FREQUENCY AND CLINICAL CHARACTERISTICS OF EARLY NEONATAL SEPSIS IN A TERTIARY CARE HOSPITAL IN QUETTA

Abstract

Background: Early-onset neonatal sepsis (EONS), occurring within the first 72 hours of life, is a major cause of neonatal morbidity and mortality, particularly in low- and middle-income countries. Early diagnosis remains difficult because of nonspecific clinical manifestations, making timely recognition and treatment essential for improving neonatal survival and reducing complications in tertiary healthcare settings.

Objectives: To determine the frequency of early-onset neonatal sepsis and describe its clinical characteristics, maternal risk factors, laboratory findings, and clinical outcomes among neonates admitted to a tertiary care hospital in Quetta.

Place and Duration of study. From May 2025 to October 2025, Paediatrics Department Balochistan Institute of Child Health & Services Quetta.

Methodology: This descriptive cross-sectional study was conducted in the Neonatal Intensive Care Unit of a tertiary care hospital in Quetta from May to October 2025. A total of 100 consecutive neonates aged ≤72 hours with suspected sepsis were enrolled using non-probability consecutive sampling. Demographic characteristics, maternal risk factors, clinical features, laboratory investigations, blood culture findings, and treatment outcomes were recorded using a structured proforma. Early-onset neonatal sepsis was diagnosed based on compatible clinical features supported by laboratory investigations and/or positive blood culture. Data were analyzed using SPSS version 26.0. Continuous variables were expressed as mean ± standard deviation, whereas categorical variables were presented as frequencies and percentages. Associations were assessed using the Chi-square test, with a p-value <0.05 considered statistically significant.

Results: Of the 100 enrolled neonates, 42 (42.0%) were diagnosed with early-onset neonatal sepsis. The mean age at presentation was 1.8 ± 0.7 days, and the mean birth weight was 2.74 ± 0.58 kg. Males accounted for 58.0% of participants. Prematurity and low birth weight were present in 30.0% and 35.0%, respectively. Respiratory distress (71.4%), poor feeding (64.3%), lethargy (57.1%), and temperature instability (45.2%) were the predominant clinical manifestations. Blood cultures were positive in 20 (47.6%) septic neonates, predominantly yielding Klebsiella pneumoniae and Escherichia coli. Prematurity (p=0.018) and prolonged rupture of membranes (p=0.011) were significantly associated with EONS. Septic neonates had a mean hospital stay of 8.6 ± 2.9 days and a higher mortality rate than non-septic neonates (9.5% vs. 1.7%; p=0.041).

Conclusion: Early-onset neonatal sepsis remains a common cause of NICU admission and adverse neonatal outcomes. Respiratory distress, poor feeding, and lethargy were the most frequent presentations, while prematurity and prolonged rupture of membranes significantly increased the risk of infection. Early recognition of maternal and neonatal risk factors with prompt diagnosis and treatment may reduce neonatal morbidity and mortality.