Prevalence and factors associated with neonatal sepsis in a tertiary hospital, North West Nigeria.

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From: Nigerian Medical Journal(Vol. 61, Issue 2)
Publisher: Medknow Publications and Media Pvt. Ltd.
Document Type: Clinical report
Length: 4,328 words
Lexile Measure: 1860L

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Byline: Abdulhakeem. Olorukooba, Williams. Ifusemu, Muhammed. Ibrahim, Muhammad. Jibril, Lawal. Amadu, Bola. Lawal

Context: Neonatal sepsis is an important cause of morbidity and mortality of newborns, especially in developing countries. Aims: Our study determined the prevalence of neonatal sepsis and its predisposing factors among neonates admitted in Ahmadu Bello University Teaching Hospital (ABUTH). Settings and Design: This was a cross-sectional descriptive study conducted in ABUTH. Subjects and Methods: The data were abstracted from the case notes of neonates admitted from May 2017 to May 2018. A pretested pro forma was used to abstract the data. Statistical Analysis Used: Odds ratios and multivariate logistic regression were used to determine the factors associated with neonatal sepsis among the study population. Results: The prevalence of neonatal sepsis was 37.6%. Escherichia coli was the most commonly isolated organism. Neonates 0-7 days of age were 2.8 times less likely to develop neonatal sepsis than older neonates. Babies born with an Apgar score of <6 within the 1st min were 2.4 times more likely to develop neonatal sepsis than those whose Apgar score was higher. Neonates of mothers who had urinary tract infection during pregnancy were 2.3 times more likely to have had sepsis and those whose mothers had premature rupture of membranes were 4.6 times more likely. Conclusions: The prevalence of neonatal sepsis was high among the neonates studied. Neonatal and maternal factors were associated with sepsis in the neonates. These findings provide guidelines for the selection of empirical antimicrobial agents in the study site and suggest that a continued periodic evaluation is needed to anticipate the development of neonatal sepsis among neonates admitted.

Introduction

Neonatal sepsis is a clinical syndrome characterized by systemic signs of circulatory collapse, caused by the invasion of the blood stream by bacteria in the first 28 days after birth.[1] It is caused by both Gram-positive and Gram-negative bacteria.[2] It can present in several ways with a substantial number of cases having nonspecific signs and symptoms at presentation. The salient clinical features include systemic signs of infection such as fever, hypothermia, tachycardia, failure to thrive, lethargy, irritability, listlessness, as well as isolation of a bacterial pathogen from the bloodstream.[3] It is an important cause of morbidity and mortality in the neonatal period.[4] It is also one of the leading causes of mortality in the first 28 days after birth both in the developed and developing parts of the world.[5] This is so because neonates (especially preterms) produce immunoglobulins at a lower rate when compared to adults, thus making them susceptible to infections due to this 'impaired immunity.'[6]

Neonatal sepsis can be broadly classified into two subtypes depending on the time of onset of symptoms: early onset if the onset of symptoms is 72 h or less after birth which is usually caused by organisms associated with female genital tract and late onset if greater than 72 h after birth.[7] The risk factors for the early onset include prematurity, low birth weight, chorioamnionitis, maternal febrile illnesses, and prolonged rupture of membranes...

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Gale Document Number: GALE|A623903195