Evaluation of Hematological Parameter, Glycemic Status and Risk Factors Responsible for Neonatal Septicemia and Bacterial agents Causing Neonatal Sepsis in Chittagong, Bangladesh

Abstract

This study was undertaken to assess haematological parameter, glucose status, the possible maternal and neonatal risk factors responsible for neonatal septicemia and the pattern of bacterial agents causing neonatal sepsis. Blood cultures were performed for 147 newborn babies (0-28 days) admitted into the hospital with a clinical diagnosis of neonatal sepsis where 66% were males, and 34% were females resulting in an overall male to female ratio of approximately 2:1. Among them, 57.1% neonates were presented with EONS, 42.9% with LONS and 21.8% were preterm. Approximately, 37.4% neonates with sepsis had low birth weight (< 2500 g), 6.8% had very low birth weight (< 1500 g). The most prevalent clinical features were reluctance to feed 56.5%, respiratory distress 36.7%, jaundice 19.7% and convulsion 15.0%. Among the 147 neonates, 8.2%  had high WBC count (>18,000/cm) and 2.0% had low WBC count (<5000/cm). Immature/total neutrophils ratio ≥0.16 and <0.16 was observed in 8.8% and 91.2% peripheral blood smear examined respectively. While 36.7% had neutropenia (<54%), 48.3% had higher (>62%) neutrophils. 23.8% neonates had low, and 76.2% had higher haemoglobin where 35.4% had higher C-reactive protein level. Out of 147 neonates 27.9% were hypoglycaemic (< 45 gm/dl) and 19.0% were hyperglycaemic (>140 gm/dl). Among the neonates with EONS, 40.5% were hypoglycaemic, and 17.9% were hyperglycaemic while with LONS, 11.1% were hypoglycaemic and 20.6% were hyperglycemic. As for the neonatal risk factors, A significant difference was found for C-reactive protein Levels (p<0.05) and neutrophils (p<0.05) between the culture positive and negative culture sepsis. However, 29.3% had positive blood culture for bacteria. Klebsiella spp. accounted for 13 (30.2%) of the total isolates followed by S. aureus 8 (18.6%). The Gram-positive and Gram negative bacteria accounted for 34.9% and 65.1% respectively.