Clinical and Microbiological Profile, Treatment Requirements, and Short-Term Outcomes of Neonatal Sepsis: A Prospective Observational Study

N. Santosh Kumar; Vidya Singaravelu

doi:10.51168/wmwjtc44

Authors

Dr N. Santosh Kumar Senior Resident, Department of Paediatrics, Neelima Institute of Medical Sciences, Ghatkesar, Hyderabad, Telangana, India. Author
Dr Vidya Singaravelu Professor and Head, Department of Paediatrics, Neelima Institute of Medical Sciences, Ghatkesar, Hyderabad, Telangana, India Author

DOI:

https://doi.org/10.51168/wmwjtc44

Keywords:

neonatal sepsis, blood culture, Klebsiella pneumoniae, low birth weight, septic shock, neonatal mortality

Abstract

Background
Neonatal sepsis remains a major cause of preventable morbidity and mortality, particularly among preterm, low-birth-weight, and outborn neonates. Local clinical and microbiological surveillance is necessary because presenting features, pathogen distribution, and treatment outcomes vary across neonatal units.

Objectives
To describe the demographic and perinatal profile, clinical manifestations, laboratory and microbiological findings, treatment requirements, complications, and short-term in-hospital outcomes of neonates with sepsis.

Methods
This prospective observational study was conducted in the Department of Paediatrics, Neelima Institute of Medical Sciences, Ghatkesar, Hyderabad, from October 2025 to March 2026. Consecutively admitted neonates with suspected sepsis were evaluated clinically and with laboratory investigations, including blood culture. Participants were followed until discharge or death, and the findings were summarised descriptively.

Results
Among 56 neonates assessed, 50 were analysed. Mean gestational age was 35.9 ± 3.1 weeks; 44.0% were preterm, 48.0% had low birth weight, and 56.0% were outborn. Poor feeding (72.0%), lethargy (66.0%), and respiratory distress (62.0%) were common. Blood cultures were positive in 18 neonates (36.0%); 66.7% of isolates were Gram-negative, and Klebsiella pneumoniae was predominant. Twenty-nine neonates (58.0%) required respiratory support, including 15 (30.0%) requiring invasive ventilation. Forty-nine neonates (98.0%) improved and were discharged, while one neonate died, giving an in-hospital mortality rate of 2.0%.

Conclusion
Neonatal sepsis in this cohort was characterised by frequent respiratory compromise, inflammatory and haematological abnormalities, and Gram-negative predominance. Most neonates recovered with antimicrobial therapy and supportive care, and the observed in-hospital mortality was low at 2.0%. Because only one death occurred, mortality predictors could not be evaluated reliably.

Recommendations
Neonatal units should strengthen infection prevention, obtain blood cultures before antibiotics whenever feasible, maintain updated local antibiograms, and prioritise rapid escalation of supportive care for low-birth-weight neonates with shock, acidosis, thrombocytopenia, or respiratory failure.

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