Indian Journal of Neonatal Medicine & Research

Newborn with Small Feet

M geetha, B Kiran, S Santosh

Introduction: The birth weight indicates maternal and child health, and reflects the health of the overall community. Low birth weight is strongly associated with neonatal, infant and child morbidity and mortality. Aim: To evaluate the correlation of foot length to birth weight in new born so as to use it as a proxy measure for detecting low birth weight neonates. Materials and Methods: A pilot study was carried out on a prospective basis over a period of three months from June 2019 to August 2019 in our tertiary care centre. All consecutive inborn neonates were included in the study. Values of birth weight in grams using digital weighing scale and foot length in centimetres using callipers were recorded. Data was tabulated in the standard proforma and statistical analysis done by SPSS software. Results: A total of 60 neonates were included in the study. The mean foot length and birth weight was 7.59 cm and 2850 g. Foot length had a linear correlation with birth weight which was statistically significant (p>0.01). The mean foot length birth weight below 2500 grams, 2500 to 3500 grams and more than 3500 grams were 7.0cm, 7.63cm and 8.17, respectively. Conclusion: The foot length correlates well with birth weight of the neonate, and can be a proxy measure for birth weight. This simple, easy, anthropometric variable can be used for screening for low birth weight in hospital and community with a proposed cut-off of 7.2 cm.

Causative Agents, Antibiotic Resistance Patterns and Risk Factors in Early and Late Onset Neonatal Sepsis in a Neonatal Intensive Care Unit

Nadire Seval Gündem, Nuriye Tarakçi Emiroglu, Erkan Atas

Introduction: Neonatal sepsis is one of the major causes of neonatal mortality. Causative agents, antibiotic resistance patterns and risk factors of sepsis differ from one region to another in the world. Periodic assessments of these will guide to use an appropriate antibiotics for rational empirical treatment and contribute to management of sepsis. Aim: To determine causative agents, antibiotic resistance patterns and risk factors of early and late onset neonatal sepsis. Materials and Methods: A total of 230 neonates diagnosed as sepsis were included in this retrospective study. Data collection was made by reviewing records of patients from laboratory and hospital information system of Konya Dr Ali Kemal Belviranli Gynaecology, Obstetrics and Children Hospital between September 2015-May 2017. Blood samples were incubated in automated blood culture system. Subcultures were performed on 5% sheep blood agar and eosin methylene blue agar. Identification of microorganisms was firstly made by conventional methods. Further identification and antibiotic susceptibility tests were performed by automatic analyser. Results were considered statistically significant at p<0.05. Results: Early Onset Sepsis (EOS) was detected in 19 (8.3%) neonates while Late Onset Sepsis (LOS) occured in 211 (91.7%) of them. Coagulase-negative Staphylococcus was the most commonly isolated microorganisms in both early and late onset sepsis with rates of 84.2% and 81.5%, respectively. The rate of gram negative microorganisms was 13% and Enterobacteriaceae compose 8.7% of these. Klebsiella pneumoniae (3.5%) was the most common bacteria within Enterobacteriaceae. High methicillin resistance rates (81.2% and 83.7%) were observed in Coagulase negative Staphylococcus in both EOS and LOS, respectively. Enterobacteriaceae had extended spectrum beta-lactamase positivity rate of 63.2% and showed high resistance to ceftriaxone (63.2%) and cefuroxime (78.9%). No carbapenem resistance were detected in gram negative bacteria. No significant associations was found between onset of sepsis and gestational age, gender and mode of delivery (p>0.05). Conclusion: There were some differences and also similarities between aetiologic agents and antibiotic resistance patterns among data obtained in this study and those from other countries. This study contributed to epidemiological information and routine antibiotic surveillance to use appropriate antibiotics for empirical treatment of sepsis and prevent its complications.

Effect of Glycerine Suppository in Achieving Early Full Feeds in Premature Infants: A Randomised Controlled Trial

Ashish Kumar Gupta, Ram Pal Singh Tomar, Sajith Surendran

Introduction: Achieving full feeds in premature infants is challenging as it can be delayed due to immaturity of their gut. Osmotic agents orally and as suppositories or enemas can be used to stimulate the passage of meconium to promote early feeding but there is little evidence to support this practice as studies have been inconclusive. Aim: To determine the effect of using glycerine suppository in premature neonates on their time required to achieve full feeds in comparison with premature neonates with no glycerine suppository. Materials and Methods: This study was a randomised, double blinded trial conducted on premature infants, with birth weight <1500 g and a gestational age <32 weeks. Study group received 500 mg glycerine suppository twice daily, started within 48 hours of life for 14 days, while Control Group (CG) received no intervention. The results were plotted in MS Excel and analysed using SPSS 22. Results: Total 50 cases, 25 neonates in each group were analysed for the primary and secondary outcomes. Mean duration for full feeds was achieved by 11.1 days in the Glycerine Suppository Group (GSG) and 11.9 days in Control Group (CG) (p-value 0.2). While the duration of hospital stay was shorter in the GSG than the CG (38.4 days vs 40.7 days), but was not statistically significant (p-value 0.49). Conclusion: There was no statistically significant difference seen between the groups in achieving Full Enteral Feeds (FEF). No differences were observed between the groups in regaining birth weight, duration of hospitalisation or incidence of complications including Necrotising Enterocolitis (NEC).