Prevalence Of Neonatal Sepsis Research Articles

Prevalence, perinatal outcomes and factors associated with neonatal sepsis in Nigeria.

To examine the prevalence, perinatal outcomes and factors associated with neonatal sepsis in referral-level facilities across Nigeria. Secondary analysis of data from the Maternal and Perinatal Database for Quality, Equity and Dignity Programme in 54 referral-level hospitals across Nigeria. Records covering the period from 1 September 2019 to 31 August 2020. Mothers admitted for birth during the study period, and their live newborns. Analysis of prevalence and sociodemographic and clinical factors associated with neonatal sepsis and perinatal outcomes. Multilevel logistic regression modelling identified factors associated with neonatal sepsis. Neonatal sepsis and perinatal outcomes. The prevalence of neonatal sepsis was 16.3 (95% CI 15.3-17.2) per 1000 live births (1113/68 459) with a 10.3% (115/1113) case fatality rate. Limited education, unemployment or employment in sales/trading/manual jobs, nulliparity/grand multiparity, chronic medical disorder, lack of antenatal care (ANC) or ANC outside the birthing hospital and referral for birth increased the odds of neonatal sepsis. Birthweight of <2500 g, non-spontaneous vaginal birth, preterm birth, prolonged rupture of membranes, APGAR score of <7 at 5 min, birth asphyxia, birth trauma or jaundice were associated with neonatal sepsis. Neonates with sepsis were more frequently admitted to a neonatal intensive care unit (1037/1110, 93.4% vs 8237/67 346, 12.2%) and experienced a higher rate of death (115/1113, 10.3% vs 933/67 343, 1.4%). Neonatal sepsis remains a critical challenge in neonatal care, underscored by its high prevalence and mortality rate. The identification of maternal and neonatal risk factors underscores the importance of improved access to education and employment for women and targeted interventions in antenatal and intrapartum care.

Antimicrobial Resistance among neonates with neonatal Sepsis Morogoro Tanzania

Background: Neonatal sepsis increases neonatal morbidity and mortality in low- and middle-income nations. however, the prevalence of neonatal sepsis, the etiological agents, and antimicrobial resistance patterns have not been documented in areas with the highest neonatal mortality rates in Tanzania.&#x0D; Aim: This study aimed to investigate the prevalence of neonatal sepsis, identify the primary causative agents, and understand their resistance patterns at Morogoro Regional Hospital.&#x0D; Methods: The study involved 252 admitted neonates at Morogoro Regional Hospital and was carried out between March and June 2019. Clinical and demographic information for each neonate was collected using a standardized questionnaire. Blood samples were obtained from all 252 neonates, and 50 swabs were randomly taken from neonates with umbilical pus discharge. The samples were then cultured using aseptic techniques on blood agar, chocolate agar, and MacConkey agar. The identification of the causative agents relied on the characteristics of colony morphology, gram staining, and biochemical tests. Antimicrobial resistance patterns were determined using the disc diffusion method with Muller Hinton agar against Ampiclox, Erythromycin, Gentamycin, Nalidixic acid, Ciprofloxacin, Norfloxacin, Ofloxacin, Kanamycin,Co-trimoxazole, Cephalexin, Ceftriaxone, and Amikacin.&#x0D; Results: The prevalence of neonatal sepsis, as determined through blood culture, was 40 % (102 /252). The predominant bacteria isolated from blood cultures were E. coli 31 %, Staphylococcus aureus 23 %, and Citrobacter spp 16%. Around 50% of the gram-negative bacteria showed resistance to Ceftriaxone, a third-generation cephalosporin. Both gram-negative bacteria and Staphylococcus aureus displayed resistance to Ampiclox.&#x0D; Conclusion: E. coli, Staphylococcus aureus, and Citrobacter spp. were shown to be the most frequent bacteria in neonatal sepsis in Morogoro. Many isolates were Ampiclox-resistant. Neonatal sepsis is common in Morogoro, highlighting the need for innovative neonatal care and preventative techniques.

Sepsis among Neonates Admitted to a Neonatal Intensive Care Unit in a Tertiary Care Centre.

Neonatal sepsis is a condition that carries a high risk for mortality as neonates rapidly transition to extra-uterine life and are subjected to various risk factors. Sepsis prevalence can be reduced by good antenatal care, early detection and treatment of risk factors. The study aimed to find out the prevalence of sepsis among neonates admitted to a neonatal intensive care unit in a tertiary care centre. This is a descriptive cross-sectional study conducted among neonates admitted to the neonatal care unit of a tertiary care centre after obtaining ethical approval from the Institutional Review Committee. Data of patients admitted from 12 December 2022 to 30 June 2023 was collected from hospital records. Symptomatic patients admitted to the neonatal intensive care unit were included and those with incomplete data were excluded from the study. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Among 379 neonates, the prevalence of sepsis was 138 (36.41%) (28.38-44.44, 95% Confidence Interval). A total of 98 (71.01%) had early-onset neonatal sepsis and 40 (28.99%) had late-onset neonatal sepsis. The prevalence of neonatal sepsis was found to be lower than other studies done in similar settings. neonate; neonatal sepsis; prematurity; prevalence.

Determinants and Magnitude of Neonatal Sepsis at Hiwot Fana Comprehensive Specialized University Hospital, in Eastern Ethiopia: A Cross-Sectional Study.

Neonatal sepsis is a serious blood bacterial infection in neonates at the age of equal to or less than 28 days of life, and it's still the major significant cause of death and long-term morbidity in developing countries. This study aimed to assess the prevalence and related factors with neonatal sepsis among newborns admitted to the neonatal intensive care unit at Hiwot Fana Comprehensive Specialized University Hospital, Harar, Ethiopia. An institutional-based retrospective cross-sectional study design was conducted among 386 neonates admitted to Neonatal Intensive Care Unit from September 2017 to August 2019. A systematic random sampling method was used. Data were analyzed using SPSS V.26. Descriptive summary statistics were done. Bivariate regression and multivariate analysis were computed. Variables with P-value <.05 were declared as having a statistically significant association. The prevalence of neonatal sepsis was 53.1%. Among the total neonates who had sepsis, 67.8% had early neonatal sepsis. Among neonatal factors, preterm neonates (AOR: 8.1, 95%CI: 2.1, 31.2), birth asphyxia (AOR: 4.7, 95%CI: 1.6, 13.6); and among maternal factors, urban residence (AOR: 0.26, 95%CI: 0.1, 0.5), antenatal care attendance (AOR: 0.32, 95%CI: 0.2, 0.6), spontaneous vaginal delivery (AOR: 0.047, 95%CI: 0.01, 0.2), and maternal antibiotic use (AOR: 0.39; 95%CI: 0.2, 0.8) were found to have significant association with neonatal sepsis. Overall, the magnitude of neonatal sepsis was high. Provision of neonatal and obstetrics care as per standard during prenatal, intranatal, and postnatal periods is needed. Training of health professionals on infection prevention and safe delivery practice should be provided.

The relationship between platelet to lymphocyte ratio with neonatal sepsis at Wangaya General Hospital

Background: Neonatal sepsis is still a major health problem throughout the world and one of the leading causes of morbidity and mortality in neonates. This disease often goes undetected and causes death. The diagnosis and treatment of neonatal sepsis is still a problem today. According to current research, the platelet-to-lymphocyte ratio (PLR) plays a significant role in the inflammatory process. This study aims to contribute to the research on whether PLR is connected with the incidence of neonatal sepsis and can be used as a biomarker of neonatal sepsis. Methods: This cross-sectional observational analytic study examines the link between platelet-to-lymphocyte ratio and neonatal sepsis. Based on medical records, this investigation's total number of samples was 36 newborns. Results: From June 2022 to June 2023, there were 539 newborns in the hospital. The prevalence of neonatal sepsis was 23 neonates (4,2%) and there were 14 neonates (2,6%) that fulfilled the criteria in this study. Based on the characteristics of PLR, the mean value in neonatal sepsis was found to be 125.71. Bivariate analysis using statistical Chi-square revealed that PLR had a p-value of 0.009, odds ratio of 6.7, and 95% CI of 1.5 - 29.6. Conclusion: There was a correlation between PLR and neonatal sepsis in Wangaya Hospital. Patients with increased PLR were six times the odds of having neonatal sepsis compared to patients with non-increased PLR.

Neonatal Sepsis and Associated Factors Among Preterm Neonates Admitted in Durame General Hospital, Southern Ethiopia: A Quantitative Study

BACKGROUND:Globally, the incidence of neonatal sepsis is estimated to be 2,824 per 100,000 live births, of which 17.6% of neonates have died. The incidence of sepsis was high among premature neonates (10,252 per 100,000 live births). Data on the association between vaginal examinations during labor and neonatal sepsis among preterm neonates in Ethiopia are sparse. This study aimed to assess the prevalence of neonatal sepsis and its associated factors among preterm babies in southern Ethiopia.METHODS:An institution-based cross-sectional study was conducted among 291 preterm neonates from May 1 to August 30, 2021. Data were collected using a pretested structured questionnaire. Data were entered into Epi Data 3.1 and exported into SPSS version 20 for analysis. We summarized participant characteristics using proportions and means. Factors associated with neonatal sepsis were analyzed using binary and multivariable logistic regression with an adjusted odds ratio (AOR) and 95% confidence interval (CI). Ap-value of &lt;.05 was a cutoff point to declare a statistically significant association.RESULTS:Overall, the prevalence of neonatal sepsis was 52.9% (95% CI: 46.2, 54.4) among preterm neonates. Performing vaginal examinations frequently during labor significantly increases the likelihood of developing neonatal sepsis (AOR: 7.45, 95% CI: 3.87, 6.79). In addition, premature rupture of the membranes (AOR: 5.79, 95% CI: 6.769, 10.65) and the 5-minute Apgar of less than 7 (AOR: 1.780, 95% CI: 2.507,6.094) were associated with neonatal sepsis.CONCLUSIONS:In this study, the prevalence of neonatal sepsis was high among preterm babies. Performing vaginal examinations frequently in labor increases the risk of preterm babies developing neonatal sepsis. Limiting the frequency of vaginal examinations during labor and good aseptic technique while performing vaginal examinations are vital to reduce the risk of developing neonatal sepsis.

Magnitude of sepsis and its predictors among neonates admitted to neonatal intensive care unit at Hawassa University comprehensive specialized hospital in Southern Ethiopia 2022

Background: Neonatal sepsis is a leading cause of neonatal death across the globe, which accounted for 15% and 30% of neonatal mortality in low and middle-income countries and developing countries including Ethiopia, respectively. Despite various efforts have been made by the Ethiopian government to prevent neonatal mortality and morbidity, sepsis-related to neonatal mortality is still high. So the objective of this study was to assess the magnitude and affecting factors of neonatal sepsis among neonates admitted to neonate intensive care units in Hawassa University Comprehensive Specialized Hospital, Southern Ethiopia. Methods and materials: Facility based cross-sectional study was conducted from January to February 2022 at Hawassa university comprehensive specialized hospital, Southern Ethiopia. A total of 216 neonate-mother pairs who were admitted to the intensive care unit was included in the study and a systematic random sampling technique was used to select study participant. A structured questionnaire was used to collect data. The data was entered into EPI Data 3.1 version and transported to SPSS version 25 for data analysis. Multi regression analysis was done for predictor variables associated at p-value &lt;0.05 with the dependent variable. Result: A total of 74 (34.3%) neonates were admitted with neonatal sepsis. A surgical procedure is done before sepsis (AOR=2.9, 95% of CI(1.5 to5.6), last pregnancy wanted (AOR=2.8, 95% of CI(1.0 to 7.3), more frequent per-vaginal examination (AOR=2.6, 95% of CI (1.3 to 5.3), educational level unable to read and write(AOR=5.4, 95% of CI(1.0 to 27.7), low birth weight (AOR=5.4, 95% of CI(3.0 to 9.8), and getting care from unskilled health workers(AOR=2.7, 95% of CI(1.5 to 4.9) were significantly associated with neonatal sepsis at multivariable with less than 0.05 p values. Conclusion: This study indicated that the prevalence of neonatal sepsis was still high. Thus, immediate action should be taken before it leads to neonatal mortality and further complications. The study used only physician diagnosis to confirm neonatal sepsis, which may affect its prevalence and needs further investigation.

Prevalence and presentation of neonatal sepsis at a paediatric emergency department in Johannesburg, South Africa.

BackgroundDespite a significant reduction in the prevalence of neonatal sepsis over the past three decades, the prevalence still remains high, especially in low- and middle-income countries. The aim of this study was to determine the prevalence and presenting features of neonatal sepsis at a paediatric emergency centre (PEC).MethodsMedical records of all neonates presenting to an academic hospital PEC over a six-month period were analysed. Data was compared between neonates with and without sepsis. The odds ratio was calculated to determine factors associated with neonatal sepsis.ResultsOf the 210 neonates who were included, 43 (20.5%) were diagnosed with neonatal sepsis. Of these, 19 (44.2%) presented within the first 72 hours of life (early-onset neonatal sepsis) and 4 (9.3%) died prior to hospital discharge. A history of maternal employment (odds ratio (OR) 2.38, p=0.021), preterm birth (OR 3.24, p=0.019), low birth weight (<2.5kg) (OR 2.67, p=0.026), perinatal human immunodeficiency virus exposure (OR 3.35, p=0.002), not being breast fed (OR 4.36, p=0.001), and signs of lethargy (OR 14.01, p<0.001), dehydration (or 11.14, p<0.001), poor feeding (OR 7.20, p<0.001), irritability (OR 6.93, p<0.001), fever (OR 5.50, p<0.001), vomiting (OR 4.14, p<0.001) and respiratory distress (OR 4.12, p<0.001) were significantly associated with neonatal sepsis.ConclusionAmong neonates presenting to the PEC, various clinical features on history and examination may be useful in predicting the diagnosis of neonatal sepsis. Clinicians working in the PEC must adopt a high index of suspicion when attending to neonates presenting with these features.

Neonatal Sepsis and Associated Factors Among Newborns in Woldia and Dessie Comprehensive Specialized Hospitals, North-East Ethiopia, 2021.

IntroductionNeonatal sepsis is a clinical illness characterized by infection-related signs and symptoms in the first month of life, with or without bacteremia. Septicemia, meningitis, pneumonia, arthritis, osteomyelitis, and urinary tract infections are all examples of systemic illnesses that can affect newborns. Hence, the main aim of this study was to assess the prevalence and factors associated with neonatal sepsis among newborns in Woldia and Dessie Comprehensive Specialized Hospitals, northeast Ethiopia, from January 1 to July 30, 2021.MethodsThis institution-based cross-sectional study was conducted from January 1 to July 30, 2021, on 344 randomly selected neonates who visited the hospital. A systematic random sampling technique was used to select samples, and data were collected using a pre-tested standardized questionnaire. For data entry and analysis, Epi Data version 4.1 and SPSS version 24 applications were used, respectively. The goodness-of-fit was tested by the Hosmer–Lemeshow statistic test. Bivariable and multivariable binary logistic regressions were used to identify associated factors at a 95% confidence interval. Significance was considered at p-value <0.05.ResultsIn this study, the prevalence of neonatal sepsis was 79.4% (95% CI: 75.2–83.6%). Maternal UTI/STI history [AOR: 3.1; 95% CI (1.5–7.1)], gestational age <37 weeks [AOR: 4.4; 95% CI (1.0–8.9)], PROM [AOR: 4.9; 95% CI (2.5–6.8)], and new-born resuscitation history [AOR: 2.3; 95% CI (1.5–4.3)] were all significantly associated with neonatal sepsis.ConclusionThis study indicates that the proportion of neonatal sepsis is high. A history of maternal PROM, being a preterm neonate, a history of maternal UTI/STIs, and having received resuscitation at birth were identified as risk factors for neonatal sepsis.

Neonatal Sepsis and Associated Factor among Neonate Admitted in Nicu at Hiwot Fana Specialized University Hospital Harar Town, Eastern, Ethiopia 2020

Background:Neonatal sepsis is a condition defined as a clinical syndrome characterized by signs and symptoms of infection in an infant 28 days of life or younger. Neonatal sepsis is one of the major causes of neonatal morbidity and mortality especially in developing countries. Socio-demographic, maternal, neonatal and medical factors were associated with risk of infection. The clinical signs and symptoms of neonatal Sepsis are nonspecific and the confirmation of diagnosis is challenging and time consuming. Therefore, the diagnostic approach should be depends up on consideration of risk factors. Objective: This study aimed to assess the prevalence and factors associated with neonatal sepsis among neonates admitted to neonatal intensive care unit at Hiwot Fana Specialize Hospital Harar, Ethiopia 2020. Methods: Retrospective cross sectional registered data based study was conducted from February 7- February 25/2020 G.C. A total of 292 neonates cards was selected systematically from neonates admitted to Hiwot Fana specialize hospital at NICU. Data was collected using data extraction tool and checked for completeness and consistency then entered in to SPSS windows version 20.0 for analysis. Bivariate logistic and multivariate regression analysis was used to check existence of association of each independent variable with the outcome variable and Variables significant in bi-variate analysis (P&lt; 0.25) was entered to a multivariate logistic regression model and statistical significance was declared at P &lt; 0.05. Odds ratios along with 95% Confidence interval were used to measure strength and to assess the presence of statistically significant association between independent variables and outcome variable. Result: The prevalence of Neonatal Sepsis was 52.7%. From these 92.2% and 7.8% 0f Neonates developed Early and Late Neonatal sepsis respectively. Among them 59.7% were males. The study found that, Rural residence, delivery place, Meconium stained amniotic fluid, ANC follow up, Gestational age, birth asphyxia and 5th minute APGAR score &lt;7 were significantly associated with neonatal sepsis. Conclusion: The prevalence of neonatal sepsis was 52.7%. Rural residence, Hospital delivery, Meconium-stained Amniotic Fluid, ANC follow up, Gestational Age &lt;37 weeks, birth asphyxia and 5th minute APGAR score &lt;7 were found to statistically significant with Neonatal sepsis.

Neonatal Sepsis and Associated Factors Among Neonates Admitted to Neonatal Intensive Care Unit in General Hospitals, Eastern Ethiopia 2020.

Introduction:Globally, the major cause of neonatal mortality and morbidity is neonatal sepsis, which is defined as a clinical course marked by systemic inflammation in the presence of infection in a newborn. There are limited data concerning neonatal sepsis in eastern Ethiopia. As a result, this study aimed to determine the prevalence of neonatal sepsis and associated factors among neonates admitted to intensive care units at general hospitals in Eastern Ethiopia.Methods:A hospital-based cross-sectional study with retrospective document review was conducted among newborns hospitalized in neonatal intensive care units. Using simple random sampling, the charts of 356 newborns who were hospitalized between January and December 2019 were included, and data were collected using a pretested checklist. Data were entered into Epi data version 3.1 and analyzed with SPSS version 22.Results:The overall prevalence of neonatal sepsis was 45.8% (95% CI 40.7, 51.4). Prolonged rupture of the membrane (AOR = 2.38, 95% CI: [1.27-4.45]), vaginal delivery (AOR = 1.78, 95%, CI: [1.09, 2.96]) APGAR score <7 (AOR = 4.55, 95% CI: [2.49-8.29]), prelacteal feeding (AOR = 3.54, 95% CI: [1.68-8.23]), and mechanical ventilation (AOR = 4.97,95%CI: [2.78-8.89]) were predictors associated with neonatal sepsis.Conclusion:In this study, the prevalence of neonatal sepsis was high, and factors associated with neonatal sepsis included prolonged rupture of membrane, mode of delivery, low APGAR score, prelacteal feeding and mechanical ventilation. As a result, maternal and neonatal care should be enhanced to lower the risk of neonatal sepsis.

Detection of Extended Spectrum β-Lactamases (ESBL) Producing Bacteria in Sepsis Suspected Neonates

Introduction: Neonatal sepsis is a clinical syndrome that is caused when the bloodstream of an infant is invaded by bacteria in the first month after birth. Objective: The objective of the study was to identify bacteria involved in the infection and to determine “extended-spectrum beta-lactamase” (ESBL) producing bacteria from blood samples of sepsis suspected neonates in the Neonatal Intensive Care Unit and Special Care Baby Unit. Methods: This cross-sectional study was conducted from January to July 2019 at Microbiology laboratory of Paropakar Maternity and Women’s Hospital. A total of 380 venous blood specimens were included in the study. The blood culture was performed and organisms were identified with standard microbiological methods. The Antibiotic susceptibility test was performed using the modified Kirby Bauer disk diffusion method. Screening of the organisms was done using cefotaxime and ceftazidime antibiotic disc and confirmation of ESBL was done by combined disk test. The data were considered statistically significant if the p-value was &lt; 0.05. Results: Out of a total of 380 blood specimens, the prevalence of neonatal sepsis was found to be 21.05% among which 57.5% were EOS type and 42.5% were LOS type. In EOS, E. coli (72.73%) was the predominant isolate while CoNS (100%) was the predominant isolate in LOS. Of the total 80 isolates, 65% isolates were found multidrug-resistant (MDR) whereas 58.75% of isolates were found to be ESBL producers. Conclusions: This study concludes that routine bacterial surveillance and study of their resistance patterns is an essential component of the neonatal care unit. Keywords: Extended-spectrum β-Lactamases; neonates; neonate intensive care unit; special care baby unit; sepsis.

Assessement of neonatal sepsis and associated factors among neonates admited neonatal intensive care unit in selected public hospitals in Somali Region, Ethiopia

Objectives: To assess neonatal sepsis and associated factors among neonates admitted neonatal intensive care unit in selected public hospitals in Somali region, Ethiopia. Methods: Institution based cross sectional study design was conducted in selected public hospitals. Data was collected using structured questionnaire adopted from other literature, entered into Epi-data version 3.1 and then was exported to SPSS version 23 for analysis. Frequency was used for descriptive analysis. Bivariate analysis was used to determine the association between different risk factors and the outcome variable. Those variables which have significant association at 5% significance level and fulfilling the minimum requirement of 0.2 level of significance with neonatal sepsis was entered for further analysis to multivariate analysis, significance was taken at α = &amp;lt; 0.05. Results: The overall prevalence of this study was 42.9% CI = (38.4-47.8) and associated factors was age of the neonate AOR = 0.085 (CI = 0.01, 0.73), Residence shown AOR = 2.567 (CI = 1.01, 6.5) Gestational age AOR = 1.869 (CI = 1.05, 3.31), Meconium stained Amniotic fluid AOR = 2.718 (CI = 1.89, 6.74), Antenatal care AOR = 8.933 (CI = 4.9, 15.9), and Mechanical ventilation after birth OR = 3.376 (CI = 1.65, 6.88). Conclusions: The present study found that the overall prevalence of neonatal sepsis in selected hospitals was 42.9%. The study identified, Age of the neonate, Residence, Gestational age, Meconium stained amniotic fluid. Antenatal care, Mechanical ventilation after birth. The findings underscore the importance of routine assessment and close monitoring of neonates. It is therefore recommended to have more skilled health personnel and advanced equipment while providing maternal and new-born health care services.

Neonatal outcomes and risk of neonatal sepsis in an expectantly managed cohort of late preterm prelabor rupture of membranes

ObjectiveExpectant management in patients with prelabor preterm rupture of membranes between between 340/7 and 36 6/7 weeks (late preterm pPROM or LpPROM) has been shown to decrease the burden of prematurity, when compared to immediate delivery. As the severity of prematurity depends on gestational age (GA) at PROM, and PROM to delivery interval, we first investigated how such variables affect neonatal outcomes (NO). Second, we assessed the risk of neonatal sepsis. Study designretrospective cohort study on neonatal morbidity among singleton infants born to expectantly managed mothers with LpPROM in five hospitals affiliated with three Italian academic institutions. The primary NO was a composite of neonatal death, non-invasive (cPAP) or invasive (mechanical ventilation) respiratory support, hypoglycemia (< 44 mg/dl needing therapy), newborn sepsis, confirmed seizures, stroke, intraventricular hemorrhage (IVH), basal nuclei anomalies, cardiopulmonary resuscitation, umbilical-cord-blood arterial pH < 7.0 or base excess < -12.5, and prolonged hospitalization (≥ 5 days). Univariate analysis described differences in the population according to GA at delivery. Multivariate logistic regression was then used to investigate the effects of GA at PROM, and PROM to delivery interval on the NO. Results258/606 (42.6 %) women with LpPROM were expectantly managed, as they did not deliver within the first 24 h. The median latency duration was 2 (95 %CI 1−3) days, having no effect on neonatal morbidity on multivariate analysis. Multivariate analysis also showed increased risks of adverse NO among PROM at 34 (OR 2.3 95 %CI 1.03−5.1) but not at 35 weeks when compared to 36 weeks, and among women receiving antenatal corticosteroids (OR 3.6 95 %CI 1.3−9.7), while antibiotic treatment showed a non-significant protective effect (OR 0.2 95 %CI 0.04−1.02). Prevalence of neonatal sepsis was 0.8 % (2/258) ConclusionExpectant management of LpPROM should be encouraged especially between 34+0 and 34+6 weeks’, when the burden of prematurity is the greatest. Antibiotics may have beneficial effects, while careful consideration should be given to antenatal corticosteroids until future studies specifically address LpPROM.

Prevalence and Associated Risk Factors of Sepsis among Neonates Admitted into Neonatal Intensive Care Units of Public Hospitals in Dhaka.

Objective: To determine the prevalence and associated risk factors of sepsis among neonates admitted into neonatal intensive care units (NICU) of public hospitals in Dhaka.Methods: This was a cross-sectional study conducted among 173 neonates admitted into the NICUs of Dhaka Medical College Hospital (DMCH) and Dhaka Shishu (Children) Hospital from March 1, 2016 to September 30, 2016 at Dhaka, Bangladesh. On the basis of the presence of clinical signs and symptoms of sepsis, neonates were admitted into the NICUs. The weight of the baby was measured and blood culture, complete blood count (CBC), C-reactive protein (CRP) and urine R/M/E were done at the time of admission. The neonates, who had positive blood culture reports, were confirmed as having sepsis. After receiving informed written consent, maternal data were collected from the mother of the neonate and neonatal data were collected from NICUs.Results: The prevalence of sepsis among the neonates admitted into NICU of the concerned public hospitals in Dhaka was 69.35%. In the multiple logistic regression model, perinatal asphyxia (adjusted odds ratio (aOR) = 3.37, 95% confidence interval (CI) = 1.27-8.90), presence of infection at umbilical cord (aOR = 3.32, 95% CI = 1.40-7.85), history of bottle feeding of the neonates (aOR = 3.02, 95% CI = 1.11-8.25) and pre-existing maternal infection (aOR = 4.44, 95% CI = 1.92-10.26) were significantly (p-value < 0.05) associated with neonatal sepsis. The odds of developing sepsis among the neonates with ≤ 2.5 kg weight at admission was more than three times higher (aOR 3.82, 95% CI = 1.59-9.19) than neonates with admission weight > 2.5 kg.Conclusion: Like other South Asian countries, the prevalence of neonatal sepsis is alarming in Bangladesh. Further research should be conducted to measure the burden of infections in the entire neonatal period and observe the effects of biological risk factors on the early and late-onset neonatal sepsis.

Presepsin as a New Marker for Early Detection Neonatal Sepsis in Al-Quwayiyah General Hospital Riyadh, KSA

Background: Early detection and start of antibiotic therapy neonatal sepsis (N.S) dramatically improves outcomes, so it is important to perform fast, reliable and specific early laboratory biomarkers.&#x0D; Aim: This study aimed to detect the prevelance, the risk factors, hematology profile, microbial profile of neonatal sepsis patients and also investigate the value of PCT and CRP, in comparison to presepsin in establishing the early diagnosis of neonatal sepsis.&#x0D; Methods: A cross sectional study was performed from March to September 2019 in Al Quwayiyah General hospital involving 120 neonates who were classified into 3 groups. The patients groups were: Proved N.S, suspected N.S and control healthy neonates, classified depending on Tollner score. Haematology profile and blood culture for each neonate were done. CRP, PCT and presepsin values were analyzed, compared, and their effectiveness as diagnostic markers was determined. Sensitivity, specificity, positive, and negative predictive values of the markers were calculated. Results: The prevelance of neonatal sepsis was 20.8%. 75 neonates were males and 45 neonates were females. 74 neonates were preterm, while 46 were full term. Gestational age in weeks was 31.1±5.9w for neonates with proved sepsis, 32.4±6.7w for neonates with suspected sepsis and 36.4±4.4w for control group. The mean birth weight was 1740±105.3 g for neonates with proved sepsis, 32.4±6.7 g for neonates with suspected sepsis, 2.650±205.2 g for control group. 36 babies suffered from respiratory distress syndrome, 10 had jaundice, 8 had cough, 28 had fever and 8 complained of other symptoms. Blood cultures were positive for all patients of proved sepsis. The identified bacteria included Gram positive bacteria 22(55%) which were Coagulase negative staph. 13(32.5%) followed by Staphylococcus aureus 4(10%) while Gram negative bacteria 15(37.5%) which were E. coli 5(12.5%) followed by Klebsiella peumoniae and also fungal infection (Candida species) detected in 3(7.5%) cases. There was significant difference between the mean and standared deviation of CRP, PCT and presepsin levels in proved and suspected N.S. groups when compared with healthy controls (P&lt; 0.05). CRP sensitivity and specificity (72%, 61% respectively) which were less useful in diagnosis of neonatal sepsis compared to presepsin which has the highest sensitivity and specificity (95%, 81% respectively) followed by procalcitonin with sensitivity and specificity (90%, 69% respectively).&#x0D; Conclusion: The prevalence of neonatal sepsis among all admitted neonates in Al-Quwayiyah general hospital was 20.8%. Our results also detected higher sensitivity, specificity and positive and negative predictive values for presepsin more than and PCT CRP in the diagnosis of NS.

Prevalence of neonatal sepsis and associated factors amongst neonates admitted in arbaminch general hospital, arbaminch, southern Ethiopia, 2019

Background: There are an estimated 2.9 million deaths worldwide from sepsis every year (44% of them in children under 5 years of age) and one quarter of these are due to neonatal sepsis. According to global burden of neonatal sepsis about 6.9 million neonates were diagnosed with possible serious bacterial infection needing treatment from these 2.9 million cases of neonates needing treatment occur in sub-Saharan Africa. Method: An institution based cross sectional study with retrospective document review was conducted among neonates admitted to neonatal intensive care unit from December 2017 to December 2018 in arbaminch general hospital. Sample size was calculated by using single population proportion sample formula with a final sample size of 351. Data were collected a checklist. Using SPSS version 21 Binary and multiple logistic regressions have been used to observe the association between independent variables and dependent variable. Result: The magnitude of neonatal sepsis was 78.3%. APGAR&lt;6,PROM&gt; 18 hours and duration of labour&gt;12 hours were positively associated with neonatal sepsis where as gestational age &gt; 37 weeks and birth weight &gt;2500 grams were protective factors as evidenced by statistical result of 2.33(0.205-0.33), 1.32(0.71-0.84), 1.20(0.70-0.95), 0.85(0.34-0.815) and 0.12(0.04-030) respectively. Conclusion and recommendation: The finding of this study shows that neonatal sepsis accounts the highest proportion cases amongst neonates admitted in the hospital. Gestational age, birth weight, APGAR score, PROM and duration of labour were found to be determinants of neonatal sepsis. Therefore, service utilization of mothers, early detection of risky situations and appropriate practice of newborn care can halt the problem.

Prevalence and Predictors of Neonatal Sepsis among Neonates Admitted at the Newborn Unit of Kenyatta National Hospital, Nairobi, Kenya

Background: Neonatal sepsis is one of the primary causes of neonatal morbidity and mortality especially in developing countries. Despite the availability of different preventive interventions, in Kenya, the burden of neonatal sepsis remains critically high. Aim: To determine the prevalence and predictors of neonatal sepsis among newborns admitted at the newborn unit of Kenyatta National Hospital, Kenya. Methods: This is a hospital-based, cross-sectional study design carried out among 196 neonates and their mothers at the new born unit of Kenyatta National Hospital. A systematic random sampling technique was employed to select the study subjects. Data on the possible contributing factors of neonatal sepsis was collected using a semi-structured questionnaire. Statistical analyses were performed using the statistical package for the Social Sciences (SPSS: version 22). Data were descriptively analyzed into frequencies and proportions. The chi-square test of independence and binary logistic regression were employed to determine associations between the dependent (neonatal sepsis) and various independents variables. A multiple logistic regression model was carried out to determine the variables independently contributed to the occurrence of neonatal sepsis. Results: Our study revealed that the prevalence of neonatal sepsis was 28.6%. Neonates born of single mothers (AOR = 5.454, p = 0.012), mothers with history of UTI (AOR = 2.969, p = 0.013), PROM (AOR = 6.124, p = 0.001) and anaemia (AOR = 3.379, p = 0.010) were at higher risk to develop neonatal sepsis. Prematurity (AOR = 6.402, p th minutes (AOR = 8.212, p Conclusion and Recommendations: The prevalence of neonatal sepsis in Kenyatta National Hospital is high. This is another piece of evidence showing both maternal and neonatal-related factor had a significant effect on the risk of neonatal sepsis. Provision of community-based health education is highly recommended to increase awareness of women on the risk factors of neonatal sepsis and their preventive methods such as anaemia and UTI during pregnancy. Healthcare providers should exercise a high standard of care when handling premature and babies with low Apgar score to reduce the risks of neonatal sepsis.

Prevalence and Factors Associated with Neonatal Sepsis in a Tertiary Hospital, North West Nigeria.

Context:Neonatal sepsis is an important cause of morbidity and mortality of newborns, especially in developing countries.Aims:Our study determined the prevalence of neonatal sepsis and its predisposing factors among neonates admitted in Ahmadu Bello University Teaching Hospital (ABUTH).Settings and Design:This was a cross-sectional descriptive study conducted in ABUTH.Subjects and Methods:The data were abstracted from the case notes of neonates admitted from May 2017 to May 2018. A pretested pro forma was used to abstract the data.Statistical Analysis Used:Odds ratios and multivariate logistic regression were used to determine the factors associated with neonatal sepsis among the study population.Results:The prevalence of neonatal sepsis was 37.6%. Escherichia coli was the most commonly isolated organism. Neonates 0–7 days of age were 2.8 times less likely to develop neonatal sepsis than older neonates. Babies born with an Apgar score of <6 within the 1st min were 2.4 times more likely to develop neonatal sepsis than those whose Apgar score was higher. Neonates of mothers who had urinary tract infection during pregnancy were 2.3 times more likely to have had sepsis and those whose mothers had premature rupture of membranes were 4.6 times more likely.Conclusions:The prevalence of neonatal sepsis was high among the neonates studied. Neonatal and maternal factors were associated with sepsis in the neonates. These findings provide guidelines for the selection of empirical antimicrobial agents in the study site and suggest that a continued periodic evaluation is needed to anticipate the development of neonatal sepsis among neonates admitted.

Sepse tardia em Unidade de Tratamento Intensivo Neonatal

Justificativa e Objetivos: É essencial conhecer os microrganismos presentes em hemoculturas de pacientes pediátricos internados para uma melhor escolha da terapêutica antibiótica. Dessa forma, este trabalho tem como objetivo verificar a associação entre parâmetros clínicos e epidemiológicos com o desenvolvimento de sepse neonatal tardia em pacientes internados em um serviço de pediatria de um hospital do sul do Brasil. Métodos: Estudo transversal, descritivo, retrospectivo e qualiquantitativo que utilizou dados secundários oriundos dos prontuários de pacientes que apresentaram critérios clínicos para sepse neonatal, internados na Unidade de Tratamento Intensivo Neonatal (UTIN) do Hospital Santa Cruz. Resultados: Dos 588 pacientes internados na UTIN do Hospital Santa Cruz no período de 01/01/2013 a 31/12/2015, 123 recém-nascidos (RNs) preencheram os critérios para sepse neonatal tardia. Destes, 59 (47,97%) apresentaram hemocultura positiva, o que foi mais frequente em RNs prematuros (39,84%) e de baixo peso (43,90%), embora não tenha havido associação estatisticamente significativa entre estes fatores e hemocultura positiva. Dentre os possíveis fatores de risco para o desenvolvimento de sepse neonatal, o uso de ventilação mecânica (p=0,005), realização de cirurgia (p=0,019) e permanência no hospital por mais de um mês (p=0,001) apresentaram associação estatística com hemocultura positiva. Os microrganismos presentes em maior frequência nas hemoculturas foram os estafilococos coagulase negativa (S. epidermidis, S. saprophyticus e S. haemolyticus), encontrados em 35,71% das hemoculturas analisadas. Conclusão: O estudo evidenciou maior prevalência de sepse neonatal tardia em RNs prematuros e de baixo peso, que necessitaram de maiores cuidados e foram submetidos a maior manipulação durante a permanência na UTIN. Procedimentos invasivos e longa permanência hospitalar se associaram significativamente com hemocultura positiva, corroborando com o descrito na literatura.