P2B081: The Clinical Epidemiology of Neonatal Sepsis at Bustamante Hospital for Children Between January 1, 2017 and December 31, 2018

Background: Neonatal sepsis is an important cause of death, especially in developing countries. This two-year retrospective study reports the risk factors and outcomes of culture-confirmed, bacterial, paediatrician-diagnosed, neonatal sepsis in the Bustamante Hospital for Children, a stand-alone referral paediatric hospital in Jamaica,

Methods: This was from a retrospective review of on-site microbiology records and patient medical records.he number of cases found over the 2 year period was 274 accounting for 319 positive cultures with 391 isolates – 58% (184) urine, 37% (118) blood and 5% (17) cerebrospinal fluid.

Results: The number of cases found over the 2 year period was 274 accounting for 319 positive cultures with 391 isolates – 58% (184) urine, 37% (118) blood and 5% (17) cerebrospinal fluid. Among the 274 newborns, the ratio of early onset septicaemia (EOS) to late onset septicaemia (LOS) was 1:9. Significant risk factors for EOS included prolonged rupture of membranes, underlying disease in the neonate and low APGAR score at 5minutes (p ≤ 0.05). While significant risk factors for LOS included maternal infection in the last trimester and prior nursery admission (p < 0.035). Gram negative bacteria accounted for 63% (248) of the isolates and Gram positive bacteria represented 37% (143). Gram negative isolates comprised Klebsiella sp. (23%), E. coli (22.3%) and Coagulase negative staphylococci (19.25%). The sepsis-attributable mortality rate during the neonatal period was 4% (11/274) and 63.6% (7) had Klebsiella species isolated. Significant predictive factors for mortality in a logistic regression model included thromobocytopenia, hypoxia on admission, low birth weight and early onset sepsis (p < 0.05). Despite unavailability of medical records and microbiology data for some cases and no reports of Group B streptococci isolated from blood, or CSF.

Conclusion: This report potentially adds significant value to the body of medical literature on neonatal sepsis in a developing country.