Proforma for Registration of Subjects for Dissertation/Thesis
Proforma for Registration of Subjects for Dissertation/Thesis
|1 |Name of the Candidate and address |DR PRARTHANA M S, |
| |(in block letters) |H.NO 964, LIG SECOND STAGE, |
| | |NEW TOWN YELAHANKA, |
| | |BANGALORE-560064 |
|2 |Name of the Institution |Vydehi Institue of Medical Sciences & Research Centre, |
| | | |
| | |No 82, EPIP Area, Whitefield, |
| | |Bangalore-560066. |
|3 |Course of study and subject |M.D Medical Microbiology |
|4 |Date of admission to course |11-06-2008 |
|5 |Title of the Topic |
| | |
| |Bacteriological diagnosis of Neonatal Sepsis in a teaching hospital: |
| |A laboratory challenge. |
|6 |Brief resume of the intended work: |
| | |
| |6.1 Need for the study |
| |There is a need to assess neonatal health in India. During the last couple of decades the proportion of neonatal mortality to |
| |infant mortality is increasing in India. One of the major causes of morbidity and mortality in neonates is due to bacterial |
| |sepsis (6). Neonatal Sepsis has been classified as either early onset ( 0-7 days of age) or late onset (7-28 days of age) (4). |
| |World over, twenty million newborns get infected each year. Four million neonates die each year, of which 36% are due to severe |
| |infection (1). 1.2 million deaths during neonatal period occurring annually in South-East Asia Region, India contributes nearly |
| |30% deaths to Global burden (6). Neonatal Sepsis is the most common indication for admission of neonates brought from the |
| |community to sub district, district and tertiary care hospitals (1). |
| |The clinical signs of neonatal sepsis are subtle , nonspecific and often diagnosis is difficult to establish on the basis of |
| |clinical findings alone. Hence the laboratory has a very significant role to play in the diagnosis of neonatal septicemia (5). |
| | |
| |6.2 Review of Literature |
| | |
| |Data available from World Health Organization (3) indicate that gram negative bacilli account to 56% of all invasive diseases. |
| |Klebsiella organisms are the most important cause of neonatal sepsis, followed by Staphylococcus and Escherichia ( 3,4,5). |
| |A study in a tertiary care hospital revealed that Pseudomonas aeruginosa topping the list followed by coagulase negative |
| |staphylococci and klebsiella species (4). These organisms have developed increased drug resistance over the last two decades and|
| |management of patients is becoming a major problem (4). Prompt diagnosis using blood culture, the gold standard for |
| |documentation of sepsis (2), would lead to early discontinuation of intravenous line and antibiotic therapy. Early discharge |
| |would decrease the risk of iatrogenic complications and nosocomial infections (5). Hence decrease the incidence of drug |
| |resistance by avoiding unnecessary treatment. |
| | |
| |6.3 Objectives of the study |
| | |
| |To assist the clinician in formulating parameters of neonatal sepsis. |
| |Early laboratory diagnosis by using blood culture (The gold standard for diagnosis). |
| |Recommending appropriate antibiotic regimens in treatment of neonatal sepsis. |
| |Prevention by advocating the basic procedure of universal precautions. |
|7 |Materials and methods |
| | |
| |7.1 Source of data |
| | |
| |A total of 60 neonates (0-28days) with clinical diagnosis of septicemia will be included in the study. |
| |Clinical signs suggestive of sepsis being-poor feeding, respiratory distress, fever and hypothermia or whose mothers had a |
| |history of prolonged rupture of membranes (≥ 24 hrs), maternal fever and premature labour will be criteria for inclusion in the |
| |study. |
| | |
| |7.2 Method of collection of data ( including sampling procedure, if any) |
| | |
| |Details of samples to be processed. |
| |A. Routinely performed |
| |1) Blood culture. |
| |2) C-reactive protein. |
| |B. Performed whenever required. |
| |1) Urine culture(suprapubic aspirate/catheterized sample) |
| |2) Gastric aspirate culture. |
| |3) Cerebro-spinal fluid culture. |
| |4) Tracheal aspirate culture. |
| |C. Performed with the assistance of dept of pathology. |
| |1) WBC count. |
| |2) Neutrophil count. |
| |3) Erythrocyte Sedimentation Rate. |
| | |
| |7.3 Does the study require any investigations or interventions to be conducted on patients or other humans or animal? If so, |
| |please describe briefly. |
| | |
| |Not Applicable |
| | |
| |7.4 Has ethical clearance been obtained from your institution in case of 7.3 |
| | |
| |Yes |
|8 |List of References ( About 4-6) |
| | |
| |Nanavathi RN, Aloke VR. Neonatal Sepsis: Overview, clinical spectrum, Indian perspective. Paediatrics Today 2006 Sep-Oct; 9(5) :|
| |245-9 |
| |Thakre R. Neonatal sepsis: Laboratory diagnosis of neonatal sepsis. Paediatrics Today 2006 Sep-Oct; 9(5): 250-3. |
| |WHO. Explore simplified antimicrobial regimen for the treatment of neonatal sepsis. Meeting report. Geneva, 2002 30th September-|
| |1st October. |
| |Movahedian AH, Morini R, Mosayebi Z. Bacterial culture of neonatal sepsis. Iranian journal public health 2006; 35(4): 84-9. |
| |Vinod kumar CS, Neelagaud YF. Incubation period for culture positivity to detect septicemia in neonates. Indian Journal of |
| |Medical Microbiology 2005; 23(4): 270-5. |
| |WHO. Child Health and Development. Publication. Improving neonatal health in South-East Asia region. Report of a regional |
| |consultation. New Delhi, India, 2002 April |
| |Barbara J Stoll. Infections of the neonatal Infants. In: Robert M Kleigman, Richard E.Behrman, Hal B. Jenson, Bonita F.Stanton |
| |Editors. Nelson textbook of pediatrics, 18th edition, Vol-1; Philadelphia: Saundars, 2008: 794-811. |
| |Collee J.G, Marr W. Culture of bacteria. In Collee J G, Fraser A G, Marmion B P, Simmons A. Editors. Mackie and McCartney: |
| |Practical Medical Microbiology.14th Edition, Churchill Livingstone: Elsevier, 2007; 121-4. |
|9 |Signature of Candidate | |
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|10 |Remarks of the guide | |
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|11 |Name & Designation of (in block letters) | |
| | | |
| |11.1 Guide | |
| | |DR SANDHYA BELAWADI |
| | |HOD DEPT OF MICROBIOLOGY. |
| |11.2 Signature | |
| | | |
| | | |
| | | |
| |11.3 Co-Guide (if any) | |
| | |DR R RAJENDRAN |
| | |PROFESSOR, DEPT OF MICROBIOLOGY. |
| |11.4 Signature | |
| | | |
| | | |
| |11.5 Head of Department | |
| | |DR SANDHYA BELAWADI |
| | | |
| |11.6 Signature | |
| | | |
| | | |
| | | |
|12 |12.1 Remarks of the Chairman & Principal |
| | |
| | |
| | |
| |12.2 Signature |
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