Priyanka Paul Biswas1, Kahkashan Akhter2, Aninda Sen3, Umesh4, Mohammad Intekhab Alam Chand5
BACKGROUND
This study was an attempt to find the association of physical parameters, risk
factors, common signs & symptoms of septicaemia, analyse the distribution of
microorganisms isolated from clinically suspected cases of septicaemia, and collect
their antibiogram. We also wanted to evaluate the haematological findings in
conventional culture, correlate them to the sensitivity and specificity, and
quantitatively identify the relevance of these haematological tests through their
positive and negative predictive values.
METHODS
A total of 350 blood samples were received from patients with clinically suspected
cases of blood stream infections (BSI) at the Department of Microbiology for
routine culture & sensitivity and were processed using standard microbiological
techniques to determine the percentage distribution of bacterial pathogens
causing BSI and their antibiotic susceptibility patterns. Mueller-Hinton agar (MHA)
with 4 % NaCl was used to detect methicillin resistance.
RESULTS
Of the 350 septicaemic cases, 58.8 % were from neonatal ICU and 41.2 % were
from paediatric wards. Maximum culture positivity (45.3 %) was seen in < 28 days
age group. Bacterial growth was seen in 62.0 % preterm babies. Probability of
sepsis was more with leukopenia (85.4 %) as compared to leucocytosis (68.9 %);
positive C-reactive protein (CRP) findings (63.8 %) were more likely to be
associated with sepsis as compared to negative CRP findings (2.1 %). Leukopenia
(97.5 %) and leucocytosis (96.3 %) had the highest specificity values.
CONCLUSIONS
Low birth weight (LBW) neonates, preterm birth and Caesarean section deliveries
are risk factors that predispose neonates to septicaemia. Meropenem can be used
in septaemia, but it should be reserved for critical cases, particularly those with
multidrug resistant (MDR) bacteria, rather than on routine basis to prevent
inadvertent promotion of bacterial resistance. This study showed that leukopenia
and CRP are good indicators of sepsis, when used in combination.
