Risk factors, clinical manifestation and bacteriological profile of neonatal sepsis in a tertiary level pediatric hospital.

This prospective study was undertaken in Dhaka Shishu hospital, Bangladesh from 15th Oct. 2005 to 15th October 2006 to determine the Risk factors, Clinical manifestation and bacteriological profile of neonatal sepsis. Eighty suspected cases of septicaemia admitted in neonatal ward of Dhaka Shishu Hospital were included in this study. Patients, who had history of perinatal asphyxia, congenital cyanotic heart disease etc. were excluded from the study. Thirty neonates without signs & symptoms of septicaemia admitted for other causes like jaundice, feeding problems etc. were taken as a control group. After taking informed consent, detailed history was obtained from mother or relatives accompanying the baby. Hematological investigations like total WBC count, differential count, absolute neutrophil count, band cell count, platelet count, CRP, blood culture were done. Low socioeconomic conditions, place of delivery, low birth weight, prolong rupture of membrane appears to be the principal predisposing factors for neonatal sepsis. Clinical presentation includes reluctant to feed (96.7%), lethargy (73.4%), abdominal distention (70%), Hypothermia (40%), Jaundice (50%) are more common. Predominant organism was gram negative. Among them: Klebsiella (60%), Serratia (20%), Acenetobactor (13.3%). This isolates were most often sensitive to third generation cephalosporin. Imipenam is highly sensitive and is recommended when other therapy fails. Periodic surveillance for agent of infection & their antimicrobial sensitivity profile is recommended.