THE PROFILE OF NEONATAL SEPSIS IN DUHOK CITY AND PREDICTORS OF MORTALITY: A PROSPECTIVE CASE SERIES STUDY
Background: Neonatal sepsis is a major cause of death all over the world. Risk factors represent an interaction between maternal-fetal colonization and each of transplacental immunity and the defense mechanisms of the neonate. This study is to assess the epidemiological, clinical and laboratory profiles of neonates with sepsis in relation to outcome and to determine the predictors of outcome.
Subject and Methods: A prospective study included neonates with sepsis admitted to neonatal care unit. 126 neonates with features of sepsis were included with age ranged from (1-30) days. From each patient, neonatal and maternal data were collected and clinical features as well as laboratory test results of hemoglobin, platelets count. total white blood cell and absolute neutrophil count , C-reactive protein and blood culture were collected and statistically analyzed.
Results: of 126 neonates, 32 (25.39%) died while others survived. Age < 7 days was in 61.9% of all cases, 69.84% had respiratory distress syndrome, 7.93% had hypoxic ischemic encephalopathy, 60.31% were preterm, 61.9% were born vaginally and male to female ratio was 1.73:1. There is a significant relation of mortality to respiratory distress syndrome and hypoxic ischemic encephalopathy, preterm delivery, low birth weight and male gender. Vomiting, apnea, sclerema, cyanosis and tachypnea were significantly related to the mortality. Eschericia coli were the most common followed by Klebsiella sp. The highest mortality is with Acenatobacterbaumani followed by Staphylococcu aureus with a significant relation. The C reactive protein was>10 mg/dl was in higher number of neonates with sepsis who died by comparison to those who survived, with a significant relation.
Conclusions: Neonatal sepsis is still a common cause of mortality in neonates with change in the pattern of causative organisms and this requires more monitoring and periodic surveillance. There is a real need to find out the local antibiotic sensitivities of pathogens to establish an optimal empirical treatment before the results of culture and sensitivity are available.
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