To study the incidence and risk factors of early onset neonatal sepsis in an out born neonatal intensive care unit of India

Abstract

Objectives: The objective was to study the Incidence and risk factors of early-onset neonatal sepsis in an out born neonatal intensive care unit (NICU) of New Delhi, India. Study Design and Setting: Prospective descriptive study over a period of 1 year. Patients and Methods: All out born neonates admitted within 72 h of life, with clinical features of sepsis with two or more high-risk factors for sepsis were enrolled and samples for sepsis screen and cultures were taken prior to administration of antibiotics in all cases. Standard data collection form was used to collect all demographic data and clinical characteristics of neonates. Bacterial isolates were identified, and their resistance patterns were analyzed using the Vitek 2 C system. Results : Among the 440 admissions to NICU during the study period, 82 neonates (19%) with early onset sepsis were enrolled. The mean (standard deviation) weight and hours of life at admission were 2016 ± 724.04 g and 23.05 ± 2.89 h, respectively. Incidence of early onset sepsis was 18/1000 patient. Twenty-eight (34%) neonates were home delivered. Low birth weight (68%), prematurity (46%), and poor hygiene/cord care (46%) were common risk factors while lethargy/refusal to feed (77%), hypothermia (47.5%), and respiratory distress (44%) were common clinical presentations. Sepsis screen and blood culture were positive in 57% and 18% (n = 15), respectively. Klebsiella pneumonie (36%), Staphylococcus aureus (21%), and Escherichia coli (14%) were common organisms. Case fatality rate was 14% (12/82). Conclusion: Clinical sepsis along with sepsis screen is a good marker of neonatal sepsis: Incidence of early onset sepsis varies in out born neonates and many factors affect it like place of delivery, perinatal risk factors, and immediate practices done in newborn.