A retrospective study on the factors associated with positive blood cultures in neonates with neonatal sepsis at mater hospital newborn unit
Background: Neonatal sepsis is a systemic infection that occurs in newborns up to the age of 28 days. A blood or CSF culture is the gold standard for making a diagnosis. Culture positive sepsis is associated with higher neonatal morbidity and mortality.
Objectives: To determine the factors that are associated with positive blood culture in neonates with neonatal sepsis at the Mater Hospital Newborn unit and paediatric ward.
Methods: This was a retrospective study that reviewed the admission records of neonates admitted to the paediatric ward and newborn unit between January 2007 and December 2014. All neonates with a diagnosis of neonatal sepsis based on the WHO criteria were included. The data collected included antepartum risk factors, peripartum risk factors, clinical findings of neonates and blood culture results. Data analysis was done to determine the factors associated with positive blood culture results.
Results: The factors associated with positive blood cultures in neonates with sepsis were place of birth (p value= 0.000) maternal level of education ( p value= 0.0027) maternal vaginal discharge ( p value = 0.015), birth weight less than 2500grams (p value= 0.006), presence of severe abdominal distension (p value= 0.001), inability to breastfeed ( p value= 0.007, tachypnea (p value = 0.014)and severe lower chest wall indrawing (p value= 0.013).
Conclusion: Culture positive results were associated with early onset neonatal sepsis and higher mortality. Knowledge of the antepartum and peripartum factors associated with culture positive neonatal sepsis is useful for prevention of neonatal morbidity and mortality.