Incidence and Clinical Outcomes of Neonatal Sepsis in NICU Admissions: A Hospital-Based Study
DOI:
https://doi.org/10.61561/ssbgjms.v6i02.96Keywords:
Neonatal Sepsis, Early-onset, sepsis (EOS), late-onset, sepsis (LOS), EpidemiologicalAbstract
Background: Neonatal sepsis remains a significant source of morbidity and mortality across the globe, particularly in poor-resource settings. This systemic inflammatory response syndrome occurs in 1-8 in 1000 live births globally, more so in the developing world. Neonates' susceptibility results from having underdeveloped immune systems and prolonged exposure to healthcare facilities, and thus, early recognition and treatment are essential for improved outcomes.
Methods: This is a retrospective observational study conducted at Bangladesh Specialized Hospital, Dhaka, Neonatal Intensive Care Unit between January 2023 and December 2024. Among 576 NICU admissions, 66 neonates with sepsis established by clinical presentation and laboratory findings were selected. Demographic characteristics, clinical presentations, laboratory findings, and outcomes were recorded. Statistical analysis was performed using SPSS v27, and Cox proportional hazards regression was employed to identify predictors of mortality.
Results: The incidence of neonatal sepsis was 11.45% (66/576 admissions) with a mortality rate of 6.06% (4/66 cases). Males predominated (60.6%), and 74.2% were preterm neonates. All the affected neonates were very low birth weight (<1500g), with a mean of 1000±320 grams. Incidence of late-onset sepsis was higher (59.1%) than early-onset sepsis (40.9%). Respiratory distress syndrome occurred in 66.7%, hyper-CRP in 71.2%, and positive blood culture in 24.2%. Minor predictors of death were positive blood culture (AOR=5.21, p=0.012), thrombocytopenia (AOR=4.82, p=0.022), and hypoglycemia (AOR=6.34, p=0.010).
Conclusion: Neonatal sepsis is a major cause of mortality in NICU admissions and occurs primarily in preterm and very low birth weight newborns. The low case fatality rate suggests good management practice, but there remains concern for healthcare-associated infections. Early recognition of high-risk factors is essential to improving outcomes.
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