Early- and Late-Onset Neonatal Sepsis: Risk Factors and Outcome Study

Zuhair Omran Easa, Dr.

	Early- and Late-Onset Neonatal Sepsis: Risk Factors and Outcome Study
Kerbala Journal of Medicine
Article 18, Volume 5, Issue 11, 2012, Pages 1314-1322 PDF (0 K)
Author
Dr. Zuhair Omran Easa
Abstract
Background: Early-onset neonatal infections are acquired before or during delivery (vertical mother-to-child transmission). Late-onset infections develop after delivery from organisms acquired in the hospital or the community. The age at onset depends on the timing of exposure and virulence of the infecting organism. Very-late-onset infections (onset after 1 mo of life) may also occur, particularly in VLBW preterm infants or term infants requiring prolonged neonatal intensive care. Aims of the study: To study the effect of some risk factors, laboratory investigations and outcome on early and late onset neonatal sepsis and their relation with early and late onset neonatal sepsis. Patients and methods: A prospective study was carried out in Karbala teaching hospital from the first of January 2011 through the first of January 2012 for a group of 150 neonates who were subgrouped into 86 (57.3%) with early onset neonatal sepsis and 64 (42.7%) with late onset neonatal sepsis. Information were taken about the patients regarding the age in days, gender, perinatal and maternal history and blood samples were aspirated for complete blood count, blood culture, and C-reactive protein. Results: We found that the neonate is more susceptible to early onset neonatal sepsis in comparison to late onset neonatal sepsis. Premature neonates were more liable for late onset neonatal sepsis than full term B 1341 [Early- and Late-Onset Neonatal Sepsis…] Dr. Zuhair Omran Easa kerbala J. Med. Vol.5, No.1, Dec, 2012 Page ones, 93 vs. 57 neonates (62% vs. 38%). Neonates of mothers with prolonged rupture of membranes were more liable for early onset neonatal sepsis than late onset neonatal sepsis, 27 neonates vs. 11 neonates (31.3 vs.17.2) respectively. Also we found that the blood culture result highly affecting by antibiotics used before culture. The number of neonates with history of maternal fever during pregnancy or shortly before labor was associated with higher number of early onset neonatal sepsis than late onset sepsis, 20 vs. 16 neonates (13.3% vs. 10.7%) respectively. The mortality rate is more in ENS in comparison to late type. Conclusion: Prematurity and prolonged rupture of membranes had significant association with early onset neonatal sepsis while gender, antenatal care and maternal fever had no difference between early onset and late onset neonatal sepsis. Incidence and mortality of early onset neonatal sepsis was higher than late onset neonatal sepsis. Immature: total neutrophils count, and platelets count had high sensitivity to the diagnosis of neonatal sepsis

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