphylococcus aureus and among gram negative Acinetobacter baumannii and Klebsiella pneumonae were most common organisms to be isolated.

Comparison of the effectiveness of oral sucrose solution and topical anaesthetics during immunization in infants between age 6 weeks-6 months

Background: Routine childhood immunization is a proven tool for eradicating and controlling infectious diseases. Despite its key role in maintaining global public health, many individuals either refuse or delay immunization because of pain from the needle puncture. Several methods have been employed to reduce injection pain during immunization in children.Methods: Study comprised of 210 healthy infants coming for immunizations. They were divided into three groups A, B and C having equal number of infants. Group A was given oral sucrose solution, group B was given topical anaesthetic prior to immunization; whereas group C acted as controls. Response to pain was recorded among the three groups and findings were analyzed.Results: Infants enrolled in group A, i.e. those who were given 24% oral sucrose solution before immunization showed significant reduction in pain (measured by modified behaviour pain scale) as compared to control group at 15 seconds and 60 seconds of injection administration. Infants enrolled in group B, i.e. those who were sprayed topical local anaesthetics (10% lignocaine spray) before immunization showed significant reduction in pain as compared to control group at 15 seconds and 60 seconds of injection administration.Conclusions: Administration of oral sucrose solution and application of topical local anaesthetics are effective measures to reduce injection pain during immunization. Administration of oral sucrose solution before immunization showed greater reduction in pain as compared to application of topical local anaesthetics in present study.

Association of vitamin D deficiency with early onset sepsis in term neonates

Background: Vitamin D is a fat-soluble steroid hormone. Vitamin D also has immunomodulatory effects on immune function. Early onset sepsis (EOS) is characterized by signs and symptoms of infection with or without accompanying bacteremia in the first three days of life. The objective of the study was to determine the possible association between neonatal vitamin D levels and EOS in term neonates.Methods: 100 term neonates with clinical and laboratory findings of EOS (study group) and 100 healthy infants with no signs of clinical/laboratory infection (control group) were enrolled. Sera was drawn during first 3 postnatal days of life in both groups for measurement of 25-hydroxyvitamin D (25-OHD) levels.Results: Neonatal 25-OHD levels (17.4ng/dL) in the study group were significantly lower than those of the control group (26.8 ng/dL) (p=0.001). In present study negative correlation was found between vitamin D level and CRP.Conclusions: Lower neonatal 25-OHD levels are associated with EOS. Adequate vitamin D supplementation during pregnancy may be helpful to prevent EOS in term neonates.