Bacterial Neonatal Sepsis and Associated Risk Factors among Neonates: The Case of Adama Hospital Medical College

Abstract

Background:Bacterial neonatal sepsis is a systemic inflammatory response to infection and/or isolation of bacteria from the bloodstream in the first 28 days of life.

Objective: the aim of this study is to assess neonatal sepsis and associated factors among neaonates admitted to Adama Hospital Medical College, Ethiopia

Methods: A cross-sectional study was conducted on 333 neonates, consecutive sampling used on neonates admitted at intensive care  unit in Adama Hospital Medical College, Adama, Ethiopia. Data were collected using semi-structured questionnaire and 1ml of blood  sample was collected following standard aseptic techniques and inoculated into a BACTEC Peds Plus culture vial, and transported to  referral laboratory. Gram staining and subculturing were performed for each presumptive positive vial. Bacterial isolation and  identification were done by enzymatic and fermentative biochemical tests and analyzed using SPSS v.20. multivariable logistic regression  was used to identify factors having significant association with neonatal bacterial sepsis and 95% CI and P-value <0.05 were to state  significance level of variable.

Results: Of the 317(95%) collected blood specimen, 147(46.4%)(95% Cl, 41.8 – 52.8%) showed bacterial  growth. Gram-negative bacteria were dominants (69.9%); K. pneumoniae 72(48.98%), coagulase negative Staphylococci species 23(14.97%)  and E. cloacae 18(12.24%). Factors like Onset of Labor(AOR=2.70, 95% CI: 2.34, 25.41), history of UTI/STI Infection (AOR=3.73,95%CI: 1.35,  10.28), Neonate age 4-7 days and 8-28 day (AOR=4.30, 95% CI: 1.91, 9.65 and AOR=6.07, 95%CI: 2.02, 18.22 respectively) low birth weight  (AOR=2.24, 95% CI: 1.1.06, 4.71), Gestation age (AOR=2.53, 95% CI: 1.19, 5.38), intravenous fluids medication (AOR= 5.21, 95% CI: 2.58,  10.51), resuscitation at birth (AOR=7.85, 95% CI: 3.50, 17.58), shows significant association with neonatal sepsis.

Conclusion: The  magnitude of bacterial sepsis was considerably high. Factors like onset of labor, history of UTI/STI infection , neonate age 4-7 days and  8-28 day, low birth weight, gestation age, intravenous fluids medication, resuscitation at birth, shows significant association with neonatal  sepsis. Therefore, adherence to strict aseptic techniques while providing neonatal resuscitation and intraveinus fluid and  medication service is important to reduce neonatal sepsis.