Maternal risk factors in early neonatal sepsis at a tertiary care teaching hospital

OBJECTIVE: To study the maternal risk factors in blood culture proven cases of early neonatal sepsis, and study the isolates and the sensitivity of these isolates.

METHODS: This is a case series of all mothers admitted from January 2008 to December 2008 and registered on a pre-designed Proforma, by the House Officers, and Resident Medical Officers of Hamdard College of Medicine & Dentistry, Hamdard University Hospital, Karachi, Pakistan. All neonates delivered at the hospital were examined; first immediately at birth, and then daily until the mother was discharged after 2 to 3 days. Neonates with suspected sepsis were included in the study, blood examination, and blood cultures were obtained, maternal information such as social status, education, fever at the time of labor, use of antibiotics before delivery, onset of labor, and mode of delivery were studied in these cultures proven cases of neonatal sepsis. Antibiotics such as cefotaxime and amikacin were started on an empirical basis until final cultures reports were received. In cases of negative cultures, antibiotics were stopped, otherwise, they were continued according to culture and sensitivity for 10-14 days.

RESULTS: The total number of deliveries at Hamdard University Hospital from January 2008 to December 2008 was 950. Neonates with suspected sepsis comprised 257. Among these 257 cases, 113 neonates had positive blood cultures. Staphylococcus aureus being the most common organism in our study (59.2%) followed by Klebsiella pneumoniae (19.4%) and Enterococci (19.4%).

CONCLUSION: This study indicates that the presence of multiple maternal risk factors makes a child more susceptible to early onset neonatal sepsis. This study indicates that the presence of multiple maternal risk factors makes a child more susceptible to early onset neonatal sepsis.