Clinical Presentations, Incidence and Risk Factors Associated with Early-Onset Neonatal Sepsis (EONS) in High-Risk Neonate in Photharam Hospital, Ratchaburi Province
Keywords:
clinical presentation, early-onset neonatal sepsis, infant at risk of early-onset neonatal sepsisAbstract
Objective: The purposes of this study were to assess the clinical presentation, incidence, and risk factors of neonates at risk for EONS.
Method: This was a retrospective analytic study. Data were collected in neonates admitted to the newborn intensive care unit, at Photharam Hospital from January 1, 2016 to December 30, 2021. Data record forms for infants at risk for EONS were used as study tools. The data were presented in percentage, average, and standard deviation; independent t test and chi-square test were implemented for the analysis of the factors that affected EONS.
Results: A total of 105 newborns were included in this study. EONS was found in 79 (75.2%). Eighty-nine percent had clinical at onset and the most common presentation was respiratory distress or apnea. The following showed a significant effect on the risk of EONS: Apgar score in the first (p < .01), fifth (p < .01), and tenth (p < .01) minutes; birth asphyxia (p = .018); and inadequate intrapartum antibiotics prophylaxis (p = .005) whereas gender; route of delivery; maternal fever; maternal infection; and PPROM ≥ 18 hours did not associate with EONS.
Conclusion: The study found that Apgar score in the first, fifth, and tenth minutes; birth asphyxia; and inadequate intrapartum antibiotics prophylaxis are risk factors for EONS. This emphasizes the urgent need for a guideline for screening pregnant women who are at risk and prompt treatment in neonates with sepsis. Collaboration of the healthcare team can be the key for reducing EONS and improving care.
References
Sankar MJ, Natarajan CK, Das RR, et al. When do newborns die? A systematic review of timing of overall and cause-specific neonatal deaths in developing countries. J Perinatol. 2016;36:1–11. doi: 10.1038/jp.2016.27.
Thatrimontrichai A, Khunnarakpong N, Tantichanthakarun P, at al. Neonatal group B Streptococcus sepsis: a multicenter study in Thailand. Southeast Asian J Trop Med Public Health. 2017;48(5):1063-71.
Sinha S, Miall L, Jardine L, Essential neonatal medicine. 6th ed. Oxford: John Wiley & Sons Ltd; 2018:98–113.
Puopolo KM, Benitz WE, Zaoutis TE. Management of neonates born at≥ 35 0/7 weeks’ gestation with suspected or proven early-onset bacterial sepsis. Pediatrics. 2018;142(6):1–10. doi: 10.1542/peds.2018-2894.
Puopolo KM, Benitz WE, Zaoutis TE, et al. Management of neonates born at ≤ 346/7 weeks’ gestation with suspected or proven early-onset bacterial sepsis. Pediatrics. 2018;142(6):e20182896. doi: 10.1542/peds.2018-2894.
Leonard EG, Dobbs K. Postnatal infection In: Martin RJ Fanaroff AA, Walse AC, editors. Fanaroff & Martin’s neonatal-perinatal medicine disease of the fetus and infant. 10th ed. Philadelphia: Suanders; 2015:734–7.
ศิริสุดา อัญญะโพธิ์. การติดเชื้อทารกแรกเกิดในโรงพยาบาลอ่างทอง. วารสารวิชาการ รพศ/รพท เขต 4. 2558;17(3):174–82.
Salem SY, Sheiner E, Zmora E, et al. Risk factors for early neonatal sepsis. Arch gynecol obstet. 2006;274(4):198–202. doi: 10.1007/s00404-006-0135-1
Adcock L, Papile L. Perinatal Asphyxia. In: Manual of Neonatal Care. Ed. Cloherty, J, Eichenwald,E. and Stark,A. 6th Ed. Wolters Kluwer. Philadelphia. 2004: 518–20.
Adatara P, Afaya A, Mohammed S, et al. Risk Factors Associated with Neonatal Sepsis: A Case Study at a Specialist Hospital in Ghana". Sci. World J 2019:1–11. DOI:10.1155/2019/9369051
Hasan M, Mahmood C. Predictive Values of Risk Factors in Neonatal Sepsis. J. Bangladesh Coll. Phys. [Internet]. 2012 Jul. 20 [cited 2022 Jul. 20];29(4):187-95. Available from:
https://www.banglajol.info/index.php/JBCPS/article/view/11324
Hannah C. Kinney, Joseph J. Volpe's Neurology of the Newborn 6th Ed, Elsevier, 2018, 484–99.
Hayun M, Alasiry E, Daud D, et al. The risk factors of early onset neonatal sepsis. AJCEM 2015;3(3):78–82.
Chacko B, Sohi I. Early onset neonatal sepsis. Indian J Pediatr. 2005;72(1):23–6. doi: 10.1007/BF02760574.
Edwards RK, Jamie WE, Sterner D, et al. Intrapartum antibiotic prophylaxis and early-onset neonatal sepsis patterns. Infect Dis Obstet Gynecol. 2003;11(4):221–6. doi: 10.1080/10647440300025525.
Verani JR, McGee L, Schrag SJ. Prevention of perinatal group B streptococcal disease--revised guidelines from CDC, 2010. MMWR Recomm Rep. 2010;59(RR-10):1–36.
Leal YA, Álvarez-Nemegyei J, Velázquez JR, et al. Risk factors and prognosis for neonatal sepsis in southeastern Mexico: analysis of a four-year historic cohort follow-up. BMC pregnancy and childbirth. 2012;12(1):1–9. doi: 10.1186/1471-2393-12-48.
Schrag SJ, Hadler JL, Arnold KE, et al. Risk factors for invasive, early-onset Escherichia coli infections in the era of widespread intrapartum antibiotic use. Pediatrics. 2006;118(2):570-6. doi: 10.1542/peds.2005-3083.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
ลิขสิทธิ์บทความเป็นของผู้เขียนบทความ แต่หากผลงานของท่านได้รับการพิจารณาตีพิมพ์ลงวารสารแพทย์เขต 4-5 จะคงไว้ซึ่งสิทธิ์ในการตีพิมพ์ครั้งแรกด้วยเหตุที่บทความจะปรากฎในวารสารที่เข้าถึงได้ จึงอนุญาตให้นำบทความในวารสารไปใช้ประโยชน์ได้ในเชิงวิชาการโดยจำเป็นต้องมีการอ้างอิงถึงชื่อวารสารอย่างถูกต้อง แต่ไม่อนุญาตให้นำไปใช้ในเชิงพาณิชย์
