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

Introduction : Globally, sepsis is still one of the major causes of morbidity and mortality in neonates, in spite of recent advances in health care units. Objectives: This study aimed at studying risk factors and outcomes of neonatal sepsis in preterm infants, determining the efficacy of using hematological scoring system in diagnosis of sepsis and detecting common bacterial organisms in Neonatal intensive care unit (NICU) environment.Methods: The study included 153 cases of preterm neonates with suspected sepsis, admitted in Kasr Al-Ainy NICU over a period of 12 months. We studied the impact of different parameters on outcome, antibiograms and the value of blood culture in diagnosis of sepsis. In addition, we tested the efficacy of hematological score of Rodwell in detection of sepsis in culture-proven cases.Results: Late-onset sepsis cases were more common than early-onset sepsis (58.8% versus 41.2%) with better survival rates (57.8% versus 38.1%). Culture-positive cases represented 39.8% only. Klebsiella MDR was the most common organism in early-onset sepsis versus CONS in late-onset sepsis. All bacterial organisms showed high resistance against Amoxicillin-clavulanic, Gentamicin and Carbapenems (first and second lines of antibiotics used). Hematological score of Rodwell showed significant p-value (0.017) in association with culture-proven sepsis cases. Immature: mature PMNs ratio had the highest sensitivity (85.7%), high specificity (78.9%), PPV (80.5%) and NPV (84.5%)

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