DOI: 10.36347/sjams.2019.v07i12.032

Pages: 3979-3982

Background: Sepsis is the commonest diagnosis of most neonatal units and is responsible for increasing morbidity, mortality and cost of treatment. A triad of high index of clinical suspicion, early lab diagnosis, with judicious use of antibiotics will lead to favorable outcome. Objective: To study the clinical presentation, investigative profile and outcome of neonates admitted with sepsis. Study Design: Prospective observational study. Place and Duration of Study: Pediatric intensive care unit of Dhaka Shishu (Children) Hospital for a period of six months from April to September 2019. Methods: This study included data of 109 newborns with clinical diagnosis of septicemia. Clinical suspicion was made on the basis of maternal risk factors like prolonged rupture of membranes, foul smelling liquor, maternal fever or features in the neonates like refusal to feed, lethargy, respiratory distress, jaundice, abdominal distension, vomiting, cyanosis etc. Total WBC, platelet count, C-reactive protein (CRP), blood cultures were sent and all babies were followed up to final outcome either discharge or death. Results: Amongst the study population, male to female ratio was 1.6:1. Majority of neonates were delivered by vaginal route. Fifty-one (46.8%) neonates had early onset sepsis 58 (53.2%) had late onset sepsis. The major clinical features of sepsis were refusal to feed, respiratory distress, convulsions, jaundice, and lethargy. Blood culture was positive in 24(22%) neonates, gram-negative multidrug resistance were mostly isolated. CRP was positive in 42 (38.6%), leucopenia in 14 (12.8%), leukocytosis in 19(17.4%) and thrombocytopenia was seen in 61(55.9%) enrolled cases. Total deaths were 16(14.7%), of which 9(56.3%) neonates had early onset and 7(43.7%) late onset sepsis. Conclusions: Septicemia is a major cause of mortality and morbidity in neonates. Prevention is preferable, outcome to a great extent depends upon early identification and prompt intensive treatment.