Current-proven neonatal sepsis in Indonesian tertiary neonatal intensive care unit: a hematological and microbiological profile

Martono Tri Utomo; Khadijah Rizky  Sumitro; Risa Etika; Agung Dwi  Wahyu Widodo

doi:10.18502/ijm.v13i3.6386

Martono Tri Utomo Department of Child Health, School of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
Khadijah Rizky Sumitro Department of Child Health, School of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
Risa Etika Department of Child Health, School of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
Agung Dwi Wahyu Widodo Department of Clinical Microbiology, School of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia

DOI: https://doi.org/10.18502/ijm.v13i3.6386

Keywords: Neonatal sepsis; Bacteremia; Blood culture; Gram negative bacteria; Klebsiella

Abstract

Background and Objectives: Neonatal sepsis is the third leading cause of neonatal death in the world. The patterns of pathogens causing neonatal sepsis varies in many countries. This study was aimed to identify hematological and microbiological profile of culture-proven neonatal sepsis in Indonesian tertiary neonatal intensive care unit (NICU).

Materials and Methods: Hospital based cross-sectional study was conducted in all inborn neonates that were suspected sepsis neonatal over a period of six months from April to September 2019. Complete blood count, c-reactive protein (CRP) and blood culture were examined before antibiotic administration. Statistical analysis were calculated based on Chi-Square’s Test and Mann-Whitney U test and p <0.05 considered significant.

Results: One hundred four inborn neonates admitted to NICU and diagnosed with suspected neonatal sepsis were recruited. Culture-proven neonatal sepsis were confirmed in 52 (50%) neonates, 13 (25%) in early-onset neonatal sepsis (EONS) and 39 (75%) in late-onset neonatal sepsis (LONS). The most common abnormal hematological profile were anemia and thrombocytopenia, with amount of 61.5% and 75%, respectively. High CRP only detected in 36.4% and only 18.5% experienced leukopenia. Gram negative bacteria responsible in 75% from total isolated pathogens. Klebsiella pneumoniae accounted for 48.1% followed by coagulase negative staphylococci (CONS) for 17.3% and Enterobacter cloacae for 11.5%.

Conclusion: Anemia and thrombocytopenia were the top two hematological profile of culture-proven neonatal sepsis. Most causes of culture-proven neonatal sepsis were Gram negative bacteria and the dominant pathogen was K. pneumoniae.