Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Introduction: Neonatal sepsis accounts for 26% of the total neonatal deaths. Neonatal sepsis is a clinical syndrome characterized by systemic signs of infection in first month of life. Its clinical presentation is non specific and the diagnosis is mainly based on laboratory tests. Objective: This cross-sectional study aimed to determine the prevalence, risk factors and commonest organism of sepsis in neonatal intensive care unit (NICU) at Cairo university children hospital (Almonira). Subjects and methods: The study was performed on all neonates admitted in NICU (Almonira) between January 2016 and June 2016. 159 neonates were studied; 108 were proven to have neonatal sepsis and 51 non septic neonates served as controls. Complete blood count with total leucocytic count, platelet count, Immature to total neutrophil ratio (I/T), C-reactive protein (CRP) and cultures were reported and compared between both control and sepsis groups. Results: Incidence of sepsis in NICU(AL Monira) was 67.9%.Starting enteral nutrition decreased risk of sepsis (P value0.005) but CVC insertion and mechanical ventilation were more in sepsis group. CVS manifestations were the most specific (P value 0.034). Leucopenia, thrombocytopenia, IT ratio > 0.2, positive CRP and positive cultures were common in sepsis group (P value<0.001). Mortality among septic neonates was 45.4%. Conclusions: Incidence of sepsis remains high. Risk factors include CVP insertion, mechanical ventilation but enteral nutrition decreased sepsis and mortality. Klebsiella MDR was the commonest organism

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