Clinical Symptoms, Pathogen Spectrum, Risk Factors and Antibiogram of Suspected Neonatal Sepsis Cases in Tertiary Care Hospital of Southern Part of Nepal: A Descriptive Cross-sectional Study.

Bijay Raj Pandit,Ashish Vyas

doi:10.31729/jnma.5094

Abstract

Neonatal mortality rate is highest in sub-Saharan Africa and Southern Asia region. The present study is undertaken to find out prevalence of neonatal sepsis, recognize bacterial pathogens, neonatal risk factors, major symptoms, and their antibiotic sensitivity pattern in neonates in tertiary care hospital in southern Nepal. A descriptive cross-sectional study was carried out in a tertiary care hospital from 2nd January 2017 to 20th February 2018 after approval (Ref: 125/2016-17). The sample size was calculated and convenience sampling was done. Data were collected from hospital records and microbiology laboratory and analyzed by Statistical Package for Social Sciences. Out of 1200 clinically suspected cases, early-onset neonatal sepsis was seen in 290 (79.89%). A positive culture was seen in 363 (30.25%) where maximum bacterial growth was found in 254 (69.98%) males. Preterm gestational age was seen in 265 (73%), low birth weight 284 (78.23%), a vaginal delivery mode in 279 (76.90%), and delivery in hospital in 232 (63.91%). Likewise, Staphylococcus aureus in 229 (63.08%) was found maximum followed by Klebsiella pneumoniae in 48(13.22%). The major symptom observed was Respiratory distress in 245 (20.41%) while culture positive was seen in poor cry in 94 (53.10%). Mainly effective antibiotics against Gram-positive and gram-negative organisms were Linezolid in 250 (94%) and Imipenem in 46 (90.19%), whereas Penicillin-G in 254 (99.21%) and Ampicillin in 38 (94.74%) found resistance towards organisms respectively. The high prevalence of neonatal sepsis in our study reflects a huge challenge to reduce the neonatal mortality rate to 12 by 2030 of Sustainable Development Goals. Bacterial isolates exhibited higher resistance towards commonly used antibiotics.

Highlights

Neonatal mortality rate is highest in sub-Saharan Africa and Southern Asia region
One thousand two hundred blood cultures of neonates were evaluated during the study period.Out of 1200 clinically suspected cases of neonatal sepsis, 1024 (84.33%) were early-onset and 176 (14.67%) were lateonset in which positive blood culture was found in 290 (28.32%) and 73 (41.47%) cases respectively
The causative organisms associated with neonatal sepsis vary from place to place and the episode of the causative organism is dissimilar in different hospitals and even in the same hospital at different times.[7]

Summary

Introduction

Neonatal mortality rate is highest in sub-Saharan Africa and Southern Asia region. The present study is undertaken to find out the prevalence of neonatal sepsis, recognize bacterial pathogens, neonatal risk factors, major symptoms, and their antibiotic sensitivity pattern in neonates in tertiary care hospital in southern Nepal. The management of neonatal sepsis, the commonest cause, of Neonatal mortality in developing countries is dependent upon the causative organism, onset of sepsis, site of infection, and related neonatal risk factors.[4] The immediate treatment with limited. Pandit et al Clinical Symptoms, Pathogen Spectrum, Risk factors and Antibiogram of Suspected Neonatal Sepsis cases in Tertiary. Sustainable Development Goals-3(SDG-3) for Nepal.[1] This requires additional data for developing countries like Nepal due to regional variation

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Results

Discussion

Conclusion