Clinical Profile and Immediate Outcomes of Suspected Neonatal Sepsis in a Tertiary Care Hospital in Bangladesh

Abstract

Background: Neonatal sepsis remains a leading cause of morbidity and mortality worldwide, with the burden disproportionately high in low- and middle-income countries. Nonspecific clinical signs, overlapping presentations with other neonatal conditions, and limited microbiological facilities complicate timely diagnosis and management. In Bangladesh, where neonatal mortality remains substantial, context-specific evidence is needed to refine empirical treatment and preventive strategies. Objective: This study aimed to evaluate the clinical and bacteriological profile, maternal and neonatal risk factors, and immediate outcomes of neonates with suspected sepsis admitted to a Neonatal Intensive Care Unit (NICU)of a tertiary care hospital in Dhaka. Methods: We conducted a prospective observational study at the NICU of Bangladesh Institute of Health Sciences (BIHS) General Hospital, Dhaka, between January 2024 and June 2024. A total of 40 neonates with one or more sepsis risk factors and/or clinical features suggestive of infection were enrolled. At the time of admission demographic, clinical, laboratory, and maternal variables were recorded and blood culture and septic screen also performed. Statistical analysis was done by using SPSS version 26. Data were summarized as frequencies and percentages for categorical variables, and continuous variables as means with standard deviations or medians with ranges, depending on distribution. Results: Among the total 40 neonates, 67.5% were male, 50% had low birth weight, and 45% were preterm. Maternal risk factors included gestational diabetes (40%), urinary tract infection (30%), and premature rupture of membranes (20%). Poor activity (95%) and desaturation (85%) were the most common presenting features. Blood culture positivity was 20%, with Klebsiella pneumoniae and methicillin-resistant Staphylococcus aureus (MRSA) each accounting for 37.5% of isolates. C-reactive protein was elevated in 50% of cases. The survival rate was 95%, with an average ICU stay of 11 days; 5% of neonates died. Conclusions: Neonatal sepsis was strongly associated with prematurity, low birth weight, maternal UTI, and PROM. Blood culture yield was low, but Klebsiella and MRSA predominated among isolates.

Northern International Medical College Journal Vol. 16 No. 1-2 July 2024-January 2025, Page 734-739