INCIDENCE AND MICROBIOLOGICAL PROFILE OF LATE ONSET NEONATAL SEPSIS IN PRETERM AND LOW BIRTH WEIGHT NEONATES, NICU, RIMS, RAICHUR

Abstract

Nagaraj S. Javali1 , Nasima Banu2 , Supriya M. Indi3

According to recent data from National Neonatal Perinatal Database (NNPD) 2000, the incidence of neonatal sepsis has been reported to be 38 per 1000 intramural live births in tertiary care institutions.[1] Septicaemia was the commonest clinical category with an incidence of 24 per 1000 live births.Neonatal sepsis was one of the common causes of neonatal mortality contributing to 23% of all neonatal deaths.[1] Neonatal sepsis is defined as clinical syndrome of bacteraemia with systemic signs and symptoms of infection in the first four weeks of life.[2] Neonatal sepsis can be classified as: ?? Early Onset Neonatal Sepsis (EONS) – onset of symptoms is before 72 hours of life. ?? Late Onset Neonatal Sepsis (LONS) – onset of symptoms is after 72 hours of life. EONS most often appears within 24 hours of life where the neonate gets infected by organisms present in maternal genital tract. LONS is caused by organisms thriving in the external environment of home or hospital. The most frequent microorganisms involved in LONS are Staphylococci, Streptococci, Escherichia coli, Klebsiella, Pseudomonas species. The common risk factors associated with the two syndromes are low birth weight (LBW) i.e. <2500gm and gestational age < 37 weeks. Several studies have reported that infants with LBW or Intra Uterine Growth Retardation or who were Small for Gestational Age, have a lower percentage of T or B lymphocytes and lower vaccine-specific IgG responses than do new born infants with Normal Birth Weight.[3] Neonates, particularly those born prematurely, are exquisitely vulnerable to lifethreatening infections. It is increasingly recognized that innate immune responses are key to the protection against infection early in life, and emerging data suggest that such responses are deficient in the new born and especially in preterm infants.[4] The present study was undertaken in Raichur Institute of Medical Sciences, Raichur to find out the incidence and microbiological profile of LONS in preterm and LBW neonates.

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