PREDICTORS AND OUTCOMES OF NEONATAL SEPSIS IN TERTIARY CARE SETTING: A RETROSPECTIVE STUDY

Authors

  • F ALI Department of Pediatrics, Sindh Rangers Hospital Karachi, Pakistan
  • H ADIL Department of Pediatrics (NICU), Shifa International Hospital Islamabad, Pakistan
  • U MANZOOR Department of Pediatrics, Jinnah Hospital Lahore, Pakistan
  • N AZIZ Department of Pediatrics (ER), Quaide Azam International Hospital, Rawalpindi, Islamabad, Pakistan
  • M IQBAL Department of Pediatrics (PICU) Shifa International hospital Islamabad, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2024i1.697

Keywords:

Neonatal sepsis, tertiary care, maternal factors, obstetric factors, clinical care, healthcare facilities, multivariate logistic regression

Abstract

Neonatal sepsis represents a critical challenge in healthcare, particularly in tertiary care settings. A comprehensive understanding of the predictors and consequences is pivotal for enhancing clinical practice and patient outcomes. A retrospective study was conducted on a sample size of 120 neonates to explore the predictors and outcomes of neonatal sepsis. The analysis encompassed a wide range of variables, including maternal characteristics (e.g., age, religion, education), obstetric factors (e.g., PROM, UTI/STI history), neonatal demographics (e.g., age, sex, birth weight), healthcare facilities (e.g., place of delivery, length of stay), and clinical care parameters (e.g., invasive procedures, mode of delivery). Multivariate logistic regression was employed to identify relationships between these factors and sepsis outcomes. Maternal and obstetric factors showed significant correlations with neonatal sepsis. Neonatal characteristics revealed a mean age of 3.1 days, equal gender distribution, and a mean birth weight of 2.6 kg. Health facility indicators pointed to balanced utilization and transport means. Clinical care variables illustrated a balance in delivery modes and attendance. The logistic regression model (Nagelkerke R²: 0.52) identified specific coefficients indicating relationships between variables and sepsis. The mortality rate among neonates with sepsis was 27.8%, with an average stay of 15 days and 38.9% complications rate. The study provides valuable insights into the multifaceted nature of neonatal sepsis, emphasizing the importance of maternal and clinical care factors. The results underscore the necessity for early identification, targeted interventions, and comprehensive care strategies to reduce the incidence and adverse outcomes of neonatal sepsis in tertiary care settings.

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References

Almidani, E., Jefferies, A. L., Khadawardi, E., and Shah, V. S. (2015). Evaluating twins at risk for sepsis: the dilemma of the well-appearing co-twin. Journal of Clinical Neonatology 4, 164-168.

Camacho-Gonzalez, A., Spearman, P. W., and Stoll, B. J. (2013). Neonatal infectious diseases: evaluation of neonatal sepsis. Pediatric Clinics 60, 367-389.

Chan, G. J., Lee, A. C., Baqui, A. H., Tan, J., and Black, R. E. (2013). Risk of early-onset neonatal infection with maternal infection or colonization: a global systematic review and meta-analysis. PLoS medicine 10, e1001502.

Dhole, S., Mahakalkar, C., Kshirsagar, S., and Bhargava, A. (2023). Antibiotic prophylaxis in surgery: current insights and future directions for surgical site infection prevention. Cureus 15.

Franz, A., Bauer, K., and Schalk, A. (2006). Bibliography Current World Literature. Current Opinion in Pediatrics 18, 209-229.

Hiarlaithe, M. O., Grede, N., de Pee, S., and Bloem, M. (2014). Economic and social factors are some of the most common barriers preventing women from accessing maternal and newborn child health (MNCH) and prevention of mother-to-child transmission (PMTCT) services: a literature review. AIDS and Behavior 18, 516-530.

Hornik, C. P., Fort, P., Clark, R. H., Watt, K., Benjamin Jr, D. K., Smith, P. B., Manzoni, P., Jacqz-Aigrain, E., Kaguelidou, F., and Cohen-Wolkowiez, M. (2012). Early and late onset sepsis in very-low-birth-weight infants from a large group of neonatal intensive care units. Early human development 88, S69-S74.

Jacobson, S. H., Hall, S. N., and Swisher, J. R. (2013). Discrete-event simulation of health care systems. Patient flow: Reducing delay in healthcare delivery, 273-309.

Lasswell, S. M., Barfield, W. D., Rochat, R. W., and Blackmon, L. (2010). Perinatal regionalization for very low-birth-weight and very preterm infants: a meta-analysis. Jama 304, 992-1000.

Metcalf, C. J. E., and Graham, A. L. (2018). Schedule and magnitude of reproductive investment under immune trade-offs explains sex differences in immunity. Nature Communications 9, 4391.

Polin, R. A., and Saiman, L. (2003). Nosocomial infections in the neonatal intensive care unit. NeoReviews 4, e81-e89.

Ruoss, J. L., and Wynn, J. L. (2019). Biomarkers in the Diagnosis of Neonatal Sepsis. In "Infectious Disease and Pharmacology", pp. 103-112. Elsevier.

Shane, A. L., Sánchez, P. J., and Stoll, B. J. (2017). Neonatal sepsis. The lancet 390, 1770-1780.

Shane, A. L., and Stoll, B. J. (2014). Neonatal sepsis: progress towards improved outcomes. Journal of Infection 68, S24-S32.

Shapiro, N. I., Howell, M. D., Talmor, D., Lahey, D., Ngo, L., Buras, J., Wolfe, R. E., Weiss, J. W., and Lisbon, A. (2006). Implementation and outcomes of the Multiple Urgent Sepsis Therapies (MUST) protocol. Critical care medicine 34, 1025-1032.

Siakwa, M., Kpikpitse, D., Mupepi, S. C., and Semuatu, M. (2014). Neonatal sepsis in rural Ghana: A case control study of risk factors in a birth cohort.

Simonsen, K. A., Anderson-Berry, A. L., Delair, S. F., and Davies, H. D. (2014). Early-onset neonatal sepsis. Clinical microbiology reviews 27, 21-47.

Stoll, B. J., and Hansen, N. (2003). Infections in VLBW infants: studies from the NICHD Neonatal Research Network. In "Seminars in perinatology", Vol. 27, pp. 293-301. Elsevier.

Sundaram, V., Kumar, P., Dutta, S., Mukhopadhyay, K., Ray, P., Gautam, V., and Narang, A. (2009). Blood culture confirmed bacterial sepsis in neonates in a North Indian tertiary care center: changes over the last decade. Japanese Journal of Infectious Diseases 62, 46-50.

Tita, A. T., and Andrews, W. W. (2010). Diagnosis and management of clinical chorioamnionitis. Clinics in perinatology 37, 339-354.

Wu, J.-H., Chen, C.-Y., Tsao, P.-N., Hsieh, W.-S., and Chou, H.-C. (2009). Neonatal sepsis: a 6-year analysis in a neonatal care unit in Taiwan. Pediatrics & neonatology 50, 88-95.

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Published

2024-02-13

How to Cite

ALI, F., ADIL, H., MANZOOR, U., AZIZ, N., & IQBAL, M. (2024). PREDICTORS AND OUTCOMES OF NEONATAL SEPSIS IN TERTIARY CARE SETTING: A RETROSPECTIVE STUDY. Biological and Clinical Sciences Research Journal, 2024(1), 697. https://doi.org/10.54112/bcsrj.v2024i1.697

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