Online ISSN: 2515-8260

Keywords : Blood culture

To compare clinical profile and outcome of pediatric patients with sepsis admitted in pediatric and neonatal intensive care unit in a tertiary care hospital of central India

Jyotsna Mishra, Shashikant Patidar, Chayan Chakma, Naresh Bajaj

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 517-524

Background: Sepsis and septic shock cases in the Neonatal intensive care unit (NICU)
and Pediatric intensive care unit (PICU) remain one of the most significant causes of
morbidity and mortality in pediatric patients. Therefore, studying and comparing the
clinical features and outcomes of pediatric patients with sepsis in ICUs are important,
especially in developing countries.
Methods: From 1st July 2021 to 31st December 2021, we have collected data from both of
our pediatric ICU and neonatal ICU of Shyam Shah Medical College using a preformed
proforma. Complete blood count, C - reactive protein and culture sensitivity reports
were used to diagnose or screen sepsis. We compared clinical features, laboratory data,
microbiologic results, and final outcome for patients with sepsis in both NICU and
Results: A total 1509 and 236 cases with sepsis from both NICU and PICU respectively
are included in the study (mean duration of stay in NICU 8.9 days±4.3; in PICU 12.5
days±5.3). Among these cases, culture positive cases with sepsis were 66% and 28% in
NICU and PICU respectively. Common pathogens isolated from blood cultures were E.
coli and pseudomonas in NICU and E.coli and S. aureus in PICU. Mortality, discharges,
refers and Left against medical advice cases were compared as outcomes in our study.
Comparing with NICU (n=24, 10.1%), mortality due to sepsis in PICU (n=111, 7.3%)
was less.
Conclusion: Sepsis in children both in NICU and PICU is associated with high mortality
despite aggressive treatment strategies, but more in NICU. Early recognition and
prompt treatment is the key to improve outcome of sepsis.

Prognostic significance ofProcalcitonin, High sensitivity C-reactive proteinandwhite blood cell count incomparison withblood culture in ICU patients with Sepsis and Septic shock inatertiary care Hospital

Dr.Kondle Raghu; Dr. Krishnan Ramalingam

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 2263-2270

Background: Sepsis is a life-threatening condition in ICU with high morbidity and
mortality. Biomarkers which can act as a predictor for diagnosis, prognosis, and patient
outcome in sepsis are needed.
Aim:Aim of the study is to compare the significance of hs-C-reactive Protein (CRP),
Procalcitonin, White blood cell count, and blood culture in patients with bloodstream
infections and compare their prognostic significance with blood cultures in sepsis.
Materials and Methods: This hospital based prospective observational study was conducted
between July 2018 to July 2019 forone year with 216 cases of sepsis. Serial determination
of Procalcitonin and CRP at admission and Day 6 was done. Data was analyzed check to
compare the prognostic significance of the PCT, CRP, and WBC count.
Results:A blood culture positivity rate of 50.9% was reported with male preponderance.
WBC count has significantly reduced after 72hrs of admission (p= 0.007). CRP levels have
significantly reduced on day 6 (p = 0.043) in comparison to at the time of admission (p=
0.032). The serial determination of PCT levels at admission and on day 6 (p= 0.032) was
found to be a better prognostic indicator in patients with sepsis than at the time of
admission. The significant patient outcome in terms of mortality and reduction in length of
hospital stay has been found (p= 0.018, p=0.002). The positive correlation of PCT and CRP
and SOFA score has been reported.
Conclusion: Prognostic significance was found for the biomarkers PCT, CRP, and WBC
count with significant patient outcomes in terms of mortality and hospital stay reduction

Aetiological profile, risk factors, antibiotic sensitivity pattern and outcome of neonatal sepsis in tertiary care hospitals- a prospective observational study


European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 2, Pages 1073-1087

Introduction:Neonatal sepsis is an important cause of morbidity and mortality in developing countries.According to the World Health Organization(WHO),around5 million newbornsdie yearly, 98% of deaths occurring in developing countries
Objectives: To identify prevalence of neonatal sepsis,aetiological profile,antibiotic sensitivity pattern and outcome in a tertiary care centre and to formulate a consensus recommendation for empirical antibiotic usage for neonatal sepsis in our hospital.
Method:A hospital based prospective observational study was done from March 2019 to August 2020 on babies diagnosed or suspected as cases of neonatal sepsis in our hospital.
Results:Atotal of 200 neonates were included in our study with clinical suspicion of sepsis during the study period. 127 (63.5%) neonates were identified as EOS (0-3 days) and 73 (36.5%) aslate onset sepsis (4-28 days).Prematurity was thecommonest predisposing factor(68.5%).Feeding intolerance was the commonest presentation (74%).Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of C-reactive protein (CRP) + absolute neutrophil count (ANC) were 93.8% ,90.8%, 34.9%, 99.6% and 90.9% respectively.(p <0.001).Klebsiella pneumonia + Klebsiellaoxytoca(16+1) was the most common isolate (35.4%),There were 6 (12.5%) isolates of Staphylococcus aureus out of which 2 were methicilin resistant aureus(MRSA).
Conclusions:Of the 200 neonates with suspected neonal sepsis,63.5% had EOS. Prematurity was the commonest predisposing factor(68.5%) and feeding intolerance was the commonest presentation (74%).Klebsiella (35.4%) was the most common isolate.