Jane Amala Sebasty, B (2020) Risk Factor Analysis for Neonatal Sepsis and the Outcome in Tertiary Care Neonatal Nursery. Masters thesis, Stanley Medical College, Chennai.
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Abstract
INTRODUCTION: New born period is the beginning of life. This provides the foundation for future health of the nation. Under-five mortality is the major concern in our country. In the Under -five mortality, the most vulnerable population is the neonatal period (0-28 days of life), accounting for more than half of under-five child deaths. According to NNPD 2002 -2003 incidence of neonatal sepsis is 30/1000 live birth3. Sustainable Developmental Goals provide a new strategy to reduce neonatal mortalities. SDG 3 aims to reduce neonatal mortality to as low as 12 deaths per 1000 live births by 2030. The World Health Organization Essential Newborn Care guidelines are evidence based measures that can be used to meet SDG 3. They encompass breastfeeding, cord care, eye care, thermoregulation, management of asphyxia, recognition of danger signs, immunization and care of the low birth weight infant. This requires active participation of health care professionals and mother in providing essential newborn care. AIM OF THE STUDY: To study the risk factors for neonatal sepsis admitted in NICU and the association of risk factors with culture positivity and mortality. STUDY DESIGN: Cross sectional study. STUDY SETTING: The study was conducted in Stanley Medical College SNCU (Extramural) and Govt RSRM Lying in Hospital NICU (Intramural) in the period of June 2018 to May 2019. Newborns admitted with signs/ symptoms of sepsis were screened and those who were sepsis screen positive were included in the study. METHODOLOGY: After obtaining Ethics committee approval and obtaining informed written consent from parents/caretakers/guardian of newborns, Venous blood drawn for complete blood count, CRP, blood culture and bedside MicroESR did in capillary blood. Total of 957 newborns who were positive for sepsis screen were enrolled in the study. Among them, 112 were sepsis screen positive in extramural and 845 in Intramural NICU. Relavent information obtained and recorded in a predesigned proforma. Neonates were managed according to our hospital protocol. All neonates enrolled in the study were followed throughout their hospital stay/death. Risk factors associated with sepsis and outcome of neonatal sepsis were analysed. STATISTICAL ANALYSIS: The collected data were analysed with IBM. SPSS statistics software 23.0 Version. To describe about the data descriptive statistics frequency analysis, percentage analysis were used for categorical variables and the mean & S.D were used for continuous variables. To find the significance in categorical data Chi-Square test was used. RESULTS: In intramural setting, among 845 babies, EOS accounted for 88% and LOS for 12%. Culture proven sepsis were 9% (72). Mortality in intramural sepsis was 5%. In the culture proven sepsis ,mortality was 11%. The most common organism isolated in blood culture was Klebsiella species. In the extramural neonates, among 112 babies, EOS accounted 50.8% and LOS accounted for 49.2%. Mortality in extramural neonates was 3.6%. Culture proven sepsis were 25.5%. In the culture proven sepsis mortality was 8%. Maternal fever within 2 weeks prior to delivery, premature rupture of membranes, Meconium stained amniotic fluid, Prematurity and Birth asphyxia had statistically significant association with the mortality of the neonatal sepsis. PROM (p = 0.029) and Prematurity (p = 0.045) had statistically significant association with blood culture positivity. CONCLUSION: ◆ Place of delivery, mode of delivery, cord hygiene and bad child rearing practices had statistically significant association with sepsis. ◆ Maternal fever within 2 weeks prior to delivery, Premature rupture of membranes, Meconium stained amniotic fluid, prematurity and Birth asphyxia had statistically significant association with the mortality of the neonatal sepsis. ◆ PROM and Prematurity had statistically significant association with blood culture positivity.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | 201717051 |
| Uncontrolled Keywords: | neonatal sepsis, culture proven sepsis, prematurity, low birth weight. |
| Subjects: | MEDICAL > Paediatrics |
| Depositing User: | Subramani R |
| Date Deposited: | 31 Jan 2021 15:30 |
| Last Modified: | 28 Feb 2021 16:27 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/13550 |
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