Course and Complications of Early Onset Nonatal Sepsis : A Descriptive Study

Abstract

Background: Neonatal sepsis is an important cause of newborn morbidity and mortality. Despite increasing knowledge of pathophysiology and upcoming novel therapeutic approaches, the mortality associated with sepsis remains high.
Objectives: To describe the spectrum of presentation and complications of early onset sepsis (EOS), and case fatality due to its major causes and complications.
Study design: Descriptive study.
Setting: Neonatology unit at Department of Pediatrics, Mayo Hospital, Lahore.
Duration of study: 1stApril 2005 t0 31st March 2006.
Patients and Method: Sixty culture proven cases of early onset neonatal sepsis. Data collected through history taking, ana-lyzing the investigations and observing the outcome of cases with the help of a questionnaire.
Results: Sixty cases of early onset sepsis suspected on clinical grounds and positive blood culture, were included. Mean age at time of presentation was 2.73 days. Thirty – seven cases (61%) presented within 48 hours of birth, while twenty – three (39%) presented from 48 hours to 7 days. Male to female ratio was 2.33:1. Twenty-five (41%) babies were delivered at home while twenty-three (39%) were delivered at private clinics and twelve (20%) at public hospitals. Forty two (70%) babies were delivered by spontaneous vaginal delivery (SVD) and eighteen (30%) babies were delivered by lower segment caesarean section (LSCS). Out of 35 babies delivered at private clinic and public hospitals, eighteen (51%) were by C-section. Reluc-tance to feed (65%), lethargy (48%), respiratory distress (45%), fever (36%) and seizures (15%) were most common present-ing complaints. Complications observed were disseminated intravascular coagulation (DIC) (73%), respiratory failure (48%), septic shock (1.7%), meningitis (1.7%) and symptomatic hypoglycemia (1.7%). Most common cause of death was DIC, fol-lowed by respiratory failure. Case fatality rate was 40%. Conclusion: Early onset sepsis is a life threatening condition with an ominous course and high subsequent fatality.
Keywords: Early onset sepsis, complications, case fatality.