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Clinical features of neonatal sepsis caused by resistant Gram‐negative bacteria
Author(s) -
Khassawneh Mohammad,
Khader Yousef,
Abuqtaish Nadeen
Publication year - 2009
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/j.1442-200x.2008.02767.x
Subject(s) - medicine , sepsis , neonatal sepsis , bacteremia , klebsiella pneumoniae , respiratory distress , ampicillin , meningitis , gastroenterology , pediatrics , antibiotics , surgery , microbiology and biotechnology , biochemistry , chemistry , escherichia coli , gene , biology
Background: Clinical features and outcomes of neonatal sepsis caused by resistant Gram‐negative bacteria are not well described in Jordan. The aim of the present study was therefore to describe microbiology and clinical features, laboratory findings and outcomes of early‐ and late‐onset Gram‐negative neonatal sepsis. Methods: All patients with Gram‐negative bacteremia between July 2003 and June 2005 were retrospectively included. Resistance profiles, clinical features and outcomes of early and late‐onset neonatal sepsis were compared. Results: A total of 79 patients (after excluding all nine cases of Gram‐positive bloodstream infection (BSI) were identified as having Gram‐negative BSI (25 had early‐onset and 54 had late‐onset neonatal sepsis). Respiratory distress, metabolic acidosis and requirement of ventilation were found in 74.7%, 40.5%, and 58.2%, respectively. Hypotension was found in 22.9% of patients. Klebsiella pneumoniae was responsible for 43 cases (54.4.2%). Klebsiella pneumoniae resistance rates to ampicillin and ceftazidime were 100% and 50%, respectively. Mortality rate was 30.9%. Forty‐eight percent of deaths occurred within 3 days of sepsis. Meningitis was diagnosed in five cases. Elevated C‐reactive protein (CRP) and thrombocytopenia were seen in 28% and 24% of infants with early‐onset sepsis, respectively, and in 79.6%, 59.3% of infants with late‐onset sepsis respectively. Conclusion: Both early‐ and late‐onset neonatal sepsis are caused by highly resistant Gram‐negative bacteria. Mortality of sepsis is high. Elevated CRP and thrombocytopenia is seen more commonly in late‐onset neonatal sepsis.