A study of clinico-bacteriological profile and to determine incidence of meningitis in late onset sepsis in newborn unit of tertiary care teaching hospital in Northern India

Abstract

Background: The daily risk of mortality in first 4 weeks of life is almost 30-fold higher than post-neonatal period. Late onset sepsis (LONS) and meningitis still continue to be major causes of mortality and morbidity in newborn period. Our study was done to study clinical profile of enrolled newborns with LONS along with incidence of meningitis in them. The objective of this study was to study clinico-bacteriological profile and to determine associated incidence of meningitis in neonates with late onset sepsis (LONS) in a hospital setting in Northern India.Methods: It was a hospital based prospective observational study conducted over a period of 12 months enrolling 122 newborn with >72 hours of age fulfilling inclusion criterias.Results: Out of total 122 enrolled newborn, 37 (30.3%) neonates had meningitis. 71 (58.20%) were of term gestation with majority 61 (50.0%) in age group of 4-7days of life. Incidence of LONS in low birth weight and very low birth weight were 54% and 13.5%. Most commonly seen symptoms in at admission were lethargy, refusal to feed and fever. Blood culture was positive in 45 (36.88%) in neonates with Acinetobacter baumanii, klebsiella pneumonia and Escherichiae coli being most commonly seen organisms. Cerebrospinalfluid (CSF) culture was positive in 4 (10.81%) newborns. Mean duration of hospital stay was 24.75±13.96 days. Mortality in neonatal meningitis was 3 (3.2%).Conclusions: Our study proved that about one third of newborn admitted with LONS also had coexistent meningitis. Thus CSF analysis is a must and it should not be missed as untreated meningitis can be devastating for newborn. Antibiotics must be added as per antibiogram of specified institute.