Mortality profile of neonatal deaths and deaths due to neonatal sepsis in a tertiary care center in southern India: a retrospective study

Abstract

Background: The Neonatal mortality rate is an important indicator for newborn care and directly reflects prenatal, intranatal, and postnatal care. Objective: Primary objective was to analyse the neonatal mortality profile, incidence of neonatal sepsis among neonatal deaths and the pattern of antimicrobial resistance.Methods: This was a retrospective descriptive study done in a tertiary care regional center. All neonatal deaths from January 2017 to December 2017 were reviewed and primary causes of deaths, incidence of sepsis among neonatal deaths and pattern of antimicrobial resistance were analyzed.Results: Common causes of neonatal deaths were respiratory distress syndrome (27.4%), asphyxia (23.3%), sepsis (20.1%), congenital malformations, extreme preterm, meconium aspiration syndrome. Case fatality rate was high in extreme preterm neonates (96.8%), followed by respiratory distress syndrome (35.9%), asphyxia (33%), meconium aspiration syndrome (29.4%), congenital malformations (28.8%), and sepsis (22.6%). In present study incidence of neonatal sepsis among total neonatal deaths was about 20.1%. Coagulase negative staphylococcus(CONS) (38.6%) and Klebsiella pneumoniae (32.7%) were the predominant organisms isolated. Highest case fatality rate was associated with Pseudomonas sepsis (80%), K. pneumoniae sepsis (64.8%), followed by Escherichia coli sepsis (57%) and non fermenting Gram negative bacilli (55.6%).Conclusions: Sepsis still remains one of the leading cause of death in developing countries. Coagulase negative staphylococcus (CONS) and Klebsiella pneumoniae were the most common organism. 15 % enterococci and 9.7 % of CONS were resistant to vancomycin. 24 % of K. pneumoniae and 16.6% non fermenting Gram negative bacilli were resistant to amikacin. Multidrug resistance is an emerging problem.