Risk factors for neonatal sepsis among neonates in the neonatal intensive care unit at Hawassa University Comprehensive Specialized Hospital and Adare General Hospital in Hawassa City, Ethiopia

Abstract

BackgroundNeonatal sepsis (NS) is a serious blood bacterial infection in children of 28 days or younger, manifested by systemic signs and symptoms of infection. Neonatal sepsis has become one of the leading causes of admission and death in developing countries like Ethiopia. Understanding different risk factors for neonatal sepsis is essential for early diagnosis and treatment. So, this study aimed to assess the risk factors for neonatal sepsis among neonates at Hawassa University Comprehensive Specialized Hospital and Adare General Hospital in Hawassa City, Ethiopia.Methods and materialsA case–control study design was employed on 264 neonates (66 cases and 198 controls) in Hawassa University Comprehensive Specialized Hospital and Adare General Hospital from April to June 2018. Data were collected by interviewing the mothers and reviewing neonates’ medical records. The data were edited, cleaned, coded, and entered into Epi info version 7 and were transported and analyzed using SPSS version 20. The odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the significance of the associations.ResultA total of 264 neonates (66 cases and 198 controls) with 100% response rate. The mean (±SD) age of mothers was 26 ± 4.042 years. The majority (84.8%) of the cases were found in children under 7 days, with a mean age of 3.32 days ± 3.376 SD. Factors such as prolonged rupture of the membrane [AOR = 4.627; 95% CI (1.997–10.72)], history of the urinary tract or sexually transmitted infections [AOR = 2.5; 95% CI (1.151–5.726)], intrapartum fever [AOR = 3.481; 95% CI (1.18–10.21)], foul smelling liquor [AOR = 3.64; 95% CI (1.034–12.86)], and low APGAR score in the fifth minute [AOR = 3.38; 95% CI (1.107–10.31)] were the independent predictors of neonatal sepsis.ConclusionProlonged rupture of the membrane, intrapartum fever, urinary tract infection, foul-smelling liquor, and low APGAR score were independent risk factors of neonatal sepsis, and this study also observed that the onset of neonatal sepsis was higher in the first week of a neonate's life. Routine sepsis evaluation must focus on neonates born with the aforementioned characteristics and make interventions for babies born with these risk factors.

Diagnostic Values of Blood Indices for Neonatal Sepsis

“…In this study, although the proportion of positive cultures was slightly higher in pre-term and male babies compared to full-term and female babies, consistent with the findings of other studies (14,15), this difference was not statistically significant. In our study, we did not find a significant relationship between neutrophil count and infection.…”

Neonatal sepsis in a tertiary health facility in Cape Coast, Ghana

“…Neonates who were born to mothers with a history of foul-smelling liquor had greater odds of developing neonatal sepsis, with reference to those born from mothers without a history of foul-smelling liquor. Foul-smelling liquor has similarly been linked with neonatal sepsis in previous studies [ 40 , 41 ] and suggested to an indication of chorioamnionitis which results in systemic infection when neonates come in contact with it. Early detection and treatment of the mother with chorioamnionitis could reduce the baby’s chances of developing neonatal sepsis.…”

A Saudi Hospital’s Experience in the Management of Well-Appearing Neonates at Increased Risk for Early-Onset Bacterial Sepsis

“…We presented categorical data as both numbers and percentages. Maternal age below 20 years, primigravida mother, and a 5-minute Apgar score below 7 may be associated with EOS according to previous studies [6,[12][13][14][15][16]. Thus, we dichotomized these variables accordingly.…”