Demographic profile and outcomes of potentially septic patients at Baguio General Hospital (July 2004-June 2006)

ABSTRACT

Abstract@#Sepsis is a common cause of morbidity and mortality among high risk neonates with intrauterine maternal history of infection. Objectives: The main objective of this study is to describe all potentially septic newborns in the neonatal care unit of the Baguio General Hospital and Medical Center (BGH) including identification of the maternal risk factors and clinico-bacteriologic profile of sepsis of this study population. @*Methods@#This is a retrospective, descriptive study where medical records of all admitted potentially septic neonates from July 1, 2004 to June 30, 2006 were reviewed. Neonates who were preterm, asphyxiated, with congenital anomalies and with incomplete charts were excluded. Data such as demographics, maternal risk factors, and clinical course were recorded using a standardized clinical assessment form. @*Results@#Out of 217 subjects, 74% (204) were included in the study. 53% were males, with birth weights of 2500 to (-) 3800 grams (85.29%) and delivered via normal, spontaneous delivery (63.24%). The more common maternal risk factor identified included premature rupture of membranes (77%), non-institutional delivery (9.2%), and maternal urinary tract infection (4.2%). 85.78% of subjects had culture negative results, while 14.22% had culture positive results . Among patients with culture negative results, 22.29% developed clinical signs of sepsis such as poor suck, pneumonia, fever, shock, and thrombocytopenia. In patients with culture positive results, the most common organisms isolated were Enterobacter aerogenes (55%), Acinetobacter baumanii (14%) and Coagulase negative staphylococcus (14%). Among these patients, 10 % presented with meningitis, pneumonia, and poor suck. Empiric antibiotics used at the time of study were Penicillin G and an aminoglycoside. 66% of the asymptomatic patients with culture negative results had 3 days duration of treatment. 94.6% went home improved. @*Conclusion@#Pediatricians should have a high index of suspicion for the possibility of sepsis guided by complete perinatal history, thorough physical examination, and laboratory work-up. Even with negative blood culture results, neonates with maternal risk factors can develop signs and symptoms of sepsis; and with the emergence of new pathogens that may cause early neonatal sepsis, it is prudent to do blood culture and sensitivity and start empiric antibiotics.