Main Article Content

Abstract

Background: Sepsis during neonatal life is one of main leading  attributer of the  neonatal mortality, it consider as a major morbidity  constituents, especially in the 3rd word and developing countries.


Identification, diagnosis and treatment delays of this main problem consider as the main cause of mortality  for this group of population.


Aims of the study: to determine the main risk factors for neonatal sepsis in Al-Nasiriya public hospitals at 2017


Methods:A case control - hospital based study was done in Al-Nasiriya public hospitals –Southern of Iraq, extended over a period of 2017,  neonates who had sepsis were the  Cases, while  with their index of pediatrician diagnosis  while neonates who hadn’t sepsis consider as controls. clinical and proper laboratory investigations was done for to prove the inclusion and diagnostic criteria for both Cases and controls. Control and cases had been selected by using  systematic random sampling. Spss version 23   had been used for statistical analysis . graph Bad had been used for epidemiological analysis. P value < 0.05 consider as significant.  dependent and independent  association had been tested by using  binary logistic regression model, while  identification of the associated risk factors to neonatal sepsis  was tested by multivariable  logistic regression.


Results: A total of 150 neonate had been studied allover 2017, sixty cases and ninety control, with mean gestational age (37.5467± 2.36753), . near  three quarters(72%) of NS were with EOS(<7 days), while the remainder were with LOS. The  only Maternal age (21-35),  CS as a mode of deliver,  presence of( bleeding,  PROM, maternal fever), and low birth weight of the of the neonate were strong risk factors for  neonatal sepsis , APGAR <7, MSAFA<7 and  Not crying immediately might be consider as neonatal sepsis predictors that might give hint for early initiation proper antibiotic


Conclusion: Both neonatal and maternal factors had contributed to the risk of NS.  The crucial things are improvement of institutional delivery practices as well as Strengthening of the existing risk based prevention strategies.

Article Details

References

  1. Goldstein B, Giroir B, Randolph A. International pediatric sepsis consensus conference: Definitions for
  2. sepsis and organ dysfunction in pediatrics. Pediatr Crit Care MED 2005; 6 (1): 1–8: doi: 10.1097/01.
  3. PCC.0000149131.72248.E6
  4. Stefanovic IM. Neonatal sepsis. Biochemia Medica 2011; 21(3):276–81. Available: http://dx.doi.org/10.
  5. /BM.2011.037 PMID: 22420241
  6. Haque KN. Defining common infection in children's and neonates. Journal of Hospital Infection. 2007;
  7. :110–114. PMID: 17540253
  8. WHO, UNICEF. Every newborn: An action plan to end Preventable deaths: Executive summary.
  9. Geneva: World Health Organization. 2014.
  10. UNICEF, Division of Data, Research, and Policy. Committing to Child Survival: A Promise Renewed:
  11. Progress Report 2014. available from: www.apromiserenewed.org/APR_2014_web_15Sept14.pdf
  12. Chu SM, Hsu JF, Lee CW, Lien R, Huang HR, Chiang MC et al. Neurological Complications after Neonatal
  13. Bacteremia: The Clinical Characteristics, Risk Factors, and Outcomes. PLOS ONE. 2014; 9(11):
  14. e105294. doi: 10.1371/journal.pone.0105294 PMID: 25364821
  15. UNICEF. Ethiopia—Health Maternal Health Brief 2014. available from www.unicef.org/ethiopia/health.
  16. html.
  17. Berhanu D, Avan B.I. Community Based Neonatal care: Baseline Report Summary. Ethiopia. London,
  18. IDEAS, London School of Hygiene and Tropical Medicine. 2014 Oct available from: ideas.lshtm.ac.uk/
  19. sites/ideas. . ./CBNCBaselineReport_18Nov15_WEB.pdf
  20. Federal Ministry of Health, Ethiopia- Tigray Regional Health Bureau. HMIS report. 2014 March.
  21. Edmond K, Zaidi A. New Approaches to Preventing, Diagnosing, and Treating Neonatal Sepsis. PLOS
  22. Med.2010; 7 (3): e1000213. doi: 10.1371/journal.pmed.1000213 PMID: 20231868
  23. Qazi SA, Stoll BJ. Neonatal Sepsis; A Major Global Public Health Challenge. The Pediatric Infectious
  24. Disease Journal.2009 Jan; 28 (1): S1–2 doi: 10.1097/INF.0b013e31819587a9 PMID: 19106756
  25. Gebrehiwot A, Lakew W, Moges F, Moges B, Anagaw B, Yismaw G, etal. Bacterial profile and drug susceptibility
  26. pattern of neonatal sepsis in Gondar University Hospital, Gondar northwest Ethiopia. Der
  27. Pharmacia Lettre, 2012; 4 (6): 1811–1816
  28. Siakwa M, Kpikpitse, Mupepi D, Mohamed SS. Neonatal sepsis in rural Ghana: A case control study of
  29. risk factors in a birth cohort. IJRMHS & K.A.J.2014 Sept; 4(5) 77–88.
  30. Gebrehiwot A, Lakew W, Moges F, Moges B, Anagaw B, Unakal C, etal. Predictors of positive blood
  31. culture and death among neonates with suspected neonatal sepsis in Gondar University Hospital,
  32. Northwest Ethiopia. Euro. J. Exp. Bio.2012; 2(6):2212–2218
  33. Woldu MA, Guta MB, Lenjisa JL, Tegegne GT, Tesafye G, Dinsa H. Assessment of the incidence of
  34. neonatal sepsis, its risk factors, antimicrobial use and clinical outcomes in Bishoftu General Hospital,
  35. Neonatal Intensive Care Unit, Debrezeit-Ethiopia. Pediat Therapeut.2014 Aug; 4: 214. doi: 10.4172/
  36. -0665.1000214
  37. Chacko B, Sohi I. Early onset neonatal sepsis. Indian J Pediatr. 2005; 72(1):23–26. PMID: 15684443
  38. Hasan MS, Mahmood CB. Predictive values of risk factors in neonatal sepsis. J Bangladesh Coll Phys
  39. Surg 2011; 29: 187–195 http://dx.doi.org/10.3329/jbcps.v29i4.11324
  40. Raghavan M, Mondal GP, Bhat BV, Srinivasan S. Perinatal risk factors in neonatal infections. Indian J
  41. Pediatr. 1992-May-Jun; 59(3):335–40. PMID: 1398868
  42. Bhat R, Baby LP. Early onset of neonatal sepsis: Analysis of the risk factors and the bacterial isolates
  43. by using the BacT alert system. Journal of Clinical and Diagnostic Research, India. 2011 Nov; 5
  44. (7):1385–1388.
  45. Risk Factors for Neonatal Sepsis
  46. PLOS ONE | DOI:10.1371/journal.pone.0154798 May 10, 2016 9 / 10
  47. Shah GS, Budhathoki S, Das BK, Mandal RN. Risk factors in early neonatal sepsis. Kathmandu Univ
  48. Med J (KUMJ). 2006 Apr-Jun; 4(2):187–91.
  49. Alam MM. Saleem AF, Shaikh AS, Munir O, Qadir M. Neonatal sepsis following prolonged rupture of
  50. membrane in a tertiary hospital in Karachi Pakistan. J Infec Dev. Ctries 2014; 8(1):067–073. doi: 10.
  51. /jidc.3136
  52. Boia M, Ilie C, Ioanas L, Manea A, Iacob D, Cioboata D. Neonatal septicemia retrospective study on
  53. premature newborn. Jurnalul Pediatrului, 2010; 8:49–50.
  54. Soman M, Green B, Daling J. Risk factors for early onset neonatal sepsis. Am.J. Epidemiol (1985) 121
  55. (5): 712–719 doi: 10.1093/aje/121.5.712 PMID: 4014163
  56. Dawodu A, al Umran K, Twum-Danso K.A case control study of neonatal sepsis: experience from
  57. Saudi Arabia. J Trop Pediatr. 1997; 45:146–51.
  58. Utomo MT. Risk factors of neonatal sepsis: A preliminary study in Dr. Soetomo Hospital. Indonesian Journal of tropical and infectious disease. January to April 2010; 1(1):23–26
  59. .