Neonatal sepsis following prolonged rupture of membranes in a tertiary care hospital in Karachi, Pakistan

Introduction: Prolonged rupture of membrane (PROM) is an important risk factor for early onset neonatal sepsis (EONS), which is associated with increased neonatal morbidity and mortality. We reported the incidence and associated risk factors of PROM for culture-proven EONS. Methodology:The medical...

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Main Authors: Muhammad Matloob Alam, Ali Faisal Saleem, Abdul Sattar Shaikh, Owais Munir, Maqbool Qadir
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2014-01-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/3136
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author Muhammad Matloob Alam
Ali Faisal Saleem
Abdul Sattar Shaikh
Owais Munir
Maqbool Qadir
author_facet Muhammad Matloob Alam
Ali Faisal Saleem
Abdul Sattar Shaikh
Owais Munir
Maqbool Qadir
author_sort Muhammad Matloob Alam
collection DOAJ
description Introduction: Prolonged rupture of membrane (PROM) is an important risk factor for early onset neonatal sepsis (EONS), which is associated with increased neonatal morbidity and mortality. We reported the incidence and associated risk factors of PROM for culture-proven EONS. Methodology:The medical records of all neonates born at Aga Khan University, Karachi over a period of five years (2007-2011) with PROM (> 18 hours) were reviewed. Data about maternal and neonatal risk factors for EONS was collected and adjusted logistic regression (AOR) analysis was applied. Results:Incidence of PROM in this neonatal birth cohort was 27/1,000 live births. A total of 17 (4%) cases with blood-culture proven bacterial sepsis were identified within 72 hours of birth. Klebsiella pneumonia (n = 5; 29%) and Pseudomonas aeruginosa (n = 4; 24%) were the commonest isolates followed by group B Streptococcus (n = 3; 18%) and Escherichia coli (n = 2; 12%). Maternal fever (p = <0.001; AOR, 36.6), chorioamnionitis (p < 0.001; AOR, 4.1), PROM > 48 hr. (p < 0.001; AOR, 8.2), neonatal prematurity < 34 weeks (p < 0.001; AOR, 4.1) and low birth weight < 1,500 grams (p 0.001; AOR, 9.8) along with neonatal thrombocytopenia and raised CRP were found to be independent risk factors associated with culture-proven EONS in PROM. Conclusions: Preventive measures should focus on recognition of these high-risk infants with prompt laboratory screening for sepsis and early institution of empirical antibiotic based on local data. Such approaches would be a safe and cost-effective strategy, especially in developing countries.
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spelling doaj-art-9d64156862cb4277bd5ca0dd2b43349a2025-08-20T02:27:06ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802014-01-0180110.3855/jidc.3136Neonatal sepsis following prolonged rupture of membranes in a tertiary care hospital in Karachi, PakistanMuhammad Matloob Alam0Ali Faisal Saleem1Abdul Sattar Shaikh2Owais Munir3Maqbool Qadir4Aga Khan University, Karachi, PakistanAga Khan University, Karachi, PakistanAga Khan University, Karachi, PakistanAga Khan University, Karachi, PakistanAga Khan University, Karachi, PakistanIntroduction: Prolonged rupture of membrane (PROM) is an important risk factor for early onset neonatal sepsis (EONS), which is associated with increased neonatal morbidity and mortality. We reported the incidence and associated risk factors of PROM for culture-proven EONS. Methodology:The medical records of all neonates born at Aga Khan University, Karachi over a period of five years (2007-2011) with PROM (> 18 hours) were reviewed. Data about maternal and neonatal risk factors for EONS was collected and adjusted logistic regression (AOR) analysis was applied. Results:Incidence of PROM in this neonatal birth cohort was 27/1,000 live births. A total of 17 (4%) cases with blood-culture proven bacterial sepsis were identified within 72 hours of birth. Klebsiella pneumonia (n = 5; 29%) and Pseudomonas aeruginosa (n = 4; 24%) were the commonest isolates followed by group B Streptococcus (n = 3; 18%) and Escherichia coli (n = 2; 12%). Maternal fever (p = <0.001; AOR, 36.6), chorioamnionitis (p < 0.001; AOR, 4.1), PROM > 48 hr. (p < 0.001; AOR, 8.2), neonatal prematurity < 34 weeks (p < 0.001; AOR, 4.1) and low birth weight < 1,500 grams (p 0.001; AOR, 9.8) along with neonatal thrombocytopenia and raised CRP were found to be independent risk factors associated with culture-proven EONS in PROM. Conclusions: Preventive measures should focus on recognition of these high-risk infants with prompt laboratory screening for sepsis and early institution of empirical antibiotic based on local data. Such approaches would be a safe and cost-effective strategy, especially in developing countries. https://jidc.org/index.php/journal/article/view/3136neonatal sepsisprolonged rupture of membranesblood cultureprematurity
spellingShingle Muhammad Matloob Alam
Ali Faisal Saleem
Abdul Sattar Shaikh
Owais Munir
Maqbool Qadir
Neonatal sepsis following prolonged rupture of membranes in a tertiary care hospital in Karachi, Pakistan
Journal of Infection in Developing Countries
neonatal sepsis
prolonged rupture of membranes
blood culture
prematurity
title Neonatal sepsis following prolonged rupture of membranes in a tertiary care hospital in Karachi, Pakistan
title_full Neonatal sepsis following prolonged rupture of membranes in a tertiary care hospital in Karachi, Pakistan
title_fullStr Neonatal sepsis following prolonged rupture of membranes in a tertiary care hospital in Karachi, Pakistan
title_full_unstemmed Neonatal sepsis following prolonged rupture of membranes in a tertiary care hospital in Karachi, Pakistan
title_short Neonatal sepsis following prolonged rupture of membranes in a tertiary care hospital in Karachi, Pakistan
title_sort neonatal sepsis following prolonged rupture of membranes in a tertiary care hospital in karachi pakistan
topic neonatal sepsis
prolonged rupture of membranes
blood culture
prematurity
url https://jidc.org/index.php/journal/article/view/3136
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