Bacteriological profile and antimicrobial sensitivity pattern in neonatal sepsis: a study from North India

Background: Neonatal sepsis is a leading cause of neonatal mortality and continues to be a formidable problem for neonatologists and pediatricians world over.  Knowledge of microbial flora and their susceptibility will help us to decide empirical treatment for the neonatal sepsis. The objective of this study was to determine the bacteriological flora prevalent in NICU and the antimicrobial sensitivity pattern.Methods: The blood culture reports of all the neonates with culture proven neonatal sepsis during the period July 2010 to September 2013 were reviewed retrospectively. A retrospective review in tertiary care teaching medical college. The data was entered in Excel sheets and percentages of various outcomes were calculated.Results: A total of 28,927 babies were born during the study period and 336 among them had positive blood culture. The incidence of neonatal sepsis was 11.62 per 1,000 live births. Three hundred fifty- six microbes were isolated, out of which 50% presented as early onset sepsis and remaining as late onset sepsis. Pseudomonas aeruginosa was the most common organism encountered in both early (43.82%) and late onset sepsis (51.35%). Gram negative bacilli were sensitive to carbapenems (92%) followed by piperacillin-tazobactam (90%) whereas linezolid (90%) was most sensitive antimicrobial for gram positive cocci.Conclusions: Pseudomonas was most commonly isolated in both early and late onset sepsis.  Gram negative bacilli were most sensitive to piperacillin-tazobactam and the carbapenems whereas linezolid and vancomycin were most effective against the gram-positive cocci. Resistance to third generation cephalosporins was rampant. Continuous surveillance for microbial flora, their antibiotic susceptibility, rational use of antibiotics and the strategy of antibiotic cycling may be of help to curtail emerging antimicrobial resistance

Neonatal care in India

The last decade has witnessed momentous changes in the Neonatal health scenario in India. Newborn Health care has received unprecedented attention and resources. It is the current focus of Central and state governments and the various funding agencies. And, like never before, there is an opportunity for the champions of newborn health to take their agenda forward . India contributes to one-fifth of global live births and more than a quarter of neonatal deaths. About two-thirds of infant deaths and half of under-five child deaths are during the neonatal period. The neonatal mortality rate has reduced over the years but the decline is at a much slower pace as compared to deaths in the older infant groups. Among neonatal deaths, the rate of decline in early NMR is much lower than that of late NMR. The Millennium Development Goal-4 (MDG-4), which stipulates a two-thirds reduction in under-five deaths by 2015, obviously cannot be achieved without ensuring a substantial reduction in the neonatal mortality rate (NMR). This article reviews the current status of Neonatal Care in India

Selenium supplementation for the preterm Indian neonate

Deficient antioxidant defenses in preterm infants have been implicated in diseases such as bronchopulmonary dysplasia, retinopathy of prematurity, necrotizing enterocolitis, periventricular leukomalacia, and intraventricular hemorrhage. The antioxidant properties of selenium make it important in the nutrition of very low-birth weight (VLBW) infants. Selenium is a component of glutathione peroxidase (GPX), an enzyme that prevents the production of free radicals. Preterm infants have low selenium stores and require supplementation by parenteral and enteral routes. This communiquι reviews the beneficial role that selenium supplementation might play in improving neonatal outcomes

A Case of Deep Vein Thrombosis and Intracranial Sinus Thrombosis : Possible rare complications of childhood abdominal tuberculosis

Severe pulmonary tuberculosis (TB) complicated by deep vein thrombosis (DVT) in adults has been reported previously in the medical literature; however, childhood extrapulmonary TB complicated by DVT is rare. We report a 13-year-old girl who presented to the Department of Pediatrics at the Postgraduate Institute of Medical Sciences in Rohtak, India, in 2012 with abdominal TB complicated by DVT and intracranial sinus thrombosis. She was treated with a course of four antitubercular drugs and short-term anticoagulation therapy with a positive outcome over the next six months. To the best of the authors’ knowledge, no previous reports have yet suggested a possible association between childhood TB and intracranial sinus thrombosis

Nonchylous idiopathic pleural effusion in the newborn

Congenital isolated pleural effusion is a rare cause of respiratory distress in neonates. It is usually chylous. Herein, we report a rare case of nonchylous congenital idiopathic pleural effusion

Cognitive and behavioral profile of treatment-naïve children aged 6–14 years with neurocysticercosis from North India

Background: Neurocysticercosis (NCC) produces a progressive organic brain damage by altering brain function with alterations in memory, difficulties in learning, and behavioral changes. The present study was designed to compare the cognitive and behavioral profile of school-going children aged 6–14 years with newly diagnosed NCC with their age-matched controls. Materials and Methods: A descriptive cross-sectional study was conducted among children aged 6–14 years with newly ( 63 as clinical range. Results: A total of 35 cases and 35 controls were enrolled. Baseline demographic characteristics were comparable between the two groups. Verbal intelligence quotient (IQ) scores were comparable between the cases (96.14 [10.23]) and controls (100.17 [10.89]) (P = 0.11). The behavioral assessment revealed normal T- scores (<60) in both the groups. Conclusions: The study revealed comparable IQ and normal behavioral profile of treatment-naïve children with recently diagnosed NCC to their age-matched peers. Further studies with larger sample size and longitudinal study design are required to evaluate the role of NCC on cognition and behavior in Indian children