Browsing by Author "Suryawanshi, Sonali"
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Publication Cerebral Hemodynamics in Late Onset Neonatal Sepsis in Preterm Neonates: A Prospective Observation Study(Nepal Paediatric Society (JNPS), 2023) Chetan, Chinmay; Gupta, Bhvya; Pareek, Prince; Suryawanshi, Sonali; Maheshwari, Rajesh; Suryawanshi, PradeepAbstract: Introduction: Late onset neonatal sepsis (LONS) is one of the most prevalent conditions in neonates in developing countries. The aim of this study was to assess the changes in cerebral hemodynamics in neonates with LONS. Methods: Preterm neonates (N = 60) with suspected LONS were enrolled over a period of 21 months and divided into three cohorts: Group A with clinical sepsis but with negative septic markers and culture report, group B, where septic markers were positive, but cultures were sterile and group C, where either blood or CSF culture was positive. Ultrasound doppler of the anterior cerebral artery was done at 0 hrs, 48 hrs and 5th day after suspecting sepsis. Peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI) were measured and compared in three groups and sequentially at specific time points. Results: A total of 60 neonates with a median gestational age of 30.5 [IQR (28 - 32.6)] weeks were enrolled: 21 in group A, 20 in group B and 19 in group C. RI was lowest in Group C at zero hours with a mean of 0.72 (SD ± 0.09) [p < 0.05], which gradually improved after starting antibiotics. Klebsiella sp. was the most common organism isolated. Conclusion: Neonates with culture-positive LONS had the least resistive index. This parameter may have diagnostic implications and significance on the hemodynamic management in LONS.Publication Trend of bacteriological profile and antibiotics sensitivity pattern in neonates with late onset sepsis(Madhesh Institute of Health Sciences (MIHS), 2025) Sah, Love Kumar; Pareek, Prince; Suryawanshi, Sonali; Banait, Nishant; Suryawanshi, PradeepABSTRACT: Background: Neonatal sepsis is a major cause of morbidity and mortality in low- and middle-income countries (LMICs). It is categorized as early onset sepsis (EOS, ≤72 hours) and late onset sepsis (LOS, >72 hours). The World Health Organization (WHO) has emphasized antibiotic stewardship. In LMICs, antibiograms are crucial where sepsis significantly contributes to neonatal deaths. Objective: To analyze trends in bacteriological profile and antibiotics sensitivity in neonates with Late Onset Sep- sis (LOS). Methods: This was a 10-year retrospective study of culture-proven LOS cases. Demographics, isolate types, and sensitivity patterns were recorded. Multidrug-resistant (MDR) gram-negative isolates were defined as resistance to ≥3 of 5 antibiotic classes: extended-spectrum cephalosporins, carbapenems, aminoglycosides, fluoroquinolones, and piperacillin-tazobactam. Results: Among 14,336 NICU admissions (2010–2019), 6092 (42.5%) were evaluated for sepsis, and 647 (10.6%) had culture-positive LOS. Gram-negative organisms comprised 488 (75.3%) isolates—Klebsiella (35.3%), E. coli (13.3%), and Acinetobacter (10.5%) were most common. Gram-positive isolates (24.7%) included S. aureus (9.4%), coagulase- negative staphylococci (10.5%), and Enterococcus (4.8%). High MDR rates were observed in Klebsiella (56.3%), E. coli (56.9%), and Acinetobacter (86.8%). Methicillin resistance was seen in 77.3% of S. aureus and 74.2% of Enterococcus. Conclusions: Alarming antimicrobial resistance in both gram-negative and gram-positive organisms calls for urgent at- tention. Antibiotic stewardship and regular antibiogram surveillance are essential to develop effective hospital policies.