Abstract
This is a retrospective study reviewed all neonates who were proved to have sepsis by positive blood culture and admitted to the neonatal unit of Kirkuk pediatric hospital from June 1, 2005 to May 31, 2006. Data regarding gestational age, gender, causative microorganisms, drug sensitivity, time of presentation and outcome were collected and analyzed. The result of the study showed higher frequency of neonatal sepsis in premature neonates 12.41% in premature newborns VS. 4.41 % in fullterm neonates). No significant statistical differences were found in outcome between early and late neonatal sepsis. Also it was found that gender had no significant effect in the frequency of neonatal sepsis. Most common causative microorganism for both early and late neonatal sepsis found to be Klebsiella followed by E Coli. Mortality rate was (50.64 %) Most dead infants had early neonatal sepsis (34.18%), while only (16.46%) died from late neonatal sepsis.
Highlights
Neonatal sepsis may be categorized as early or late onset
The microorganisms most commonly associated with early-onset infection include group B Streptococcus (GBS), Escherichia coli, Haemophilus influenzae, and Listeria monocytogenes.Late-onset sepsis syndrome occurs at 7-90 days of life and is acquired from the caregiving environment
At the conclusion of the study, data of 79 neonates whom proved to have bacterial sepsis -by presence of signs and symptoms and positive blood culture for growth of microorganism- have been collected and analyzed.No statistical significant deference was found in the frequency of sepsis between male (4.98%) and female infants (5.31%) as shown in table(1)
Summary
Neonatal sepsis may be categorized as early or late onset. Eighty-five percent of newborns with early-onset infection present within 24 hours, 5% present at 24-48 hours, and a smaller percentage of patients present between 48 hours and 6 days of life. The infant's skin, respiratory tract, conjunctivae, gastrointestinal tract, and umbilicus may become colonized from the environment, leading to the possibility of late-onset sepsis from invasive microorganisms Vectors for such colonization may include vascular or urinary catheters, other indwelling lines, or contact from caregivers with bacterial colonization (Remington & Klein, 2001).The clinical signs of neonatal sepsis are nonspecific and are associated with characteristics of the causative organism and the body's response to the invasion. These nonspecific clinical signs of early sepsis syndrome are associated with other neonatal diseases, such as respiratory distress syndrome (RDS), metabolic disorders, intracranial hemorrhage, and a traumatic delivery. Given the nonspecific nature of these signs, providing treatment for suspected neonatal sepsis while excluding other disease processes is prudent. (Gibbs & Duff,1991)
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