Prospective study to evaluate the risk factors associated with mortality in neonatal septicemia
DOI:
https://doi.org/10.18203/2349-3291.ijcp20173767Keywords:
Blood culture, CRP, Mortality, Neonatal sepsisAbstract
Background: Neonatal sepsis is a clinical syndrome of bacteremia characterized by systemic signs and symptoms of infection in the first month of life. Neonatal sepsis refers to infection occuring within the neonatal period i.e. first 28 days of life for a term baby and up to 4 weeks beyond the expected date of delivery in a preterm baby. Neonatal sepsis is one of the major cause of neonatal morbidity and mortality.
Methods: The present study is a prospective observational study conducted in the neonatal intensive care unit (NICU) of Sri Guru Ram Das Institute of Medical Sciences and Research (SGRDIMSAR), Sri Amritsar over a period of one year from January 2015 to January 2016. Aim of the study is to know the incidence of neonatal sepsis, to study bacteriology of neonatal septicemia and to evaluate the risk factors associated with mortality in neonatal sepsis in our hospital.
Results: During the study period (January 2015 to January 2016), 727 neonates were admitted in NICU of SGRDIMSAR, Sri Amritsar. Out of them, 109 neonates were diagnosed as having septicemia. Incidence of neonatal sepsis in our hospital in this study is 149.9/1000 neonatal admissions. 59 (54.1%) neonates had positive blood culture. Out of 109 septic neonates, 50 died and 59 survived. Mortality observed in the present study is 45.9%.
Conclusions: It is concluded from present study that the main factors associated with neonatal mortality are low birth weight, prematurity, positive blood culture, neutropenia and prolonged prothrombin time. Some of the risk factors like low birth weight and prematurity are preventable by proper antenatal check ups and measures can be taken for safe and hygienic delivery. Babies with risk factors should be monitored closely for early detection of sepsis and the neonates with sepsis having abnormal laboratory parameters should be subjected to appropriate therapeutic intervention in order to decrease the mortality.
Metrics
References
Chacko B, Sohi I. Early onset neonatal sepsis. Indian J Pediatr. 2005;72:23-6.
Gerdes JS, Polin R. Early diagnosis and treatment of neonatal sepsis. Indian J Pediatr. 1998;65:63-78.
Deorari AK. Changing pattern of bacteriologic profile in neonatal sepsis among intramural babies. J Neonatal. 2006;20(1):8-15.
Mathur NB, Khalil A,Sarkar R, Puri RK. Mortality in neonatal septicemia with involvement of mother in management. Indian Pediatr. 1991;28:1259-63.
Polin RA, Parravicini E, Regam JA, Taeusch HW. Bacterial sepsis and meningitis. Avery’s Disease of the New Born. 8th ed. Elsevier;2005:551-73.
Niduvaje K, Amutha C, Roy J. Early neonatal Streptococcal infection. Indian J Pediatr. 2006;73:573-6.
Dunham EC. Septicemia in the newborn. Am J Dis Child. 1993;45:229-34.
Aggarwal R, Sarkar N, Deorari AK, Paul VK. Sepsis in the newborn. Indian J Pediatr. 2001;68:1143-7.
Raghavan M, Mondal GP, Bhat V, Srinivasan S. Perinatal risk factors in neonatal infections. Indian J Pediatr. 1992;50:335-40.
Russel AA. Neonatal sepsis. Pediatr Child Health. 2010;21(6):265-9.
Erickson M. Neonatal septicemia. Acta Pediatr Scand. 1983;72:1-5.
Singh M. Neonatal septicemia. In: Care of the Newborn, 6th Ed. Sagar Publications, New Delhi; 2004:209-16.
Mathur NB, Singh A, Sharma VK, Satyanarayana L. Evaluation of risk factors for fatal neonatal sepsis. Indian Pediatr. 1996;33:817-22.
Sharma PP, Halder D, Dutta AK, Dutta R, Bhatnagar S, Bali A et al. Bacteriological profile of neonatal septicemia. Indian Pediatr. 1987;24:1011-7.
Choudhury VP, Fazel MI, Choudhury M, Ghafary A. Neonatal infections and their outcome in Afghanistan. Indian Pediatr. 1987;24:1019-25.
Khatua SP, Das AK, Chatterjee BD, Khatua S, Ghose B, Saha A. Neonatal septicemia. Indian J Pediatr. 1986;53:509-14.
Malik A, Hasani SE, Khan HH, Ahmad AJ. Nosocomial infections in newborn. Indian Pediatr. 2001;38:68-71.
Tallur SS, Kasturi AV, Nadgir SD, Krishna BV. Clinicobacteriological study of neonatal septicemia in Hubli. Indian J Pediatr. 2000;67:169-74.
Placzek MM, Whitelaw A. Early and late neonatal septicemia. Arch Dis Child. 1983;58:728-31.
Jiang JH, Chiu NC, Huang FY, Kao HA, Hsu CH, Hung HY et al. Neonatal sepsis in the neonatal intensive care unit: Characteristics of early versus late onset. J Microbiol Immunol Infect. 2004;37:301-06.
Bhakoo ON, Agarwal KC, Narang A, Bhattacharjee S. Prognosis and treatment of neonatal septicemia- A clinicobacteriological study of 100 cases. Indian Pediatr. 1974;11:519-28.
Ohlsson A, Bailey T, Takieddine F. Changing etiology and outcome of neonatal septicemia in Riyadh, Saudi Arabia. Acta Pediatr Scand 1986;75:540-9.