Burden, clinical characteristics, and determinants of neonatal sepsis in a tertiary hospital in North-Central Nigeria: a retrospective study
摘要
Neonatal sepsis remains a leading cause of neonatal morbidity and mortality in low- and middle-income countries, including Nigeria. Despite improvements in neonatal care, the burden of sepsis persists, and locally generated evidence is essential for guiding context-specific prevention and management strategies.
ObjectiveTo determine the prevalence, clinical presentation, laboratory and microbiological profile, and associated maternal, neonatal, and health-system factors of neonatal sepsis among neonates admitted to Federal Medical Centre (FMC), Keffi, North-Central Nigeria.
MethodsThis retrospective study reviewed records of 530 neonates admitted to FMC Keffi between January 2023 and April 2025. Data on socio-demographic characteristics, clinical features, laboratory findings, microbiological results, maternal and obstetric factors, and neonatal outcomes were extracted using a structured proforma. Neonatal sepsis was diagnosed based on clinical assessment supported by laboratory and microbiological findings. Descriptive statistics were used to summarize variables. Associations were tested using chi-square tests and independent samples t-tests. Multivariable logistic regression was performed to identify independent predictors of neonatal sepsis. Statistical significance was set at p < 0.05.
ResultsThe prevalence of neonatal sepsis was 35.3% (187/530). Fever was the most common presenting feature among neonates with sepsis (55.6%), followed by lethargy (26.2%) and respiratory distress (18.2%). All neonates had elevated C-reactive protein levels, and elevated white blood cell counts were common in both sepsis and non-sepsis groups. Blood cultures yielded pathogens in 42.8% of septic neonates, with Escherichia coli, coagulase-negative Staphylococci, Candida albicans, and Pseudomonas aeruginosa being the predominant isolates. No significant associations were found between neonatal sepsis and gestational age, sex, prolonged premature rupture of membranes, place of birth, or mode of delivery (p > 0.05). Multivariable logistic regression identified no independent predictors of neonatal sepsis, although CRP showed a borderline association.
ConclusionNeonatal sepsis remains a substantial burden among admitted neonates in FMC Keffi. The absence of strong associations with traditional risk factors highlights the complexity of neonatal sepsis and underscores the need for enhanced diagnostic capacity and comprehensive clinical surveillance.