Clinical and Laboratory Features of Culture-positive Neonatal Sepsis: A 5-year Single-center Experience at Tertiary Neonatal Intensive Care Unit in Turkey

Objective: Neonatal sepsis is an important cause of neonatal mortality and morbidity, especially in low birth-weight premature babies. This study aimed to examine the clinical and laboratory features of cases with culture-positive neonatal sepsis. Method: Medical records of 233 newborn infants with culture-positive sepsis among 4241 hospitalized patients between January 2013 and December 2017 were reviewed. Demographic and clinical data of these patients were retrospectively recorded. Results: The majority of patients was extremely and moderately preterm infants (39.1% vs. 11.6%). These patients had a history of invasive mechanical ventilation (74.2%) or central catheterization (26.9%). The mostly isolated pathogens (56.2%) were Gram-negative bacteria, especially Klebsiella pneumoniae in 67 (28.8%) cases. Post-hoc test showed a statistically significant difference in the incidence rates of leukopenia between patients infected with Gram-positive, Gram-negative bacteria and fungi (12.3%, 16.8% and 17.2%, respectively) (p=0.021). Patients who developed leukopenia (n=36, 15.5%) had a higher mortality rate compared to those with leukocytosis (n=50, 21.5%) (72.2% vs. 50%, p<0.001). The duration of total parenteral nutrition was found to be a significant risk factor in terms of mortality (p=0.015). Conclusion: Prolonged parenteral nutrition is an important risk factor for mortality in low-birth weight newborns and those with sepsis. It is noteworthy that the mortality rate is higher in newborns with sepsis who developed leukopenia and neutropenia.