Chandigarh:
A single theme workshop on Neonatal Sepsis (meaning serious infections in newborn babies) is currently underway at the Advanced Pediatric Centre, PGIMER, Chandigarh. 100 delegates from all over India are attending this workshop. On the second day of the workshop, several important lectures were delivered followed by case discussions of real-life cases of newborn babies with serious infections.
The second day’s proceedings started with a talk on newborn meningitis (infection of the covering of the brain) by the organising secretary of the workshop, Prof Sourabh Dutta. He stressed that the occurrence of meningitis is more common in the newborn period than in any other age group. The consequences of missing a diagnosis of meningitis or undertreating meningitis are devastating and lifelong. A sample of spinal fluid has to be analysed for diagnosing meningitis.
Dr Sajan Saini spoke about a dangerous but rare complication of meningitis called ventriculitis. In this the central fluid spaces inside the brain get infected. This disease requires prolonged periods of antibiotics and long hospitalisation. There are typical changes on MRI of the brain and ultrasound of the brain which help to identify this dreaded complication.
Dr Nandkishor Kabra spoke about urinary tract infections in newborn babies. He said that paediatricians need to look more actively for urinary infections in newborn babies than what they are currently doing. To be able to get a clean sample of the urine without contamination, the urine has to be collected either by catheterisation of the urinary bladder or by inserting a needle in the urinary bladder. A diagnosis of urinary infection may require further investigations such as ultrasounds of the kidneys.
Prof Deepak Chawla spoke about non-antibiotic ancilliary treatments and preventive strategies of newborn infections. These included several innovative approaches such as the application of colostrum (mother’s first thick milk) in the oral cavity and throat of newborn babies, using probiotics (friendly bacteria), lactoferrin (an anti-infective component of human milk), oil application etc.
Prof Praveen Kumar, the head of the neonatal unit and the chairperson of the workshop, spoke about the important topic of antibiotic stewardship.
Antibiotic stewardship refers to a coordinated set of strategies aimed at optimising the use of antibiotics to improve patient outcomes, reduce antimicrobial resistance and minimise adverse events and unnecessary healthcare costs. Antibiotic stewardship involves having written down policies and audit procedures to ensure that antibiotics are used sparingly and rationally in a neonatal unit, they are proactively and immediately stopped when they are not required.
Dr Jogender Kumar and Dr Harsimran Kaur jointly presented an important talk on fungal infections in newborn babies. The incidence of fungal infections is gradually rising in India, especially among smaller hospitals and neonatal units, which is a matter of grave concern. Dr Joginder Kumar spoke about when to suspect and diagnose fungal infections and how to treat them effectively. Dr Harsimran Kaur dealt with the issues of laboratory diagnosis of fungal infections among newborn babies. PGI has one of the most advanced mycology (study of fungal diseases) centres in the country.
The highlight of the 2nd day of the workshop were 3 case discussions of actual newborn babies who had been managed for severe newborn infections in the PGIMER unit in recent times. Identification details of these babies were anonymized but all their clinical and laboratory details were discussed at length with the delegates.
