Neonatal Sepsis as a Major Cause of Morbidity in a Tertiary Center in Kathmandu

  • Badri Thapa Genesis Laboratory and Research, Kathmandu,Nepal.
  • Anurag Thapa
  • Dhan Raj Aryal Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal.
  • Kusum Thapa Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal.
  • Asha Pun UNICEF, Country Office for Nepal, Kathmandu, Nepal.
  • Sudhir Khanal UNICEF, Country Office for Nepal, Kathmandu, Nepal.
  • Kishori Mahat SOPHYN, Kathmandu, Nepal.

Abstract

Introduction: Neonatal sepsis causes high morbidity and mortality of newborns. The study aims to study the predictors and clinical, haematological and bacteriological factors of neonatal sepsis.

Methods: A descriptive cross sectional study was conducted in a Neonatal Intensive Care Unit (NICU) of Paropakar Maternity and Women’s Hospital in Kathmandu between October and December 2011. Demographic, obstetrics, clinical and microbiological data were studied for 300 neonates.

Results: The NICU prevalence rate of sepsis was 37.12%. Early onset neonatal sepsis was common (91.39%) (P=0.000). Cesarean section (OR 1.95, 95% CI 1.15-3.31), apgar score <4 at 1 min (P=0.00) and <7 at 5 min of birth (P=0.00) predicted sepsis. Neonates with sepsis were more likely to present with hypothermia (OR 1.180, 95% CI 0.080-17.214), pustules (OR 2.188, 95% CI 0.110-43.465), dehydration (OR 3.040, 95% CI 0.170-54.361), diminished movement (OR 3.082, 95% CI 0.433-21.950) and bulging fontanels (OR 16.464, 95% CI 0.007-41495.430). Coagulase negative Staphylococcus spp. (CoNS) (21, 41.17%) was most common pathogen of neonatal sepsis. Variable antibiotic resistance patterns of isolates with emergence of meropenem resistance in Pseudomonas spp. and methicillin resistance in CoNS and S. aurues were noted. Mortality due to sepsis was highest (15, 8.06%) among total mortalities (21, 11.29%).

Conclusions: Delivery via cesarian section, apgar score <4 at 1 min, and <7 at 5 min predicted sepsis. Morbidity and mortality of neonatal sepsis was common in this setting and early maternal and neonatal interventions are required to address this issue.

Keywords: morbidity; mortality; neonatal sepsis; predictors.

Published
2013-12-31
How to Cite
Thapa, B., Thapa, A., Aryal, D., Thapa, K., Pun, A., Khanal, S., & Mahat, K. (2013). Neonatal Sepsis as a Major Cause of Morbidity in a Tertiary Center in Kathmandu. Journal of Nepal Medical Association, 52(192). https://doi.org/10.31729/jnma.2424
Section
Original Article