Epidemiology, etiology and risk factors of culture confirmed, nosocomial late onset neonatal sepsis in Western Mexico

<h2>Abstract</h2><h3>Problem considered</h3> Neonatal sepsis is an urgent global problem, as it is one of the leading causes of neonatal mortality and morbidity worldwide. The objectives of this study are to determine the rate of late onset sepsis (LOS) in a large university hospital in Mexico, to investigate what pathogens are causing LOS and in particular what part of them are not adequately covered by initial empiric treatment, and to objectify risk factors for LOS. <h3>Methods</h3> A retrospective case control study was performed in Hospital Civil de Guadalajara "Dr. Juan I. Menchaca" (HCGJIM) from October 2021 to April 2023. Each episode of culture proven LOS was included as a case. For each case a control was matched based on gestational age ± 7 days and birthweight ± 200 g. <h3>Results</h3> LOS rate was 16.95 per 1000 newborns. 30.4 % of the pathogens causing LOS were not adequately covered by initial empiric treatment. Multivariable analysis revealed that central venous catheters (OR 3.65, 95 %CI 1.60–8.31, p = 0.002), total parenteral nutrition (OR 2.44, 95 %CI 1.32–4.49, p = 0.004), mechanical ventilation (OR 2.34, 95 %CI 1.31–4.20, p = 0.004) and surgery (OR 5.51, 95 %CI 2.60–11.72, p < 0.001) were independently associated with LOS. <h3>Conclusion</h3> This study demonstrates that HCGJIM has a high LOS rate with a large number of bacteria that are not adequately covered by initial empiric treatment. Additionally, this article affirms several risk factors for LOS, highlighting the importance of improvement of neonatal care in order to lower the rate of LOS.