Coagulase negative staphylococcus (CONS) infection in neonatal lCU

Mundkur, Suneel C and Ramesh, B and Lewis, Leslie (2011) Coagulase negative staphylococcus (CONS) infection in neonatal lCU. WebmedCentral, 2 (12). pp. 2-12. ISSN 2046-1690

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Objective: To study the mortality in CONS infection in neonates in relation to clinical and hematological profile. Design-Retrospective study. Methods: A total of 131 newborns admitted to the NICU of Kasturba Hospital, Manipal between March 2000 and February 2005 whose blood culture had grown CONS were included in the study group. They were classified into two groups-1) Neonates who recovered 2) Neonates who died of infection or discharged at request in a moribund state. The clinical features, sepsis screen parameters, birth weight, mode and place of delivery and interventions in relation to the outcome were analyzed statistically. Antibiotic sensitivity pattern was studied. Results: Out of 131 babies studied, mortality was observed in 13 cases (9.9%). The mortality in VLBW and LBW babies was 30.8% (n=4) and 7.9% (n=3) respectively. Higher mortality of 12.7% (n=10) was observed in babies delivered vaginally as compared to 5.8% (n=3) in those born by Caesarian section. Mortality in preterm babies was 16.7% (n=5) as against 7.9% (n=8) in term babies. Mortality rate was 25% (n=7) in babies with 3 or more positive sepsis parameters as compared to 5.8% (n=6) in babies with less than 3 positive parameters. A mortality of 17.4% (n=12) was seen in babies with clinical features of l sepsis compared to 1.6% (n=1) in those without any clinical features. Morality rates were 12% (n=5) and 8.6% (n=8) in outborns and inborns respectively. Mortality rate of 33.3%(n=12) was observed in babies wherein interventions like lCD, umbilical catheterisation, arterial cannulation, mechanical ventilation were done compared to 1.1 %(n=1) in babies where no interventions were done. In the present study the Antibiotic sensitivity pattern was Amikacin 79%(n=113), Gentamicin 73.4%(n=105) Cefotaxime 62%(n=89), Ampicillin 60.1 %(n=86), Cefuroxime 49%(n=71). Conclusions: In CONS infection mortality was higher in LBW and VLBW babies, vaginal deliveries and outborns. Prognosis worsens if 3 or more sepsis screen parameters or clinical manifestation of sepsis are present. Mortality rate was higher in babies who have undergone interventions. Amikacin was the most sensitive antibiotic both invitro and in vivo.

Item Type: Article
Subjects: Medicine > KMC Manipal > Paediatrics
Depositing User: KMC Manipal
Date Deposited: 06 Jul 2015 04:29
Last Modified: 17 Mar 2017 04:33

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