Incidence, Pathogen Distribution, and Hematological Responses in Neonatal Sepsis: A Three-Year Retrospective Study in the UAE

Objective: This study aimed to evaluate the incidence of neonatal sepsis per 1,000 live births, identify the prevalence of causative pathogens, and examine hematological differences between Gram-negative and Gram-positive neonatal sepsis. Methods: A retrospective study was conducted from January 1, 2021, to December 31, 2023, at Al Qassimi Women’s and Children’s Hospital (AQWCH), UAE. Neonates admitted to the NICU with positive blood cultures were included and categorized as early-onset (EONS) or late-onset (LONS) sepsis. Incidence rates (IRs) were calculated per 1,000 live births with 95% confidence intervals (CIs). Univariate logistic regression was initially performed to identify potential factors associated with Gram-negative versus Gram-positive sepsis. Variables with p < 0.20 were included in a multivariate logistic regression model to determine independent predictors. Statistical analyses were conducted using R (v4.5.0), with significance defined as p < 0.05. Results: A total of 145 cases of neonatal sepsis were analyzed, including 138 bacterial and 7 Candida isolates. The overall IR was 11.7 per 1,000 live births (95% CI: 9.8–13.6), with preterm infants showing a higher rate of 8.5 compared to 3.1 in full-term infants. LONS accounted for 8.8 per 1,000 live births, higher than 2.9 for EONS. Coagulase-negative staphylococci (CoNS) were the most common pathogens, accounting for the 50.8% (70/138) of bacterial isolates, predominating in both LONS (58.8%) and EONS (27.8%). Low WBC count (<5,000 cells/μL) (aOR = 3.96, 95% CI: 1.45–10.82, p = 0.007), low platelet count (<150,000 cells/μL) (aOR = 2.54, 95% CI: 1.11–5.80, p = 0.028), and elevated CRP (>10 mg/L) (aOR = 3.20, 95% CI: 1.34–7.64, p = 0.009) were independently associated with Gram-negative sepsis. Conclusion: The incidence of neonatal sepsis aligns with other high-income countries. Hematological abnormalities, including low WBC and platelet counts and elevated CRP, were strongly associated with Gram-negative sepsis, suggesting pathogen-specific responses and potentially greater disease severity.