Clinical Profile, Risk Factors, and Short-Term Outcomes of Neonatal Sepsis Among Neonates Admitted to a Tertiary Care Hospital
DOI:
https://doi.org/10.62497/irjcs.243Keywords:
Neonatal sepsis, early-onset sepsis, late-onset sepsis, sepsis, prematurity, low birth weight, neonatal mortality, septic shock, tertiary-care hospitalAbstract
Background
Neonatal sepsis is one of the leading causes of neonatal morbidity and mortality especially among the low birth weight and preterm neonates who need tertiary care.
Objective
To evaluate the clinical profile, maternal and neonatal risk factors, and short-term outcomes of neonatal sepsis among neonates admitted to a tertiary-care hospital.
Methodology
This was a prospective observational study carried out at Pakistan Institute of Medical Sciences (PIMS) Islamabad from March 2024 to February 2025. 300 neonates (≤28 days) who were suspected or confirmed to have neonatal sepsis were consecutively enrolled. All maternal, perinatal, neonatal, clinical, laboratory, microbiological and treatment-related data were obtained in a prospective manner. Assessment of outcomes was performed at hospital discharge, death, referral, or at 28 days of life. The Chi-square test, independent-samples t-test, Mann–Whitney U test, and multivariable logistic regression were used for statistical analysis.
Results
Among 300 neonates, 155 (51.67%) were premature and 159 (53.00%) had low birth weight. Late-onset sepsis occurred in 172 (57.33%) neonates, while early-onset sepsis occurred in 128 (42.67%). Poor feeding was the most common clinical manifestation, affecting 201 (67.00%) neonates, followed by respiratory distress in 184 (61.33%). Elevated CRP was observed in 191 (63.67%), thrombocytopenia in 127 (42.33%), and positive blood cultures in 83 of 276 (30.07%) cultured neonates. Mortality was significantly higher in late-onset than early-onset sepsis (35, 20.35% vs. 12, 9.38%; p=0.013). Among all neonates, 47 (15.67%) died. Prematurity, late-onset sepsis, respiratory distress, apnea, seizures, mechanical ventilation, and septic shock independently predicted mortality.
Conclusion
Late-onset sepsis and severe clinical deterioration were associated with substantially poorer outcomes, highlighting the need for early recognition and timely management of high-risk neonates.
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