A Study of Early Onset Septicemia in Neonates Admitted to NICU of a Tertiary Care Centre in Western India
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Abstract
Background: Early-onset neonatal septicemia remains a major cause of neonatal morbidity and mortality in developing countries. Its rapid progression, nonspecific clinical features, and high risk among preterm and low birth weight neonates make early diagnosis and appropriate management challenging. Objective: To determine the incidence, clinicoepidemiological profile, risk factors, diagnostic parameters, antimicrobial sensitivity patterns, and early outcomes of early-onset neonatal septicemia in neonates admitted to the neonatal intensive care unit. Methods: A prospective interventional study was conducted in neonates presenting with clinical features of septicemia within 72 hours of birth and admitted to the NICU of a tertiary care hospital between January and December 2021. Neonates with a positive sepsis screen and/or positive blood culture were enrolled after informed consent. Data on maternal, perinatal, and neonatal risk factors, presenting clinical features, laboratory results, microorganism profile, antimicrobial sensitivity, complications, and early outcomes were systematically recorded and analyzed using SPSS version 27.0. Results: Among 2867 NICU admissions, 165 neonates (5.8%) had early onset septicemia (EOS). EOS was significantly associated with outborn status, prematurity (<34 weeks), low birth weight (<1500 g), and male gender (p<0.05). Common presentations included poor feeding and respiratory distress. Gram-negative organisms, predominantly Klebsiella pneumoniae and Escherichia coli, were most frequent. Overall mortality was 30.9%, significantly higher among preterm, low birth weight, outborn, and culture-positive neonates. Conclusion: Early-onset neonatal septicemia continues to be a significant cause of morbidity and mortality. Early recognition, appropriate screening, and rational antibiotic use are essential to improve outcomes.
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Copyright (c) 2026 Dhara K. Gosai, Gargi H. Pathak, Jigar K. Jain, Amit Das
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[1] Lawn JE, Cousens S, Zupan J. 4 million neonatal deaths: when? where? why? Lancet 2005; 365: 891–900.
[2] Shane AL, Sánchez PJ, Stoll BJ. Neonatal sepsis. Lancet 2017; 390: 1770–1780.
[3] World Health Organization. Neonatal and perinatal mortality: country, regional and global estimates. Geneva: WHO; 2006.
[4] Sankar MJ, Agarwal R, Deorari AK, Paul VK. Sepsis in the newborn. Indian J Pediatr 2008; 75: 261–266.
[5] Camacho-Gonzalez A, Spearman PW, Stoll BJ. Neonatal infectious diseases. Pediatr Clin North Am 2013; 60: 367–389.
[6] Murthy S, Godinho MA, Guddattu V, et al. Risk factors of neonatal sepsis: a meta-analysis. PLoS One 2019; 14: e0215683.
[7] Gerdes JS. Diagnosis and management of bacterial infections in the neonate. Pediatr Clin North Am 2004; 51: 939–959.
[8] Polin RA. Management of neonates with suspected early-onset bacterial sepsis. Pediatrics 2012; 129: 1006–1015.
[9] Thaver D, Zaidi AK. Burden of neonatal infections in developing countries. Pediatr Infect Dis J 2009; 28: S3–S9.
[10] Zaidi AK, Thaver D, Ali SA, Khan TA. Pathogens associated with sepsis in newborns. Pediatr Infect Dis J 2009; 28: S10–S18.
[11] Verma P, Sharma P, Choudhary R, et al. Clinical profile and outcome of neonatal sepsis in a tertiary care hospital. J Clin Neonatol. 2017;6:123–128.
[12] Lalana G. Early onset neonatal sepsis: incidence and outcome in a tertiary care center. Int J Contemp Pediatr. 2018;5:1875–1880.
[13] Pankaj AK, Singh A, Kumar V. Risk factors and outcome of neonatal sepsis. Int J Pediatr Res. 2016;3:141–146.
[14] Kumar R, Singhi S, Chakrabarti A. Early-onset neonatal sepsis: epidemiology and outcomes. Indian Pediatr. 2013;50:101–104.
[15] Bharad V, Patil A, Kulkarni S. Neonatal sepsis: a hospital-based study. Int J Med Public Health. 2015;5:75–79.
[16] Alam MS, Akhter S, Begum N, et al. Risk factors and outcome of neonatal sepsis. Mymensingh Med J. 2014;23:653–660.
[17] Ghosh S, Basu S. Neonatal sepsis: a review of epidemiology and risk factors. J Neonatal Biol. 2011;1:102.
[18] Singh N, Kumar A, Singh T. Gender differences in neonatal sepsis. J Trop Pediatr. 2015;61:189–194.
[19] Jajoo M, Kapoor K, Garg LK, et al. To study the incidence and risk factors of neonatal sepsis. Indian J Pediatr. 2015;82:550–555.
[20] Assa NP, Youssouf B, Amadou I, et al. Early-onset neonatal sepsis: risk factors and outcomes. Pan Afr Med J. 2019;33:250.
[21] Investigators of the Delhi Neonatal Infection Study (DeNIS) Collaboration. Characterisation and antimicrobial resistance of sepsis pathogens in neonates. Lancet Glob Health. 2016;4:e752–e760.