Abstract

Early and Late Onset Neonatal Sepsis in Very Low Birth Weight Infants in a Tertiary Center in Saudi Arabia

Bader Hasan Sobaih and Hazem Al-Mandeel

Background: Incidences and causative organisms of neonatal sepsis in the developing countries are underreported. The aim of the study was to determine the overall incidence of neonatal sepsis in very low birth weight (VLBW) infants born at one of university hospitals in Riyadh, Saudi Arabia for the period 1999 to 2007, and identify the incidences and commonest isolated pathogens in both early and late onset episodes of sepsis in this group of infants.

Methods: A retrospective study of all very low birth weight (500grams to 1500 grams) infants born at King Khalid University Hospital (KKUH) in Riyadh over a 9-year period from January 1999 to December 2007 were included. Data were collected from medical records and NICU database after obtaining ethics approval. All cultures were taken (blood and/or CSF) prior to initiation of antibiotics. Only first episodes of sepsis were considered in this study. The main outcomes are total incidences of sepsis, incidence of early and late onset sepsis, and the causative pathogens for each type of sepsis.

Results: 48% of included infants (225/468) had positive blood cultures. The incidence of early onset sepsis (EOS) was 10.9% and of late onset sepsis (LOS) was 37.1%. Gram positive pathogens were the commonest causative organisms in both early and late onset sepsis (74.5% and 87.4% respectively). Staphylococcus epidermis was the commonest single pathogen isolated in both groups (45% in EOS, and 63.8% in LOS).

Conclusion: The rate of neonatal sepsis in VLBW infants was high (48%) with high rates of EOS as well as LOS which necessitates a high priority to prevent and control sepsis in our unit.