Clinical Outcomes in Gram Negative Bacteraemia in a Tertiary Neonatal Unit
Year: 2018
Type: other
Abstract: Background and AimsNeonatal sepsis caused by Gram-negative bacteraemia is a significant cause of mortality and morbidity in newborns admitted to neonatal intensive care units (NICU). The aim of this review was to identify the clinical outcomes of neonates admitted to NICU with gram-negative bacteraemia and to look at profiles based on place of birth .MethodA retrospective review of patient records of all newborns admitted to a tertiary NICU over a 10-year period from April 2007 -March 2017 with Gram-negative bacteria isolated in blood cultures.The following data were analysed: place of birth, age of onset of sepsis, Clinical status of babies with sepsis u2013 need for invasive ventilation, hypotension, markers of sepsis. Results82 babies were identified as having Gram-negative bacteraemia. The case-fatality rate was 30%. Highest mortality was seen in the extreme premature group below 27 weeks and out-born babies with bacteraemia. Systemic Hypotension, thrombocytopenia and significant ventilator support were more prevalent in babies who died. Of those requiring ventilatory support during sepsis, 96% died (p=0.006). Outborn newborns with gram negative bacteraemia sepsis were at greater risk of developing NEC or CLD.ConclusionIn newborns admitted to NICU, the extreme preterm babies have the highest risk of having gram-negative sepsis and outborn infants have the highest mortality rates. This could be attributed to a combination of factors in addition to extreme prematurity.The babies with gram-negative sepsis who do not survive have associated multi-systemic involvement and present with systemic hypotension, thrombocytopenia and ventilator associated pneumonias in our review.
Authors: Narasimha SUBBARAYA, Sophie Hine, Laura Kelly, Pooja Siddhi, Manobi Borooah
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4213099998