Investigation of the effect of clinical and laboratory properties of cultural positive neonatal sepsis on morbidity and mortality in a newborn intensive care unit

Neonatal sepsis is an important cause of mortality and morbidity, especially in low-birth weight premature infants. In this study, relationship between the clinical and laboratory features of the patients with culture-positive neonatal sepsis, and mortality and morbidity was investigated. Medical records of 233 patients with culture-positive sepsis out of the 4241 babies hospitalized in neonatal intensive care unit of Firat University Hospital between January 2013 and December 2017 were investigated. The majority of patients was extremely and moderate preterm infants (39.1% and 11.6%). Of the patients, there was the history of invasive mechanical ventilation and central catheterization in 74.2% and 26.9% cases. The mostly isolated pathogens (56.2%) were Gram-negative bacteria, especially Klebsiella pneumoniae (n = 67, 28.8%). There was a statistically significant difference between Gram-positive and Gram-negative bacteria and fungi (12.3%, 16.8% & 17.2%) in terms of leukopenia (p = 0.021). Patients with leukopenia (n: 36, 15.5%) had a higher mortality rate than those with leukocytosis (n: 50, 21.5%) (72.2% vs 50%, p = 0.000). Twenty-three (68.6%) of the extremely low-birth weight patients, 27 (54%) of the moderately low-birth weight patients, 22 (30.1%) of the low-birth weight patients and 29 (38.6%) of normal birth weight patients died (p = 0.02). The duration of total total parenteral nutrition intake was significantly longer in died patients (n: 102) than the survivors (16.48 ± 15.7 days & 14.38 ± 13.7 days, p = 0.015). Of the patients, 102 (43.8%) died, 107 (45.9%) survived without sequela and 24 (10.3%) survived with sequela. Maximum compliance with infection control measures in neonatal intensive care unıts, avoidance of unnecessary invasive procedures and early initiating to breast milk will decrease the frequency of neonatal sepsis. Keywords: Newborn, microorganism, risk factors, sepsis, prognosis.