Journal of AdvancedMedical and Dental Sciences Research

Background & Method: Neonatal sepsis remains one of the leading causes of mortality and morbidity in developing countries. Sepsis within the first 72 hours is defined as early-onset sepsis (EOS).Most frequently, EOS is caused by vertical transmission, and despite implementation of guidelines on screening for maternal group B Streptococcus (GBS) colonization, GBS continues to be the most frequent organism causing EOS .The aim of the study to recognise the clinical pattern of early onset sepsis and mortality rate in our hospital . The present study conducted at RKDF Medical College and Research Centre, Bhopal, M.P. 300 newborns consecutive deliveries were taken and they were assessed. All the newborns were attended and assessed at the time of delivery in the labour room or operation theatre and a detailed examination was performed in a warm comfortable, well lighted quiet atmosphere. Gestational age was assessed at this first examination. Result: 78% cases had vomiting/ regurgitation and 61.5% out of them proved to be septic. Tachypnea or grunting was present in 72% and only 36% of them were blood culture positive. 60% cases presented with poor feeding and out of them 36% were septic. This study revealed streptococci in 2 cases, staph. Aureus in 10 cases, Klebsiella in 18 cases and E. coli also in 18 cases. Overall gram positive cocci were in 25% and gram negative bacilli in 75% cases. Mortality from early onset septicemia is 60.4% and death is mostly due to Klebsiella sepsis(94.4%). Conclusion: Incidence wise vomiting, regurgitation, irregular respiration, tachypnea, poor feeding, lethargy occurred more. These features however showed more false positivity as regards diagnosis of neonatal morbidity is concerned. These were present in association with prematurity and difficult labour, while temperature instability, icterus, hyporeflexia, pallour, skin mottling, had greater chance of being associated with neonatal infection. Convulsions, hepatosplenomegaly, abdominal distension and sclerema were present only when infection coexisted.Decreased activity, poor feeding in the early phase of infection and neutropenia were associated with poor outcomes.