Incidence of Sepsis and Its Determinants among Neonates Admitted in Level III Neonatal Unit - A Prospective Observational Study.

Lavanya Eswaran, Vetriselvi Prabakaran, Adhisivam Bethou
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Abstract

Introduction: Neonates are prone for sepsis due to their immature immune system. Sepsis is preventable if we aware of the maternal and neonatal risk factors. This study aimed to identify the incidence of sepsis and its risk factors. Methods: A prospective observational study was carried out among 288 neonates in level III Neonatal unit. Convenience sampling technique was used to enroll the neonates who met the inclusion criteria. Data pertaining to neonatal and maternal demographic and clinical characteristics, incidence of sepsis, risk factors of sepsis were collected by direct observation and from medical record. Data regarding number of skin pricks for blood sample and intravenous cannulation and number of handling of the baby were collected from Tally counters. Data were analysed using chi square test, t-test and logistic regression with SPSS software version 25. Results: The incidence of sepsis was 34.7% in level III neonatal unit. Culture positive sepsis constituted 7.3%, urinary tract infection 0.3%, meningitis 7 % and probable sepsis 26.4%. Neonatal factors like extreme preterm, extreme low birth weight, gestational age, birth weight, duration of stay in level III neonatal unit, number of handling, number of skin pricks, duration of intravenous line, duration of tube feeds, mechanical ventilation and maternal premature rupture of membrane were associated with neonatal sepsis significantly. Conclusion: Incidence of neonatal sepsis can be minimized by concentrating on modifiable risk factors and implementing the protocol of minimum handling and minimal skin pricks for the neonates.

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III级新生儿病房新生儿脓毒症发生率及其决定因素——一项前瞻性观察研究。
新生儿免疫系统发育不成熟,易患败血症。如果我们意识到孕产妇和新生儿的危险因素,脓毒症是可以预防的。本研究旨在确定脓毒症的发生率及其危险因素。方法:对288例III级新生儿进行前瞻性观察研究。采用方便抽样法对符合纳入标准的新生儿进行入组。通过直接观察和病历收集新生儿和产妇人口统计学和临床特征、脓毒症发生率、脓毒症危险因素等相关数据。在计数器上收集皮肤穿刺采血和静脉插管次数以及婴儿处理次数的数据。数据分析采用卡方检验、t检验和logistic回归,采用SPSS软件25版。结果:III级新生儿病房脓毒症发生率为34.7%。脓毒症培养阳性占7.3%,尿路感染0.3%,脑膜炎7%,可能脓毒症26.4%。新生儿因素如极早产、极低出生体重、胎龄、出生体重、III级新生儿病房停留时间、处理次数、皮肤刺痛次数、静脉插管时间、管饲时间、机械通气时间、母体膜早破与新生儿脓毒症显著相关。结论:通过关注可改变的危险因素,实施对新生儿最少处理和最少皮肤刺痛的方案,新生儿脓毒症的发生率可以降到最低。
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