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


  • N. Muthukumaran Department of Neonatology, Madurai Medical College, Madurai, Tamil Nadu, India



Antimicrobial resistance, Multidrug resistance, Neonatal sepsis


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.


Soin Report Final Cover - SOIN_PRINTED 14-9-2014.pdf. Available at Accessed on 2017 Apr 20. Dec 29, 2017/ Vital Statistics / Sample Registration System (SRS) Bulletins. Sample Registration System (SRS) Bulletins. September 2017 (NEW)

Investigators of the Delhi Neonatal Infection Study (DeNIS) Collaboration. Characterisation and antimicrobial resistance of sepsis pathogens in neonates born in tertiary care centres in Delhi, India: A cohort study. Lancet Glob Health. 2016;4(10):e752-60.

Liu L, Johnson HL, Cousens S, Perin J, Scott S, Lawn JE, et al. Global, regional, and national causes of child mortality: An updated systematic analysis for 2010 with time trends since 2000. Lancet. 2012;379:2151-61.

Mmbaga BT, Lie RT, Olomi R, Mahande MJ, Kvåle G, Daltveit AK. Causespecific neonatal mortality in a neonatal care unit in Northern Tanzania: A registry based cohort study. BMC Pediatr. 2012;12:116.

Million Death Study Collaborators. Causes of neonatal and child mortality in India: Nationally representative mortality survey. Lancet. 2010;376(9755):1853-60.

Available at oa13_-_2016.pdf. Accessed on 2017 Apr 29.

Microsoft Word - Nnpd report for pdf.doc - nnpd_report_2002-03.PDF. Available at PDF. Accessed on 2017 Apr 29.

Darmstadt GL, Bhutta ZA, Cousens S, Adam T, Walker N, de Bernis L. Lancet Neonatal Survival Steering Team. Evidence-based, costeffective interventions: How many newborn babies can we save? Lancet. 2005;365(9463):977-88.

Jeschke E, Biermann A, Günster C, Böhler T, Heller G, Hummler HD, et al. Mortality and major morbidity of very-low-birth-weight infants in Germany 2008-2012: A report based on administrative data. Front Pediatr. 2016;4:23.

Neonatal Sepsis in a Tertiary Care Hospital in South India: Bacteriological Profile and Antibiotic Sensitivity Pattern Springer Link. Available at [Last cited on 2017 May 17].

M39-A4: Analysis and Presentation of Cumulative Antimicrobial Susceptibility Test Data; Approved Guideline-Fourth Edition - M39A4_ sample.pdf. Available at M39A4_sample.pdf. Accessed on 2017 Apr 29.






Original Research Articles