Early-Onset Neonatal Sepsis: The Challenges of Management

Abstract

Early-onset sepsis (EOS) is a worldwide major cause of morbidity and mortality especially in developing countries. The objectifs of our studie is to estimate the frequency of EOS, explore the different risk factors, the clinical features, the hematological; inflammatory and bacteriological parameters necessary for diagnosis, different causative organisms and ATB susceptibility in EOS. A 10-year retrospective study was used, including 153 cases that met the inclusion criteria. Among the 8908 admissions in NICU, sepsis occurred in 2,28% of cases. The sex ratio was 2,1 (Male: 62%, Female: 38%). Chorioamnionitis occurred in 13,7% of cases, PPROM in 44,4%. Intrapartum fever was found in 7% of cases, and amniotic fluid abnormalities in 36,6%. In neonatal risk factors we found prematurity in 76,15% of cases and VLBW in 21,56%. Respiratory distress was the most common symptom at admission with 66,1%. Bacteriological exam showed a positive Blood culture in 19,6% (30) of cases. The most common organisms isolated were E. coli in 16 cases, Group B streptococcus in 11 cases, and a positive LP in only 1 case isolating E. coli. All patients admitted to the NICU suspected of sepsis had a triple antibiotherapy. In our study, sepsis was responsible for 46,4% of deaths out of which 15 died at the first day of admission. Neonatal sepsis is associated with high rate of neonatal mortality. Poor antenatal care, absence of pregnancies follow-up, prematurity and very low birth weight are risk factors associated with EOS. In order to decrease EOS incidence and improve outcome for neonates, a contribution between Neonatologists and Obstetricians is a must.