PROSPECTIVE OPEN LABEL STUDY, TO DETERMINE THE INCIDENCE OF EARLY ONSET SEPSIS AMONG TERM NEWBORNS IN THE POST NATAL WARD OF TERTIARY CARE HOSPITAL

Umesh Patel, Pranav H Punasanvala, Alpa N Parekh, Mehul Gosai

Abstract


Background and Aims:

Neonatal sepsis is the commonest cause of neonatal mortality. Sepsis related mortality is largely preventable with early identification, rational antimicrobial therapy and aggressive supportive care

 Method:

A prospective open label non-randomised study conducted in 1507 live birth.1244(82%) were full term(>37 wks) and 263(18%) were preterm (<37 wks)(excluded from the study).Out of 1244, 37were congenital anomaly, 6-had diabetic mother, 12-HIV positive mother, 87- <1.8Kg, 226 MSL (18.1%) and 163-Birth asphyxia(13.1%), so 531 cases were excluded. 126 cases had risk factors(maternal, clinical, both) for early onset septicaemia(EOS). Out of 126, 26 cases were not included (blood samples not collected).

Result

Among 100 patients,14 patients had proven sepsis (14%) & 34  probable sepsis. Out of 56 vaginal deliveries 9-proven sepsis and 18-probable sepsis. Out of 44 caesarean, 5-proven sepsis and16-probable sepsis.  Out of 59 (>2500 grams birth weight) 8-proven sepsis and 19-probable sepsis. Out of 41 (birth weight  1800 -2499 grams), 6-proven sepsis and 15-probable sepsis.24 patients had only maternal, 54 had only clinical and 22 newborns had both (maternal & clinical) risk factors. PROM & Fast breathing-most common maternal and clinical (37.03%) risk factors respectively for EOS. CONS,Ecoli,Klebsiella and Acinetobacter were most common pathogen. Overall, 94% alive and 2% died , 4% - lost to follow up.

Conclusion:

PROM (Maternal) and fast breathing (clinical) are strong risk factors for development of EOS.. In the presence of these factors, the neonate should be screened and observed for sepsis and considered for early institution of antibiotics


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