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Introduction@#One in every three preventable under-five deaths occur in the neonatal period and one of the leading causes of neonatal death in Low and Middle-Income Countries (LMIC) is sepsis. Organisms isolated varies between and within geographical locations, its trend changes with time. Each setting hence needs to have its antibiogram for susceptible isolates to optimize treatment outcome, the background on which this study was conducted. @*Methodology@#A retrospective study was done on neonates admitted to the Neonatal Intensive Care Unit of Bowen University Teaching Hospital, a missionary hospital in South West Nigeria, between January 2016 and December 2017. The medical records of these neonates were retrieved from the comprehensive electronic database for all neonates admitted into the unit. @*Result@#Of the 129 newborns eligible for the study, early-onset sepsis (56.6%) predominated. There were 79 (61%) males giving a M:F ratio of 1.6:1. The incidence rate of neonatal sepsis was 15 per 1,000 live births with a mortality rate of 24%. Gram-Negative Bacilli were mostly isolated in positive cultures. The likelihood of getting a positive culture was unrelated to the age and sex of patients at presentation. There was a varying resistance pattern of the isolates to commonly used empiric antibiotics. @*Conclusion and Recommendation@#Gram-Negative Bacilli was the commonest cause of neonatal sepsis in our center, associated with poor outcome. The high incidence of resistance to the commonly used empirical treatment calls for an urgent review of practice if the trend of high morbidity and mortality would be curtailed, as well as improved infection control practices.
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Sepsis Neonatal , Pruebas de Sensibilidad MicrobianaRESUMEN
Background: The high incidence and antimicrobial resistance among the pathogens causing neonatal sepsis is alarming. In addition to substantial immediate mortality, survivors of infections in the neonatal period are at increased risk of long-term disability. The present study was conducted to know the bacteriological profile and risk factors associated with culture proven neonatal sepsis in a peri urban population.Methods: This study was conducted over a period of 4 year (2015-2019). On clinical suspicion, blood culture specimens were sent to microbiology laboratory. The organisms isolated from blood cultures were identified and tested for antimicrobial susceptibility. As part of infection control practices, environmental samples from the neonatal intensive care units were tested.Results: Of 907 blood cultures of neonates received in the microbiology laboratory, 20.7% were culture positive. Majority of the episodes occurred at or before 72 hours of life (81.4%). 54.3% were Gram positive cocci including Coagulase negative Staphylococci, Staphylococcus aureus and Enterococcus spp. The common Gram-negative pathogens included Escherichia coli, Klebsiella spp. and Pseudomonas spp. Common risk factors involved were preterm birth, low birth weight, premature rupture of membrane, prolonged labour and iatrogenic causes.Conclusions: The early signs of sepsis are often subtle and nonspecific. Therefore, a high index of suspicion is needed for early diagnosis. Rapid, reliable detection and appropriate case management can save lives of many new-borns.
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Central Venous Catheters (CVCs) are indispensable in current intensive care treatment; also pose a greater riskof device related infections in comparison to any other type of medical device and are major cause of morbidity,mortality and increased expense. A cross sectional prospective study of one year duration was conducted inthe tertiary care University Hospital ICU located in the rural region of Haryana, India, to determine the incidenceof the central venous catheter related bloodstream infection (CRBSI), rate of catheter colonization and toidentify the associated risk factors and the microbial spectrum of CRBSI along with the antimicrobial sensitivitypattern of microbial isolates. Sixty patients with central venous catheter inserted and admitted under ICUhaving signs and symptoms of septicaemia post 48 hours of central venous catheter insertion were included.The rate of CRBSI was assessed by paired quantitative blood culture method in the CVC and peripheral vein.The CRBSI incidence was 16.67% and catheter colonization was found to be 53.3%. Methicillin-resistantstaphylococcus aureus and Acinetobacter baumanni were the predominant isolates. A statistically significantassociation of duration of catheterization with CRBSI was found. It is concluded that CRBSI incidence ishigh, with significant association of prolonged duration of catheterization with CRBSI. By knowing the changingtrends of microbial flora, empirical therapy can be formulated for early and effective management of CRBSI.
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Background: Burkholderia cepacia is highly virulent and multidrug resistant organism to cause fatal and serious infections in ICUs leads to rise in mortality and morbidity. aim of present study was to know the prevalence of Burkholderia cepacia in blood stream infection in Intensive Care Unit and to know the drug susceptibility.Methods: This is a prospective study was carried out in the Intensive Care Unit and Department of Microbiology, Narayana Medical College, Nellore, from February to March 2018. As a part of routine investigations Blood, urine, sputum or tracheal secretions sent for culture and sensitivity to the Microbiology laboratory. By conventional method, all the samples were cultured (except blood) onto Blood agar, Chocolate agar and MacConkey, s agar; incubated for 18-24 hours at 37?C. Blood cultures were performed in BACT/ Alert 3D (Biomeriux), only positives were subculture by conventional method. Further analysis was done in culture positive samples only.Results: A total of 448 patients admitted in ICU were included in the study, from them 586 samples were collected. out of which we got 238 culture positives. Among them 19 patients were positive for Burkholderia cepacia, most of them isolated from blood (78.9%), followed by respiratory secretions (21.1%) and none of them were isolated from urine samples. Most of the isolates were sensitive to Meropenam and Tigecycline (89.4%) followed by minocycline (84.2%), ceftazidime (73.6%), levofloxacin (63.1%). While B. cepacia isolates showed high resistance to cefaperazone-sulbactam, ciprofloxacin, ticarcillin-clavulanic acid with (84.2%), (89.4%), (89.4%) respectively.Conclusions: To conclude that, Burkholderia cepacia is one of the emerging causes of septicemia with multidrug resistance, cross contamination may be the root cause so it should be treated quickly and effectively.
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In a developing country like India, one of the most important health hazards is neonatal sepsis. The ever full SNCUs of the hospitals are living proof of this. The neonates both early and late are extremely vulnerable to all organisms, both in the community and much more so in the hospital. Neonatal sepsis contributes to infant mortality rate in a very significant way. Nosocomial neonatal sepsis is much more dangerous and contributes to morbidity and mortality in a very big way.METHODSIn this study, neonatal sepsis was assessed by culture of blood, pus from infected umbilical stump, and CSF sample received from SNCU. The isolated organisms were identified phenotypically following our laboratory protocol. Antibiotic sensitivity testing was done by Kirby-Bauer method, following CLSI guidelines.RESULTSIt was found that 48% of the total samples received from SNCU were growth positive. Klebsiella pneumoniae was isolated in maximum number of cases, 42.85% followed by Staphylococcus aureus 18.53%. Antibiotic sensitivity test by Kirby- Bauer method showed that all Gram-positive cocci were sensitive to vancomycin. There was only one linezolid resistant Staphylococcus aureus. Among the Gram-negative bacilli 100% isolates were sensitive to carbapenems. Acinetobacter baumannii and Pseudomonas aeruginosa isolates were multidrug resistant.CONCLUSIONSSNCU admitted babies are extremely vulnerable to septicaemia. The ever-changing drug resistant patterns of the infecting organisms is a perineal problem. Thus, infection control measures are to be strictly enforced in this setting.
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Background: Early diagnosis of neonatal sepsis continues to be a problem because of subtle and non-specific clinical features. Blood culture is the gold standard, but it takes several days and is expensive. The hematological scoring system (HSS) consisting of different blood parameters could be an effective and simple method to help diagnose and treat neonatal sepsis. Aim of the present study was undertaken to highlight the importance of HSS in the early diagnosis and evaluation of neonatal septicaemia.Methods: This was a prospective study done in a peripheral hospital in Kerala. The inclusion criteria involved all inborn babies above 34weeks gestation. Exclusion criteria involved babies with congenital anomalies, congenital heart diseases, pathological jaundice, birth weight less than 2kg and babies requiring NICU admission, 550 babies were included in the study. Cord CRP and 48 hours CRP was taken. At 48 hours, blood samples were also taken for Total count (TC), Absolute Neutrophil Count (ANC), Platelet count, and peripheral smear. Blood culture was taken for babies suspected to have sepsis and started on antibiotics. The screening parameters were assessed for individual performance and in combination.Results: Individually, though parameters like TC, ANC, 48 hrs CRP and platelet count had excellent sensitivity (100%) and NPV (100%), their specificity was low 65%-82%. Degenerative changes showed sensitivity 94.1%, specificity 91% and NPV 99.8%. HSS score >5 and >6 had better specificity and NPV.Conclusions: HSS scoring can be used to safely exclude neonatal sepsis, thus avoiding unnecessary antibiotic exposure in newborns and undue worry for parents.
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Background: Nearly 10% of neonatal deaths are due to congenital malformations requiring surgical intervention. Hence our aim is to study spectrum and outcome of the different neonatal congenital anomalies requiring surgical intervention.Methods: This prospective study was conducted over a period of 2 years. 130 cases which required surgical intervention in neonatal period were included in the study. Plain x-ray abdomen was done in all the cases of our study. Ultrasound scan was done in all the cases to rule out renal and other anomalies. Contrast radiography was also performed in selected cases. All cases underwent their respective operations depending upon the diagnoses. Complication and mortalities during hospital stay were noted.Results: During the study period total 130 neonates underwent surgical intervention. Out of 130 cases 5(3.84%) neonates had trachea-esophageal fistula, 2(1.53%) had pure esophageal atresia, 5(3.84%) had duodenal atresia, 9(6.92%) had jejunal atresia, 14(10.76%) had ileal atresia, 3 had meconium ileus(2.30%), 9(6.92%) had malrotation, 15(11.5%) had HD and 5(3.84%) had Meckel's diverticulum, 10(7.69%) had Hypertrophic Pyloric Stenosis, 2(1.53%) had gastroschisis, 3(2.30%) had omphalocele, 16(12.30%) had anorectal malformation, 4(3.07%) had Patent Vitello Intestinal Duct, 3(2.30%) had persistent patent urachus, 4(3.07%) had congenital diaphragmatic hernia, 1(0.76%) had Congenital Lobar Emphysema, 4(3.07%) had Neural Tube Defects, 8(6.15%) had Inguinal Hernia, 6(4.61%) had Posterior Urethral Valve and 2(1.53%) had Pelvi-ureteric Junction Obstruction. There were 85 males and 45 females (M: F-2:1). Septicaemia (40%) was most common complication, 21 (16.15%) cases had mortality.Conclusions: There is lack of awareness regarding dog bite and its management among the rural population.
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Background: Respiratory distress is a medical emergency responsible for most of the admissions in NICUs during neonatal period. It is a major contributor to neonatal morbidity and mortality and results from a variety of respiratory and non-respiratory etiology. It occurs in 0.96 to 12% of live births and responsible for about 20% of neonatal mortality. Aim of study to find out the proportion of patients with different etiology of respiratory distress in neonates.Methods: The present study is a prospective, descriptive study which was carried out at neonatal units attached to SMS Medical College, Jaipur. All the neonates with respiratory distress admitted in NICU admitted from April 2012 to March 2013were selected for the present study. Detailed history including antenatal history, natal history, postnatal history with thorough clinical examinations and investigations done in each case and were recorded in the performa.Results: A total of 500 neonates were admitted and among them 375 were inborn (delivered in our hospitals) and 125 out-born (referred to our hospitals from outside). In inborn group hyaline membrane disease (HMD) was the most common cause (32%) of respiratory distress and in out-born congenital pneumonia/septicaemia (34.4%). There was male preponderance in both inborn and out-born groups with male: female ratio 1.45:1 and 1.6:1 respectively.Conclusions: Majority of cases in both inborn and out-born groups were preterm (56.8% and 54.4% respectively) which emphasises the need for care of mother during antenatal period for prevention of premature delivery.
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Background: Scrub typhus is the most common rickettsial infection in the Indian subcontinent with the manifestation ranging from mild symptoms to serious disease with or complication or death. The objective of this study was to study epidemiology and clinical profile of scrub typhus outbreak in a tertiary care centre of central India.Methods: Present study is a record based retrospective study enrolling 173 confirmed positive cases with ELISA test during the period from 1st August to 31st December 2018.Results: Maximum number of the cases 94 (54.3%) had occurred in September 2019. Majority of the female 94(54.3%) were Ig M positive for scrub typhus. Maximum cases 134 (77.5%) were from rural area. Most common symptoms were fever 170 (98.3%), followed by fever with chills 65 (37.6%), breathlessness 49 (28.3%), cough 35 (20.2%), and 28 (16.2%) each with altered sensorium and headache. Mortality was recorded in 30 (173%) and amongst them 10 (34.5%) and 4 (13.8%) cases had ARDS and septicaemia as complication respectively.Conclusions: This study shows that majority of the cases occurred in the month of September 2018 with female preponderance. Most of the residence were from rural areas with common presenting symptoms as fever or fever with chills followed by breathlessness, cough and altered sensorium and headache.
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Introduction: Neonatologists face a perpetual challenge in managing neonatal septicaemia due to changing patterns of the microbial flora and their antibiotic sensitivity. The present study was designed to evaluate the clinical spectrum, bacteriological profile, antibiotic sensitivity patterns in neonates with suspected septicaemia in a tertiary care teaching hospital. Material and Methods: This prospective observational study was carried out in neonatal intensive care unit for a period of nine months. All the neonates with suspected septicaemia, were evaluated by sepsis screen (C- reactive protein). C-reactive protein positive neonates were subjected to blood culture for isolation of microorganisms. Antibiotic sensitivity testing was done with disc diffusion method. The data was analyzed using descriptive statistics. Results: Among 519 neonates, blood culture was positive in 183 (35.2%). Most of the neonates presented with early onset sepsis(65%), were preterm(59%) and of low birth weight (58.5%). Major clinical presentation was respiratory distress (31.2%). Gram negative bacteria were frequently isolated (68.3%). Most common isolates were Klebsiella pneumonia (34.70%) and staphylococcus aureus (21.8%) respectively. Gram negative organisms were sensitive to imipenem, followed by piperacillin tazobactam and amikacin. Gram positive organisms showed good sensitivity to vancomycin, teicoplanin and imipenem. High resistance was observed to ampicillin and ceftriaxone in both gram positive and gram negative organisms. Conclusions: Preterm and low birth weight neonates were more susceptible to neonatal sepsis. Gram negative organisms were frequently isolated. The present study would suggest rational use of empirical antibiotic therapy and to review the antibiotic policy periodically basing on the microbial flora detected in their region time to time.
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El lupus eritematoso sistémico (LES) es una enfermedad multisistémica con manifestaciones proteicas. La pancreatitis lúpica es la segunda enfermedad más frecuentemente asociada con el abdomen agudo en relación con el LES. Si bien la pancreatitis aguda es rara, es clínicamente importante porque puede ser potencialmente mortal si no se trata de inmediato. En este artículo, describimos el caso de una niña de 10 años que desarrolló pancreatitis asociada a LES después del tratamiento con corticoesteroides que se complicó posteriormente debido a septicemia fúngica. Los signos y síntomas clínicos mejoraron marcadamente después de la administración de glucocorticoides y ciclofosfamida.
Systemic lupus erythematosus (SLE) is a multisystem disease with protean manifestations. Lupus pancreatitis is the second most common disease associated with SLE-related acute abdomen. Although acute pancreatitis is rare it is clinically important because this condition can be life threatening if not treated promptly. Here, we report a case of a 10-year-old girl who developed SLE-associated pancreatitis after steroids therapy that was subsequently complicated by fungal septicaemia. Her clinical symptoms and signs markedly improved after administration of glucocorticoids and cyclophosphamide.
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Humanos , Femenino , Niño , Pancreatitis , Niño , Sepsis , Lupus Eritematoso Sistémico , MicosisRESUMEN
Background: Bloodstream infections are important causes of mortality and morbidity. Rapid empiric antibiotic therapy is often needed. Knowledge of epidemiological data of common pathogens and their antibiotic sensitivity pattern is needed for rapid therapy. Methods: This study was done to analyze the common causes of septicaemia and their antibiotic sensitivity pattern from the Department of General Medicine, Kanachur Institute of Medical Sciences, Natekal, Mangaluru. Isolates were identified using bacteriological and biochemical methods and antibiotic sensitivity was done using the Kirby-Bauer disc diffusion method. Results: This study showed that of the 75 patients examined 22 had septicaemia. 31-45 years age group patients constituted the greatest percentage of infected subjects (n=28) followed by patients aged between 46-60 years (n=17). Gram-positive bacteria were encountered more often than gram negative bacteria. Among the gram-positive bacteria, majority isolated were S. epidermiidis; followed by S. aureus. Conclusion: Majority of the organism isolated were from Gram positive category, in which S. epidermiidis was the most isolated.
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Traditionally, transrectal ultrasound (TRUS)-guided biopsies are done for the diagnosis of prostatecancer (PCa) in Pakistan. The transperineal template-guided saturation biopsy (TTSB) approach hasbeen recently introduced in Pakistan and we share diagnostic yields and pathological findings ofspecimens taken for PCa diagnosis in men with elevated serum total prostate specific antigen (PSA)and negative TRUS-guided prostate biopsies. In all, 16 patients investigated at the Department ofUrology, Sindh Institute of Urology and Transplantation (SIUT), underwent TTSB. The mean ageof patients was 67.8 ± 8.8 (range: 55 - 84) years. The median PSA was 9.5 (IQR: 7.9 - 19.8) ng/ml. The duration of symptoms before biopsy ranged from 1 month to 144 months. The prostatewas enlarged with mean weight of 73.5 ± 55.5 g. Histopathology revealed PCa in 5 of 16 (31.2%)cases. The Gleason score was 6 (3+3), 7 (3+4) and 8 (4+4) in 1 case each (6.3%) and 10 (5+5) in 2cases (12.5%). At least two cores were positive in all positive cases. None of the patients requiredantibiotics post-procedure. In conclusion, the TTSB technique is a promising option for patients withelevated PSA level and negative transrectal prostate biopsies for the detection of PCa in our settin
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Neonatal meningitis is a lethal infection occurring in the 1st month of life. The risk of developing permanent neurological sequels is high among the neonates who survive. Bacterial pathogens are commonly associated with this condition. Aeromonas is a Gram‑negative bacteria of aquatic habitat. Although isolation of Aeromonas species from neonates with blood stream infection is infrequently reported, neonatal meningitis caused by Aeromonas is exceedingly rare. We present a case of fulminant sepsis and meningitis caused by Aeromonas hydrophila in a preterm newborn male. The bacteria was isolated in culture from blood and cerebrospinal fluid. In spite of targeted antibiotics and supportive therapy, the baby failed to respond and died on the 12th day of life.
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Background & objectives: Despite advances in therapy and overall medical care, acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) management remains a problem. Hence the objective of this study was to develop a rat model that mimics human ALI/ARDS. Methods: Four groups of Wistar rats, 48 per group were treated with (i) intratracheal (IT) lipopolysaccharide (LPS) (5 mg/kg) dissolved in normal saline (NS), (ii) intravenous (iv) oleic acid (OA) (250 μl/kg) suspension in bovine serum albumin (BSA), (iii) dual hit: IT LPS (2 mg/kg) dissolved in NS and iv OA (100 μl/kg) and (iv) control group: IT NS and iv BSA. From each group at set periods of time various investigations like chest X-rays, respiratory rate (RR), tidal volume (TV), total cell count, differential cell count, total protein count and cytokine levels in bronchoalveolar lavage fluid (BALF), lung wet/dry weight ratio and histopathological examination were done. Results: It was noted that the respiratory rate, and tumour necrosis factor-α (TNF-α) levels were significantly higher at 4 h in the dual hit group as compared to LPS, OA and control groups. Interleukin-6 (IL-6) levels were significantly higher in the dual hit group as compared to LPS at 8 and 24 h, OA at 8 h and control (at all time intervals) group. IL-1β levels were significantly higher in LPS and dual hit groups at all time intervals, but not in OA and control groups. The injury induced in dual hit group was earlier and more sustained as compared to LPS and OA alone. Interpretation & conclusions: The lung pathology and changes in respiration functions produced by the dual hit model were closer to the diagnostic criteria of ALI/ARDS in terms of clinical manifestations and pulmonary injury and the injury persisted longer as compared to LPS and OA single hit model. Therefore, the ARDS model produced by the dual hit method was closer to the diagnostic criteria of ARDS in terms of clinical manifestations and pulmonary injury.
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Haemorrhagic Septicaemia is one of the most common, fatal and acute bacterial diseases of livestock which causes mortality above 70% and is caused by Pasteurella multocida. The only satisfactory and practical method of control and prevention is timely vaccination of all the healthy and in contact animals. Different types of vaccines are being used for the immunity against this disease. In this project three oil based vaccines were produced. Two single emulsion vaccines were prepared by utilizing Montanide ISA-50 and liquid paraffin with lanolin where as one double emulsion with the help of Montanide ISA-206 was prepared. In house quality control testing and safety testing was performed on swiss albino mice. For immune titre IHA was performed by collecting serum from each and every animal including control animals. The comparison of IHA was done via statistical analysis by using GMT, Single emulsion vaccine prepared from liquid paraffin with lanolin gave maximum immune titre out of all the three vaccines in large animals and in young calves ISA 206 gave a significant titre.
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Objective To isolate and identify the pathogenic bacteria from peripheral blood of a patient with septicemia of unknown etiology and to analyze their drug resistance genes.Methods Two peripheral blood samples were collected from the patient after having fever.Several assays including culturing bacteria on blood agar plates by using streaking technique,Gram-staining of bacterial colonies and microscopic observation,VITEK 2-compact automatic bacterium detection and analysis system as well as a sequencing analysis of the 16s rRNA gene were performed to identify the bacterial pathogens in blood samples.Microdilution test was performed to detect the drug susceptibilities of isolated bacteria to antibiotics.Confirmatory tests were performed to detect the production of β-lactamase and extended spectrum β-lactamase by the isolated strains and the phenotypes of AmpC enzyme and carbapenemase.PCR was used to identify the β-lactamase-encoding genes in the isolated strains by using the primers of 19 common β-lactamase-,AmpC enzyme-and carbapenemase-encoding genes in Enterobacteriaceae strains and the primers of 21 annotated gene sequences encoding the β-lactamase of a Ralstonia mannitolilytica strain.The PCR products were sequenced and analyzed after T-A cloning.Results Ralstonia mannitolilytica strains were isolated from the two peripheral blood samples.The isolated strains were sensitive to ceftriaxone,cefepime,ciprofloxacin,ofloxacin,tigecycline and compound sulfamethoxazole (SMZ-TMP),but resistant to the other 11 tested antibiotics.Results of PCR amplification by using the primers of common genes encoding β-lactamase of Enterobacteriaceae strains were all negative.Fragments of genes encoding the β-lactamase of the isolated Ralstonia mannitolilytica strain were successfully amplified,which were TK49_09850,TK49_12955,TK49_14470,TK49_14495and TK49_18990.The sequences of the amplified gene fragments were not similar to those of the common β-lactamase-encoding genes in Enterobacteriaceae strains.Conclusion The patient was infected with Ralstonia mannitolilytica.The isolated Ralstonia mannitolilytica strain showed a high-level drug resistance with a noticeable diversity against different β-lactam antibiotics.The genes encoding β-lactamase of the isolated Ralstonia mannitolilytica strain were completely different to those of Enterobacteriaceae strains.
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Background: Neonatal Septicaemia (NNS) remains a major cause of morbidity and mortality in neonates despite advances in antimicrobial therapy, life support measures and the early detection of risk factors. This study aimed at determining the risk factors, aetiologic agents and antibiotic sensitivity pattern of NNS in Wesley Guild Hospital, Ilesa. Methods: This was a prospective study involving 360 neonates admitted into Wesley Guild hospital, Ilesa over a period of seven months. Socio-demographic data and clinical characteristics of the neonates were collected using a standard proforma. Blood culture was done on admission and bacterial isolates were identified using standard procedures. Antibiotic susceptibility testing was done using disc diffusion method. Results: The prevalence of neonatal septicaemia (NNS) was 16.0% in this study. Multivariate regression model of significant risk factors revealed prolonged labour (AOR 2.2(1.036 - 4.912) p=0.041) as the only independent risk factor for NNS. Staphylococcus aureus was the predominant isolate (70%). The case fatality rate from the study was 25%. Ciprofloxacin (86.7%), Cefuroxime (82.7%) and Ceftriaxone (81.3%) were the antibiotics with the highest sensitivity, while the infective organisms were most resistant to Cloxacillin (80%) and Ampicillin (77.3%). Conclusion: Neonatal septicaemia remains a significant cause of neonatal mortality. S. aureus was the predominant bacterial isolate in this study. Cephalosporins should be considered as first-line antibiotics in its management. Prevention of preterm deliveries and encouraging good antenatal care and supervised deliveries will help in reducing the high incidence.
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Background: Blood cultures form a critical part of evaluation of patients with suspected sepsis. The present study was undertaken to study the risk factors, duration of incubation for obtaining positive cultures, and the clinical impact of the culture report. Methods: A total of 224 samples from 110 critically sick pediatric patients presenting with suspected bacteraemia were processed aerobically. Results: Cultures were positive in 25.45% of the Patients. Most of the positive cultures were obtained after 24 hours of incubation of the broth and no isolates were obtained beyond day 4 of incubation. Therapy was modified in 52.73% of the patients after receipt of culture report. Conclusions: Incubation beyond four days (unless with specific indication like enteric fever) may be unnecessary for issuing a negative culture report. Repeated isolation of doubtful pathogens confirms true bacteraemia. Early culture report increases therapeutic compliance.
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The aim of the present study was to determine the spectrum of microorganisms isolated from blood culture and their resistance pattern.This study was carried out between January 2014 and December 2014 in the Department of Microbiology , Era's Lucknow Medical college & Hospital, Lucknow . A total of 2278 blood culture samples of patients with suspected sepsis were included in the study. BHI broth and BACTEC aerobic & anaerobic culture bottles were used for taking cultures.All bottles were subcultured onto Blood and MacConkey's agar. In case of any growth , it was identified and antibiotic susceptibility test was done according to standard procedures.Cultures were positive in 278 samples (12.2%). Spectrum revealed that Coagulase Negative Staphylococci accounted for 34.89%,Staphylococcus aureus17.98% and Klebsiella spp9.35% . Staphylococcus strains showed Methicillin resistance in 10% of isolates. Extended spectrum beta lactamases constituted 26.92% each for Klebsiella and Escherichia coli strains and 40% of Citrobacter strains isolated .Vancomycin resistant Enterococcus strains accounted for 10% of strains isolated .A large proportion of patients presenting with sepsis at a tertiary care hospital, are already treated with antibiotics elsewhere. This leads to a low positive yield in blood culture.The present study highlights the increasing resistance in microorganisms causing sepsis Their early detection and resistance pattern will definitely help in modifying the treatments. Thus early blood culture report increases therapeutic compliance.