Profile of sepsis in extramural neonates admitted to a tertiary level nicu in a rural hospital

Abstract

Objectives: 1)To study the causative organisms and profile of sepsis in outborn newborns admitted to NICU in a rural hospital.2)To study the usefulness of S.CRP as a tool in rural and resource limited settings for diagnosis of Early and Late onset sepsis as well as in suspected & proven sepsis cases. Setting: The prospective study was undertaken in the tertiary level NICU of MVJ Medical College & Research hospital located in rural Bangalore, India. Extramural neonates admitted with clinical features suggestive of sepsis were included. Results: A total of 90 neonates were included in the study. Neonates were divided into early onset sepsis (EOS, n=49) and late onset sepsis (LOS, n=41) groups. Depending on the blood culture positivity the neonates were categorized into proven (culture positive, n=36) and suspected (culture negative, n=54) sepsis groups. The blood culture positivity was 40% and EOS was seen in 54.44% and LOS in 45.56%. The blood culture positivity in LOS group was 48.78%, much higher than in EOS group. Gram negative organisms formed majority of the isolates. Klebsiella was the predominant isolate in both EOS (25%) and in LOS (40%) groups followed by CONS and E coli respectively in EOS and LOS. Serum CRP had a specificity of 75.92%, with a positive predictive value of 50% and a negative predictive value of 64.06% in the proven and suspected sepsis groups. The specificity of Serum CRP in EOS was 81.82%, higher than in LOS group of 66.67%.