PREVALENCE AND CLINICAL PROFILE OF NEONATAL SEPSIS IN A TERTIARY CARE NICU: A CROSS-SECTIONAL ANALYSIS
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Keywords
Neonatal sepsis, tertiary care, clinical profile, mortality, antimicrobial resistance
Abstract
Introduction: Neonatal sepsis remains a leading cause of morbidity and mortality in developing countries. This study aimed to determine the prevalence and clinical profile of neonatal sepsis in a tertiary care neonatal intensive care unit and identify associated risk factors and outcomes.
Methods: A hospital-based cross-sectional study was conducted at People's College of Medical Sciences & Research Centre, Bhopal, from January to June 2012. All neonates aged 0-28 days admitted to the NICU with clinical suspicion of sepsis were included using consecutive sampling. Data were collected using structured proforma including demographic details, clinical presentation, laboratory investigations, and outcomes. Statistical analysis was performed using SPSS version 19.0.
Results: Among 250 neonates studied, males predominated (56.8%) with 53.6% being low birth weight and 50.0% preterm. Late-onset sepsis was more common (60.8%) than early-onset sepsis (39.2%). The most frequent clinical presentations were temperature instability (75.6%), jaundice (79.2%), and feeding intolerance (66.8%). Elevated C-reactive protein was observed in 68.8% cases, while blood culture positivity was achieved in 36.8% cases. Gram-positive organisms predominated (60.9%), with coagulase-negative staphylococci being the most common isolate. The overall mortality rate was 18.0%, with 62.4% requiring hospitalization exceeding seven days.
Conclusion: Neonatal sepsis showed significant burden with male predominance and higher prevalence among preterm and low birth weight neonates. The predominance of late-onset sepsis and nosocomial pathogens emphasizes the need for enhanced infection prevention strategies and antimicrobial stewardship programs in tertiary care settings.
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Dr Dharam Chand Munot
Assistant Professor, Department of Pediatrics, People's College of Medical Sciences & Research Centre, Bhopal