STUDY OF CLINICAL PROFILE AND OUTCOME OF SEPSIS IN NEONATAL INTENSIVE CARE UNIT IN A TERTIARY CARE HOSPITAL - A PROSPECTIVE OBSERVATIONAL STUDY

Abstract

BACKGROUND: Neonatal sepsis(NS) is defined as a clinical syndrome of bacteraemia with systemic signs and symptoms of infection in the first 4 weeks of life. Sepsis is the commonest cause of neonatal morbidity and mortality.1 Neonatologists managing NICUs constantly encounter the ongoing challenge of addressing newborn infections due to evolving microbial flora patterns. Understanding the microbiological profile and antimicrobial susceptibility patterns is crucial for paediatricians when selecting the most effective antibiotics for treating neonates with sepsis.2 OBJECTIVES: To determine the clinical profile of neonatal sepsis in neonates admitted to NICU and Sick Neonatal Intensive Care Unit(SNICU). METHODOLOGY: This prospective study was done in neonatal intensive care unit at R.L.JALAPPA HOSPITAL. All neonates who were admitted in NICU or SNICU fulfilling the inclusion criteria were included in the study and evaluated for clinical profile of sepsis and outcome. RESULTS: In the present study, among the 80 neonates, tachypnea was the most prevalent symptom, noted in 57.5% of cases. Blood culture results showed that 25 neonates (31.3%) were tested positive, while 55 neonates (68.8%) tested negative. The most frequently identified organism was Klebsiella species, found in 11 neonates (13.8%). Additionally, xviii Candida was detected in 5.0% of cases, E. coli in 3.8%, Acinetobacter in 2.5%, and Enterococci in 2.5%.It was observed that 31.25% of neonates had Culture Positive Sepsis (Definitive) while 68.75% had Probable (Clinical) Sepsis. CONCLUSION: This study focuses on the clinical profile and outcome of neonatal sepsis in a NICU setting, highlighting its substantial burden on neonatal health. Clinical manifestations varied widely, with tachypnea being the most common symptom. Blood culture results highlighted Klebsiella species as the most prevalent pathogen. Despite advances, the high mortality rate underscores the ongoing need for better early detection, prompt intervention, and overall care practices to improve outcomes for newborns affected by sepsis.