Prevalence and Associated Risk Factors of Sepsis among Neonates Admitted into Neonatal Intensive Care Units of Public Hospitals in Dhaka

Abstract

Objective: To determine the prevalence and associated risk factors of sepsis among neonates admitted into neonatal intensive care units (NICU) of public hospitals in Dhaka. Methods: This was a cross-sectional study conducted among 173 neonates admitted into the NICUs of Dhaka Medical College Hospital (DMCH) and Dhaka Shishu (Children) Hospital from March 1, 2016 to September 30, 2016 at Dhaka, Bangladesh. On the basis of the presence of clinical signs and symptoms of sepsis, neonates were admitted into the NICUs. The weight of the baby was measured and blood culture, complete blood count (CBC), C-reactive protein (CRP) and urine R/M/E were done at the time of admission. The neonates, who had positive blood culture reports, were confirmed as having sepsis. After receiving informed written consent, maternal data were collected from the mother of the neonate and neonatal data were collected from NICUs. Results: The prevalence of sepsis among the neonates admitted into NICU of the concerned public hospitals in Dhaka was 69.35%. In the multiple logistic regression model, perinatal asphyxia (adjusted odds ratio (aOR) = 3.37, 95% confidence interval (CI) = 1.27-8.90), presence of infection at umbilical cord (aOR = 3.32, 95% CI = 1.40-7.85), history of bottle feeding of the neonates (aOR = 3.02, 95% CI = 1.11-8.25) and pre-existing maternal infection (aOR = 4.44, 95% CI = 1.92-10.26) were significantly (p-value < 0.05) associated with neonatal sepsis. The odds of developing sepsis among the neonates with ≤ 2.5 kg weight at admission was more than three times higher (aOR 3.82, 95% CI = 1.59-9.19) than neonates with admission weight > 2.5 kg. Conclusion: Like other South Asian countries, the prevalence of neonatal sepsis is alarming in Bangladesh. Further research should be conducted to measure the burden of infections in the entire neonatal period and observe the effects of biological risk factors on the early and lateonset neonatal sepsis.

Prevalence and Predictors of Neonatal Sepsis among Neonates Admitted at the Newborn Unit of Kenyatta National Hospital, Nairobi, Kenya

“…Our study found that neonates born of anaemic mothers were more likely to develop neonatal sepsis compared to neonates born of mothers without anemia. This finding is in agreement with a study conducted in Dhaka, Bangladish [31]. This could be explained by the fact that babies born of anaemic mothers are probably born with low immunity and other important proteins and therefore are more likely to suffer from neonatal sepsis.…”

Risk Factors for Neonatal Sepsis in Secondary and Tertiary Care Hospitals of a District in Sri Lanka: A Case–Control Study

“…The results were consistent with five other studies. 23,[26][27][28][29] A total of >3 vaginal examinations before delivery were a risk factor for neonatal sepsis regardless of whether the membranes were ruptured or not. This is consistent with the finding of another study, 30 which discovered that having more than three vaginal examinations was a risk factor for neonatal sepsis in India.…”

“…Five other studies also reported that LBW was a risk factor. 14,19,22,29,32 Three other studies reported that premature birth was a risk factor for neonatal sepsis. 14,28,31 Birth weight is a basic biological determinant of neonatal outcome.…”

Factors Predicting Failure of Empirical Antibiotic Therapy in Neonatal Sepsis in the First One Week of Life

“…18 Similar findings have been observed in other studies as well. [19][20][21] Blood culture is considered the "gold standard" for diagnosis of neonatal sepsis. 22 A report by WHO Sepsis Technical Expert Meeting states that the main pathogens causing sepsis in newborn period are gram-negative bacteria (Klebsiella spp., Enterobacter spp., Acinetobacter spp.)…”