A Study on Incidence and Risk Factors of Early Onset Neonatal Sepsis in an Out Born Neonates in a Tertiary Care Centre in Eastern Bihar.

Dr Rakesh Kumar; Dr Brajesh Kumar

Volume : X, Issue : VI, June - 2020

A Study on Incidence and Risk Factors of Early Onset Neonatal Sepsis in an Out Born Neonates in a Tertiary Care Centre in Eastern Bihar.

Dr Rakesh Kumar, Dr Brajesh Kumar

Abstract :

Introduction: Neonatal septicemia is diagnosed when generalized systemic features of sepsis are associated with pure growth of bacteria from one or more sites. It refers to systemic infection of neonates including Septicemia, Pneumonia, Meningitis, Arthritis, Osteomyelitis and UTI. The incidence of neonatal sepsis in India is the highest in the world. Objectives: The objective was to study the Incidence and risk factors of early–onset neonatal sepsis in an out born neonates in a tertiary care centre in Eastern Bihar. Methods: The present study is a prospective descriptive study done over a period of 1 year from May 2019 to April 2020 in department of Pediatrics in Jawahar Lal Nehru Medical College and Hospital, Bhagalpur, Bihar. All out born neonates admitted within 72 hours of life, with clinical features of sepsis with two or more high–risk factors for sepsis were enrolled and samples for sepsis screen and cultures were taken prior to administration of antibiotics in all cases. Standard data collection form was used to collect all demographic data and clinical characteristics of neonates. Bacterial isolates were identified, and their resistance patterns were analyzed using the Vitek 2 C system. Results: In the present study, among the 440 admissions to NICU during the study period, 82 neonates (19%) with early onset sepsis were enrolled. The mean (standard deviation) weight and hours of life at admission were 2016 ± 724.04 g and 23.05 ± 2.89 h, respectively. Incidence of early onset sepsis was 18/1000 patient. 28 (34%) neonates were home delivered. Low birth weight (68%), prematurity (46%), and poor hygiene/cord care (46%) were common risk factors while lethargy/refusal to feed (77%), hypothermia (47.5%), and respiratory distress (44%) were common clinical presentations. Sepsis screen and blood culture were positive in 57% and 18%, respectively. Klebsiella pneumonie (36%), Staphylococcus aureus (21%), and Escherichia coli (14%) were common organisms. Case fatality rate was 14%. Conclusion: Clinical sepsis along with sepsis screen is a good marker of neonatal sepsis: Incidence of early onset sepsis varies in out born neonates and many factors affect it like place of delivery, perinatal risk factors, and immediate practices done in newborn. Evidence regarding its risk factors can guide clinical practice and prevention strategies