Abstract
Background: The incidence of neonatal sepsis (NS) varies from 6 to 9 cases per 1,000 live births, but is higher among low-birth-weight neonates. The purpose of the present study was to examine the risk factors, antimicrobial use pattern and clinical outcomes of NS. Methods: A prospective cross-sectional study was conducted using pretested and validated checklists. Results: Among the total 306 neonates 249(81.4%) were age less than or equal to 7days, and 169(55.23%) were male, while 251(82%) were attended antenatal care, 136 (44.44%) were low in birth weight ( 12000/mm3. Two hundred twenty one (72.2%) of the neonates were receive antibiotics for management of sepsis while 74 (24.2%) were receive antibiotics for other managements. The most frequently prescribed antibiotic was the combination of ‘ampicillin + gentamicin’ with 67(21.9%) followed by single antibiotic prescriptions of benzyl penicillin 33(10.8%) and cloxacillin 8(2.6%). A significant number of neonates (p=0.000) with 95% C.I of (1.934-8.967) were born in health center and developed sepsis. This value is 4.2 times higher when compared to the neonates born in home. A significant number of neonates born with the aid of instrument in hospitals were also developed sepsis (p=0.26). The risk of acquiring sepsis in neonates born with the aid of instruments was 6.2 times higher than children born vaginally in natural way. A significant number of neonates born from mothers’ with urinary tract infection (UTI) developed sepsis (p=0.02) and this figure was 2.9 times higher than neonates born from mothers’ with no UTI. Conclusions: In the present study, the most common risk factors for the incidence of neonatal sepsis were place of delivery, mode of delivery and mothers with UTI.
Highlights
The incidence of neonatal sepsis (NS) varies from 6 to 9 cases per 1,000 live births, but is higher among low-birth-weight neonates
In 37(12.09) of the neonates the status of their clinical outcome was unknown because they were referred for further investigation and management (Table 2)
Determinants of neonatal sepsis In this study we have identified that significant number of neonates (p=0.000) with 95% C.I of (1.934-8.967) were born in health center and developed sepsis
Summary
The incidence of neonatal sepsis (NS) varies from 6 to 9 cases per 1,000 live births, but is higher among low-birth-weight neonates. Bacterial organisms causing NS may differ among countries, in most developing countries, gram-negative bacteria remain the major source of infection [3]. Onset neonatal sepsis (sepsis that presents during the first 5–7 days of life) usually is caused by organisms acquired from the maternal genital tract. The most common pathogens found in early-onset neonatal sepsis are group B streptococcus (50%) and E. coli (20%). Bacterial infections in neonates are commonly due to Escherichia coli, other enterobacteriaceae, listeria monocytogenes, and coagulase negative staphylococci and group B Streptococcus [7]. Late-onset sepsis (sepsis presenting after 5–7 days postnatal age) usually is caused by these primary organisms or by nosocomial pathogens, such as coagulasenegative staphylococci (CONS), S.epidermidis, S.aureus, Pseudomonas species, anaerobes, and Candida species [5]
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