Neonatal Sepsis-Culture Positive Sepsis vs Clinical Sepsis

Abstract

Background: The incidence of sepsis is increasing globally, with high morbidity and mortality. Diagnosis of neonatal sepsis is still a clinical and laboratory challenge. Though blood culture is gold standard, it sometimes gives false negative result. So, judgement of clinical condition along with various investigations is important. Objectives: To find out the risk factors associated with neonatal sepsis, to isolate & identify the pathogens from various clinical specimens and to find out antimicrobial susceptibility of the pathogens. Material and methods: Blood culture, sepsis screen, haematological & biochemical markers, cerebrospinal fluid (CSF) study, radiology, MRSA (methicillin resistance Staphylococcus aureus) surveillance were carried out in this study. Some samples were processed in BacT/ALERT-3D system (BioMerieux) and identified by VITEK-2 (BioMerieux). Epi Info Software system was used to calculate statistics. Results: One seventy (65.9%) were culture positive and 88 (34.1%) were culture negative out of 258 clinically suspected cases. Methicillin sensitive Staphylococcus aureus (MSSA) 66 (38.82%) was the commonest organism. Among 88 culture negative cases, 38(43.2%) babies were two or more sepsis screen tests positive, 40(45.5%) culture negative babies were with risk factors and 5(5.7%) had radiological evidence of pneumonia. Conclusion: The clinical diagnosis of it remains difficult as the symptoms are non-specific. So, blood culture is mandatory. Other diagnostic tests also help in this situation. Blood culture is still the "Gold standard" for the diagnosis of septicaemia in neonates, but culture negativity cannot exclude the sepsis as a whole.