Study of etiology and risk factors of neonatal sepsis in a tertiary care hospital in North Karnataka

Neonatal sepsis (NS) accounts for around 23% of annual neonatal deaths in India. The aetiopathogenesis of early neonatal sepsis (ENS) and late neonatal sepsis (LNS) vary. This study intends to analyse the associated risk factors associated with NS, bacteria causes, their antibiotic susceptibility patterns, and treatment outcome. In this hospital-based prospective observational study, 102 consecutive cases of NS admitted to NICU were included. Blood samples were cultured in BacT/Alert and bacterial isolates were further processed in Vitek2. Details of potential risk factors were collected using a checklist, and the participants were followed up till recovery/transfer/death. Data was analysed by calculating the proportions, percentages and chi square test. Participants included 86 ENS and 16 LNS cases. Majority of the ENS (62%) and nearly half of the LNS (55%) cases were born premature. Majority of the ENS (67%) and nearly half of the LNS (47%) cases had low birthweight. Meconium-stained liquor (19%) and premature rupture of membranes (14%) were the commonest perinatal risk factors associated with ENS. Other risk factors noted in NS were poor APGAR score, perinatal asphyxia, intravenous fluid administration (98%) and central venous catheter (22%). The culture positivity among NS cases was 22%. Staphylococcus spp. was the commonest bacterial pathogen isolated from neonatal sepsis cases, both among ENS and LNS, most of them being methicillin resistant. Klebsiella pneumoniae was the commonest GNB isolated. Common risk factors associated with neonatal sepsis in general were prematurity and low birth weight. Meconium-stained liquor, and premature rupture of membranes were seen more commonly in ENS. In this hospital, though NS is predominantly caused by MDR bacteria, the treatment outcome is good.