Title: Risk Factors and Immediate Outcome of Early Onset Neonatal Sepsis
Authors: Dr Rahul V Bharad, Dr Ch Shyamsunder Singh, Dr L Ranbir Singh
DOI: https://dx.doi.org/10.18535/jmscr/v5i4.207
Abstract
Background - Neonatal septicemia remains one of the main causes of mortality and morbidity despite the progress in hygiene, introduction of new and potent antimicrobial agents for treatment and advanced measures for diagnosis. Estimates of direct causes of death indicate that severe infections account for 36% of neonatal deaths (sepsis/pneumonia 26%; tetanus 7%; diarrhoea 3%). Three-fourths of neonatal deaths occur in the first week of life.
Aims of the study-1. To identify the maternal and neonatal risk factors associated with early onset neonatal sepsis. 2. To recognize the common clinical features with which the newborn are most likely to present with early onset neonatal sepsis. 3. To determine the various factors associated with increased risk of mortality in early onset neonatal sepsis. 4. To evaluate immediate outcome of early onset neonatal sepsis.
Study design- A descriptive study. Material and methods- The study was carried out in the Department of Pediatrics, RIMS, Imphal for a period of 2 years from October 2011 to September 2013 in neonates admitted with history, clinical features and laboratory parameters / cultures suggestive of sepsis within first 7 days of life. Neonates included in the study were followed up till they were admitted in this hospital and immediate outcome was evaluated.
Results- Out of 120 eligible cases, 75.8% presented within first 3 days of life. Male to female ratio was found to be 1.22:1. Hindus accounted for 68.3% while 59.2% were delivered preterm. Maternal fever was the most common maternal risk factor present in 67.5% cases. Amongst culture positive cases, E. coli was the predominant organism. 84.2% were discharged with advice, 4.2% left against medical advice and 11.7% babies expired (mortality).
Conclusion- Early onset neonatal sepsis is to be strongly suspected when risk factors associated with it are present or when newborns present with clinical features suggestive of it. Thorough history taking about risk factors and detailed clinical evaluation needs to be done followed by laboratory analysis and blood culture for confirmation of the diagnosis.
Keywords: Neonatal sepsis, risk factors, prematurity, sepsis screen.
