Clinical Study of Neonatal Sepsis in a Central Teaching Hospital

Abstract

ABSTRACT

Background: Neonatal sepsis categorized as early and late onset. Early onset sepsis occurs in the first 7 days of life with 85% occur in the first 24 h of life. Late onset sepsis occurs after the first week of life and is mostly   acquired from care giving environment.

Objective: To determine the incidence of pathogenic agents, risk factors and outcome of septicemia in neonates admitted to neonatal intensive care unit in Central Teaching Hospital of Pediatric in Baghda

Methods: A prospective study was done among 200 neonates with clinical suspicion of neonatal sepsis from 20th of August 2011 to 20th of December 2011. Blood samples of at least 2 ml of blood were taken from peripheral vein from 2 separate sites after disinfection with 70% alcohol and povidone iodine solution and each mixed with brain-heart infusion broth then incubated at 37oC for 7 days and cultured aerobically

Results: the causative agents have been isolated by blood culture in 15% of the neonates. Late onset sepsis is more common 142 (71%) than early onset sepsis 58 (29%) and the predominant isolates in both early and late onset sepsis were Gram negative bacteria 23/30 (76.7%). E. coli was the commonest organism in early and late onset sepsis 11/30 (36.7%). Klebsiella was the second commonest organism especially in late onset sepsis 6/30 (20%). Overall death rate 56/200 (28%). Pseudomonas aeroginosa and Proteus have the highest fatality (100%) while no death was recorded among pneumococcal sepsis, E. aeroginosa and Listeria.

Conclusion: Gram negative bacteria (especially E. coli and Klebsiella) were the leading bacterial agents of neonatal sepsis in our environment with relative high frequency of late onset sepsis due to nosocomial infection, with high mortality rate.