Neonatal Sepsis: Evaluation the Risk Factors, Pathogenic Agents and OutcomeAuthor(s): Mohammed Mahdi khadim, Methaq Ibrahim Abed* and Nehad Kadhim Hashim
Objective: To determine prospectively the etiology, risk factor and outcome of neonatal sepsis.
Patients and methods: Prospective case study. Six hundred neonates were admitted to neonatal unit of children central hospital (Baghdad) between first of December 2018 to first of December 2019. Neonates with clinical findings reveal of sepsis like feeding intolerance; apnea; cyanotic spells or suggestive perinatal history of infection was included in this study. Neonatal sepsis was suspected in 214 neonates based on clinical finding; 120 neonates with sign and symptoms of sepsis were included in the research (after accepting those previous antibiotics treatment or severe asphyxia). Blood culture was done to determine pathogenic agents.
Result: The causative agent was identified by blood culture in 23 cases (19.1%) of the neonates. Early onset of neonatal sepsis (from 0-7 days age) forms (39.16%) while late onset sepsis (from 8-30 days age) forms (60.83%) our study shows there is association between ,prolonged rupture amniotic membrane(>18 hr.) before delivery (63.2%). Maternal fever prior to delivery (78%) and increased risk of development of neonatal sepsis (60%) of studied neonates were male (NO.72): (40%) were female (NO.48): (61.6%) were preterm (NO.74) and (38.3%) were term (NO.46). Gram negative bacteria were the predominant isolated both in early onset disease (66.6%) and late onset (33.3%). Gram-positive it forms (54.5%) of early and (45.4%) of late onset disease. overall mortality rate was 24/120 (20%), (54%) in early onset disease and (25%) in late onset disease of positive blood culture.
Conclusion: Gram negative bacteria (E. coli. Klebsiella) were the major bacterial agents of early oncent sepsis, may be due to large number of preterm deliveries and gram positive bacteria in the late onset disease (Staph aureus).