Clinical, Hematopathological, and Bacteriological Profiles in Neonatal Septicemia and Meningitis

Gurpreet Singh Chhabra, Manmeet Kaur Sodhi, Manu Sharma

Abstract

Background: The most common causes of morbidity and mortality in neonates admitted to the neonatal intensive care unit (NICU) are suspected sepsis and meningitis. The presentation of sepsis includes symptoms and signs that are nonspecific and seen in other conditions as well. Mortality rates of neonates and infants are the most important indices used to assess the health status of a community.

Objective: To examine the clinical, hematopathological, and bacteriological profile of neonates with septicemia and meningitis in a tertiary care hospital in northern India

Methods: One hundred neonates with clinical sepsis admitted to the NICU were included in the study. Every neonate underwent blood culture, urine culture, and cerebrospinal fluid (CSF) analysis. These parameters were compared among neonates with clinical sepsis, culture-proven sepsis, and CSF analysis–positive meningitis.

Results: The incidence of early-onset sepsis (EOS) and late-onset sepsis (LOS) was 49% and 51%, respectively. Perinatal asphyxia was observed in only 11%. Peripheral blood flow analysis revealed a significant association of toxic granulations and band forms with septicemia. Culture isolates were positive in 53% of study neonates, 48% from blood and 8% from urine. Staphylococcus aureus was most commonly isolated. Analysis of CSF indicated meningitis in 28% of the total neonates. CSF cytology was polymorphonuclear in 19% of cases, whereas the biochemical indices were indicative of meningitis in 21% of cases. CSF cultures were positive for microbial growth in 3%.

Conclusions: The incidence of meningitis and positive cultures was high in neonates with LOS, high in birth order, low gestational age and birth weight, and those born extramurally.

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