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International Journal of Recent Trends in Science and Technology, ISSN 2277-2812 E-ISSN: 2249-8109
Volume 12, Issue 1, September 2014 pp 141-146
Bacterial profile of neonatal sepsis and the role of biomarkers
Bodkhe Aashish H.1, Sarkate Pankaj V.2, Sarkate Purva P.3, Tardeja Pankaj N.4
1,4Consultant Pediatrician, Harish Hospital, Navi Mumbai, Maharashtra, INDIA.
2,3Assistant Professor, Department of Pediatrics, Seth GSMC and KEM Hospital, Mumbai, Maharashtra, INDIA.
Context: Infections are the single largest cause of neonatal deaths globally. Until now, there is no ideal diagnostic test for detecting sepsis and thus management of possible sepsis cases often depends on clinical algorithm leading to empirical treatment. Aims: To evaluate the utility of various laboratory tests (blood culture, C- reactive protein and pro-calcitonin) for the early diagnosis of neonatal sepsis and to determine the bacterial profile of neonatal sepsis with antimicrobial susceptibility pattern. Settings and Design: Prospective study in a tertiary care teaching hospital over a period of one year. Materials and Methods: Neonates with suspected clinical features of sepsis were included in the study. Maternal and neonatal risk factors were noted. Blood culture was done using BACTEC and antimicrobial susceptibility pattern determined, C- reactive protein levels and serum pro-calcitonin levels were estimated. Results: Prematurity was the most common risk factor (63%). Out of 60 cases, blood culture was positive in 42 (70 %), K. pneumoniae was the most common organism isolated. Sensitivity and specificity of Pro-calcitonin test was 97.6 % and 88.8 % respectively whereas that of C- reactive protein was 59.5% and 55.6%. Conclusion: Prematurity is an important risk factor for neonatal sepsis. K. pneumoniae, S. aureus and P. aeruginosa in decreasing order are the predominant pathogens and initial therapy should cover these organisms. Pro- calcitonin has a good sensitivity and specificity for diagnosis of neonatal sepsis and can be used as an early marker of neonatal sepsis.