TRENDS IN NEONATAL SEPSIS: INCIDENCE, CAUSATIVE ORGANISMS, AND ANTIBIOTICS SUSCEPTIBILITY IN NEONATOLOGY DEPARTMENT OF SERVICES HOSPITAL, LAHORE.

Background: Neonatal sepsis remains a critical contributor to neonatal morbidity and mortality in low-resource countries, particularly Pakistan. Despite advances in perinatal care, early diagnosis and appropriate antimicrobial management remain challenging due to changing microbial patterns and resistance. Understanding local prevalence, causative organisms, and resistance trends is essential for guiding empirical therapy and improving neonatal outcomes in hospital-based settings. Objective: To assess the prevalence, bacterial etiology, and antibiotic susceptibility patterns of culture-confirmed neonatal sepsis in a tertiary care hospital in Lahore, Pakistan. Methods: A retrospective cohort study was conducted over a 12-month period (January to December 2024) at the Neonatology Department of Services Hospital, Lahore. The study included 307 neonates aged ≤28 days who presented with clinical signs of sepsis and had positive culture results from sterile sites. Data were extracted from hospital records, including maternal, perinatal, and laboratory parameters. Statistical analysis was performed using SPSS version 27.0, with Pearson correlation, chi-square tests, and binary logistic regression applied to identify associations and predictors. Results: Out of 307 neonates, 200 (65.1%) were male, and 159 (51.8%) were born preterm. Cesarean section deliveries accounted for 188 (61.2%) cases, and 230 (74.9%) mothers had received antenatal antibiotics. A total of 185 (60.3%) neonates required resuscitation. The most commonly isolated pathogen was Pseudomonas species in 142 (46.25%) cases, followed by Klebsiella (26.38%) and Burkholderia (11.07%). Significant correlations were observed for abnormal CTG (r = -0.737), positive swab cultures (r = 0.666), and need for resuscitation (r = 0.713). Logistic regression identified antenatal antibiotic exposure, preterm status, congenital anomalies, and birth-related complications as significant predictors of sepsis (p < 0.001). Conclusion: Pseudomonas emerged as the leading cause of neonatal sepsis in this tertiary care setting. High rates among preterm infants, those with deformities, and neonates requiring resuscitation underscore the need for early identification, targeted screening, and locally guided antibiotic policies to improve survival outcomes.