Clinicopathological and bacteriological profile of neonatal sepsis: a tertiary centre experience from Bangladesh

Introduction: Neonatal sepsis is a primary cause of newborn hospitalization, morbidity, and mortality. Common newborn sepsis symptoms are widely documented. Bacterial and non-bacterial sepsis in neonates may have different clinical presentations and laboratory characteristics. Again, newborn sepsis bacteria vary by region. Objectives: This study investigated the current etiology of neonatal sepsis and the clinicopathological distinctions between bacterial and non-bacterial sepsis. Materials & methods: This cross-sectional observational study was conducted in Bangladesh Shishu Hospital & Institute’s [former Dhaka Shishu (Children) Hospital] SCBU and NICU wards from May 2013 to June 2014. The study included 597 infants of both sexes who were diagnosed with clinical sepsis upon admission. We collected clinical and pathological data in all instances. Blood culture and susceptibility testing isolated and identified the microbial organism. Results: After cultivation, only 20.6% of organisms were identified. The majority of bacteria were Klebsiella (30/63). Most identified Gram-negative bacteria were susceptible to Meropenem (100%), followed by Imipenem (75%) and Cefepime (75%). E. coli was the most delicate. All isolated S. aureus were vancomycin-sensitive (100%). Nearly all bacteria were resistant to ampicillin (93.7%), gentamicin (93.7%), and third-generation cephalosporins. Clinical characteristics of neonatal bacterial sepsis include lethargy (85.7%), poor feeding (81.0%), hyperthermia (71.4%), hypoperfusion (66.7%), and jaundice (66.7%). In bacterial sepsis, hemoglobin, lymphocyte, and platelet levels were significantly lower (p<0.05), whereas neutrophil and CRP levels were significantly greater (p<0.05). Conclusion: Klebsiella dominates neonatal sepsis. The most sensitive antibiotics were meropenem and imipenem. Almost all gram-negative bacteria except E. coli were ampicillin, gentamicin, and third-generation cephalosporin-resistant. Bacterial sepsis caused greater lethargy, poor eating, heat, hypoperfusion, and jaundice. In bacterial sepsis, ANC, neutrophil, and CRP were greater, and hemoglobin, lymphocyte, and platelet were lower.