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Background: Neonatal sepsis remains one of the biggest clinical challenges in the Indian intensive care nurseries despite continuing advances in diagnosis and management it is a leading cause of morbidity and mortality in neonatal period. Objectives: This study was undertaken to determine the demographic profile, haematological parameters, outcome and pattern of bacterial isolates responsible for early and late onset neonatal sepsis based on the presence of one or more clinical signs. Methods: This was a tertiary hospital based; observational & prospective study conducted over a period of one year (May 2012 to April 2013) at the Neonatal Intensive Care Unit of Kamla Nehru hospital, Shimla. Total 156 newborns (0-28 days) of >30 weeks gestation and >1000grams weight with features suggestive of sepsis were included in the study. Results: In our study out of 156 newborns, 95(60.8%) presented with Early onset sepsis (EOS) and 61(39.2%) with late onset sepsis (LOS). Overall blood culture positivity in septicemia came out to be 44.8%. Significantly high incidence of sepsis was seen in preterms, males, LBW and newborns delivered vaginally but these parameters were not statistically significant (p value > .05). TLC, IT Ratio, Toxic granules, platelet count and Micro – ESR were statistically significant (p value of <.05) in both EOS as well as LOS. Gram negative organisms accounted for septicaemia in 67.1%, Gram positive organisms in 27.1% and Candida in 5.7% of neonates. In the present study overall mortality was 30.1% with 80.8% mortality in EOS and 19.2% in suspected LOS. Conclusion: The spectrum of organisms that cause neonatal sepsis changes overtime. Therefore, it is necessary to conduct periodic surveillance to assess the changing pattern of organisms causing neonatal sepsis. In our study there was significant correlation between mortality rate and type of causative pathogen, gestational age, birth weight and onset of sepsis.

Neonatal infections: Incidence and Outcome in a Tertiary Level Hospital in North India