Mortality profile and incidence of deaths due to neonatal sepsis in an urban tertiary care center in South India: A retrospective study

Abstract

Background: The neonatal mortality rate is a key outcome indicator for newborn care and directly reflects prenatal, intrapartum, and neonatal care. Objective: Primary objective was to assess the neonatal mortality profile, incidence of neonatal sepsis among total neonatal deaths and pattern of antimicrobial resistance. Methodology: This was a retrospective descriptive study done at a tertiary care center. All neonatal deaths from January 2014 to December 2014 were reviewed, and primary causes of mortality, incidence of sepsis among neonatal deaths and pattern of antimicrobial resistance were analyzed. Results: Common causes of neonatal mortality were sepsis, respiratory distress syndrome, congenital malformations, asphyxia, extreme preterm, meconium aspiration syndrome. Case fatality rate was high in extreme preterm neonates (82%), followed by respiratory distress syndrome (29%), congenital malformations (29%), sepsis (25%), asphyxia (25%). In our study incidence of neonatal sepsis among total neonatal deaths was about 20.5%. Staphylococcus aureus (60%) and Klebsiella pneumoniae (23%) were predominant organisms. Highest case fatality rate was associated with K. pneumoniae sepsis about 60%, followed by Escherichia coli sepsis (54%) and Acinetobacter sepsis (50%). Multidrug resistance is an emerging problem, especially in Acinetobacter sepsis. Conclusion: Sepsis still remains the leading cause of death in developing countries. S. aureus was the most common predominant organism; of this, two-thirds were methicillin-resistant S. aureus. About 90% of K. pneumoniae were resistant to extended-spectrum cephalosporins. Multidrug resistance is an emerging problem, especially in Acinetobacter sepsis.