Affiliations: Department of Pediatrics, Postgraduate Institute of
Medical Education and Research, Chandigarh, India
Note: [] Correspondence: Dr. Praveen Kumar, Neonatal Unit, Department of
Pediatrics, Postgraduate Institute of Medical Education and Research,
Chandigarh, 160012, India. Tel.: +91 172 2755308; Fax: +91 172 2744401; E-mail:
drpkumarpgi@gmail.com
Abstract: Traditional division of neonatal sepsis into early (EOS) and late
onset sepsis (LOS) may be fallible. We analyzed the bacteriological profile of
neonatal sepsis day wise to see if the organisms causing EOS and LOS are really
different in the current era. This retrospective study was conducted in a
tertiary care neonatal unit from 1995–2006. Neonates with proven sepsis
were included. The exact age of the neonate when the blood culture was obtained
was extracted. To identify the overlap between vertically and hospital acquired
sepsis, a similar percentage contribution of a particular organism on a day
wise analysis in the first 7 days of life was required. Day wise analysis was
done by χ2 for trends. One thousand and four hundred and ninety-one
neonates had blood culture proven sepsis (38.6 per 1000 live births). EOS was
caused predominantly by Klebsiella pneumoniae and non-fermenting Gram-negative
bacilli; whereas LOS was caused mainly by Staphylococcus aureus. All organisms
were isolated on all the days of life. Thirty one percent developed culture
proven sepsis in first 24 hours of life. Non-fermenting Gram-negative bacilli
significantly contributed on day 1 while S. aureus sepsis was significantly
higher from day 7 onward on trend analysis. The definition of EOS and LOS based
on day of isolation alone may not be applicable. A prospective evaluation of
the source of early bacterial infections is required.
Keywords: Bacterial sepsis, neonate, organisms, trends, EOS, LOS
