Combating neonatal sepsis: insights and improved outcome interventions for neonatal intensive care unit

Background: Neonatal sepsis (NS) is a severe systemic infection caused by bacteria, viruses, or fungi disrupting the immune systems of newborns. Based on the timing of symptom onset, it is classified into early-onset (EONS) and late-onset (LONS). This study aimed to investigate the incidence, risk factors, and clinical outcomes of NS in a neonatal intensive care unit (NICU). Methods: A cross-sectional descriptive study was conducted from December 2022 to August 2023, involving 121 patients in the NICU and outpatient departments. Data was analyzed using statistical package for the social sciences (SPSS) version 24.0. Results: The neonatal cohort had 62 (51.2%) males and 59 (48.8%) females, with 81 (66.9%) exhibiting EONS. Significantly higher antimicrobial usage (p<0.01), especially penicillin (p<0.01), was noted. MANOVA showed significant associations between sepsis and neonatal factors like gestational age, age, admission type, birth weight, birth asphyxia, and resuscitation at birth (p<0.01). Maternal factors like age, occupation, education, residence, parity, and mode of delivery showed significant associations (p<0.0001), along with place of delivery (p=0.007), UTI (p=0.001), intrapartum fever (p=0.006), premature rupture of membranes (p=0.004), labor duration (p=0.001), bleeding disorders (p=0.006), and diabetes (p=0.006). Conclusions: The study concluded that neonatal and maternal factors significantly contribute to the risk of NS. Appropriate and adequate antenatal screening for early diagnosis and treatment of maternal infection during pregnancy as well as identifying high-risk pregnancy for adequate perinatal management of neonates are recommended to prevent NS-related morbidity and mortality.