Original Research Article DOI: 10.18231/2394-5478 .2017.0020 Indian J Microbiol Res 2017;4(1):96-98 96 Gram positive organisms isolated from neonatal septicaemia Nawaz Umar 1 , S. Mohammed Shahid 2,* , Bilal Ahmad Mir 3 1 Associate Professor, Dept. of Microbiology, Gulbarga Institute of Medical Sciences, Gulbarga, Karnataka, 2 Lecturer, Dept. of Microbiology, Khaja Banda Nawaz Institute of Medical Sciences, Gulbarga, Karnataka, 3 Assistant Professor Dept. of Microbiology, Khaja Banda Nawaz Institute of Medical Sciences, Gulbarga, Karnataka *Corresponding Author: Email: mdshahid06@gmail.com Abstract Introduction: Neonatal septicaemia constitutes an important cause of morbidity, mortality and fatality amongst Indian neonates. A remarkable feature of the clinical manifestation of neonatal septicaemia is non-specificity of symptoms, which creates difficulty in diagnosis of infection in the early stage. Materials & Methods: 1-10 ml of blood collected and inoculated 10ml of Brain-Heart infusion broth. Sub culture on Blood agar, chocolate agar after 24 hrs with sterile inoculation loop (4mm) again after 48 hrs subculture on same culture plates and every day for five days. The organisms were identified by using different characteristic tests like, colony morphology, Gram’ s stain, coagulase tests (both slide and tube) along with serological test procalcitonin test. Results: Neonatal septicaemia was seen in 82 cases, in that 53 cases were males and 29 cases were females. 45 cases (male) were isolated in early sepsis and 07 cases (females) were isolated in late sepsis. Procalcitonin test positive were in 67 cases in which 56 cases were positive for both blood culture and Procalcitonin test, 11 cases were positive to Procalcitonin test only and negative for blood culture. The organisms isolated in this study were Gram positive bacteria like Staphylococcus aureus, Coagulase negative Staphylococci (CONS) and few resistance strains of Staph. aureus like MRSA. Conclusion: A positive blood culture and PCT test are the only definitive and full proof methods of confirming the septicaemia. Hence, we conclude that in our study the best combination of tests in diagnosis for confirming neonatal septicaemia shows a high degree of sensitivity, specificity and positive predictive accuracy. Keywords: Neonatal Septicaemia, Early Sepsis, Late Sepsis, Cons, PCT. Introduction Neonatal sepsis is a bacterial infection in blood which is found in infants during the first month of life also called sepsis neonatorum. Neonatal septicaemia constitutes an important cause of morbidity, mortality and fatality amongst Indian neonates especially in rural areas with history of home deliveries and non- institutional deliveries that too without proper antenatal checkups. The WHO estimates that 4 to 4.5 million children die each year under one month of age under one month of age and that nearly all (98%) of deaths occur in developing countries. (1) Males are noticed to be infected more than females, the ratio being 2:1. Neonatal sepsis can be classified into two major categories depending upon the onset of symptoms. (2) 1. Early onset sepsis: Presents within the first 24-72 hrs of life. At birth some neonates were symptomatic in severe cases. The risk factors are seem to be prematurity, prenatal asphyxia, prolonged labour, low birth weight, preterm rupture of membranes. (2,3) 2. Late onset of sepsis: Presents after 72 hrs of age. Factors are prematurity, invasive procedures, mechanical ventilation, parenteral fluids administration, low birth weight, poor hygiene, poor umblicalcord care, bottle feeding. Infected amniotic fluid is a major source of neonatal septicaemia. Several obstetrical complications place the mother at high risk for infection of the amniotic fluid. After birth bacterial organisms may be acquired in the delivery room or in the new born nursery via respiratory and gastrointestinal route. And also skin, umbilical cord are major routes for the bacterial entrance into systemic circulation and leading septicaemia. A remarkable feature of the clinical manifestation of neonatal septicaemia is non-specificity of symptoms, which creates difficulty in diagnosis of infection in the early stage. High degree of suspicious and keen observation can help to save child. (9) Providing clean birth environment and treating the pregnant women with any bacterial infections, previous history of complete or incomplete abortion and immediate conception and also those who have given birth with sepsis previously. Otherwise neonatal sepsis is a serious condition that can put infants at increased risk of death/or long term disability. The organisms isolated in this study were Gram positive bacteria like Staphylococcus aureus, Coagulase negative Staphylococci (CONS) and few resistance strains of Staph. aureus like MRSA. Aim To know the incidence of neonatal septicaemia in this area, isolate the organism and to evaluate various screening tests for the detection of septicaemia.