DOI: 10.36347/sjams.2020.v08i10.008

Pages: 2246-2250

Neonatal sepsis is the most common cause of neonatal mortality and morbidity. Studies have recorded an incidence of neonatal sepsis, varying between 11 and 24.5 per 1000 live births. It is responsible for about 30-50% of the neonatal deaths. Depending on the onset of symptoms, it can be classified into early onset sepsis within 72 h of life and late onset sepsis usually after 72 h of life. It has been one of the major diagnostic problems for physicians due to non-specific symptoms and the absence of a reliable Para clinical marker. Fungal blood stream infection (BSI) is an important cause of neonatal sepsis and sepsis related mortality. According to our study, the common risk factors for Fungal BSI include prematurity, low birth weight, central vascular catheterization, use of broad spectrum antibiotics, prolonged hospital stay, birth canal infections or discharges and male newborns. Neonatal fungal sepsis occurs in immunologically immature or very ill patients because of individual susceptibility and due to health care related infection. Early signs of sepsis are non-specific and may commonly presents with respiratory distress, feed refusal, apnoea and bulging fontanelle etc. A heart rate above 160 can also be an indicator of sepsis, this tachycardia can present even 24 hours before the onset of other signs. Culturing for microorganisms from a sample of CSF, blood or urine, is the gold standard test for definitive diagnosis of neonatal sepsis. Widespread infection despite negative culture is common. It is often difficult to establish the diagnosis of fungal sepsis because there are no easy, reliable and rapid tests. In addition to fluid resuscitation and supportive care, Amphotericin B continues to be the mainstay of therapy for systemic fungal infections. Recently Indian liposomal Amphotericin B derived from neutral lipids (L-Amp-LRC-1) has shown effective response at lower dose with less toxicity and inexpensive drug for the treatment of neonatal candidiasis.