Finding etiological factors for the onset of neonatal sepsis diagnosed in tertiary care hospitals in Dhaka, Bangladesh

Abstract

With an incidence rate of 76.8/1000 live births, or 36% of all neonatal fatalities, neonatal sepsis is one of the main causes of infant mortality in Bangladesh. Research from a few lower-middle-income (LMI) countries has shown that maternal and neonatal features are among the factors determining the incidence of sepsis in newborns. Thus, the purpose of this research is to determine whether maternal and newborn characteristics are associated with the incidence of neonatal sepsis in patients who are admitted to various Bangladeshi tertiary care facilities in Dhaka, Bangladesh. Finding the causative agents responsible for newborn sepsis along with their antibiogram patterns is the second objective. This study collected blood samples and information on maternal and neonatal risk factors from suspected neonatal sepsis patients admitted at Ad-Din Medical College and Hospital, BIRDEM Women and Child Hospital, and Kurmitola General Hospital from Dhaka City. Maternal and neonatal risk variables have been identified using the Chi-square test with the SPSS analysis tool. A total of sixty questionnaire forms and 40 blood samples have been gathered among which E. Coli (19 isolates), Klebsiella pneumonia (16 isolates), and Pseudomonas aeruginosa (16 isolates) have been identified as the primary organisms causing neonatal sepsis. While E. coli isolates showed the most resistance only against ceftazidime antibiotic and had three beta-lactamase-resistant genes (blaCTX, blaSPM, and blaTEM), Klebsiella pneumonia showed the most resistance towards six classes of antibiotic drugs and had two beta-lactamases resistant and one carbapenem gene (blaSPM and blaSHV, blaNMD). Nonetheless, most of the Pseudomonas aeruginosa exhibited reduced susceptibility to the antibiotic drug classes beta-lactamase, macrolide, and penicillin, as well as one gene that was resistant to beta-lactamase (blaVIM). Neonate gender, Apgar score, premature birth, low birth weight, maternal history of UTI, preeclampsia, gestational diabetes, parity, antepartum haemorrhage, and meconium-stained amniotic fluid were found to be linked with neonatal sepsis. The findings of this study will contribute to better treatment, early detection, and prevention, which could aid in reducing Bangladesh's neonatal sepsis death and prevalence rates.