More than a third of newborns diagnosed with sepsis— a life-threatening immune system response to an infection— could die, a study published recently in The Lancet Global Health journal said.
The study conducted at five district hospitals in India analysed data of over 6,600 newborns and found that the overall incidence of sepsis ranged from 0.6% to 10%. The incidence was higher among newborns referred from other hospitals than in those born at the same facility. The study stated that while the high case-fatality rate in the former category was expected, given the late and selective referral of sick neonates from other health facilities, the 25·9% case-fatality rate in inborn neonates (born in same facility) was especially concerning.
“The incidence of culture-positive sepsis was 3.2% (213 of 6612). It varied among the study sites, ranging from 0.6% to 10%. The incidence was 2.5-fold higher in outborn neonates than inborn neonates. Also the case-fatality rate in neonates with culture-positive sepsis was 36.6% (78 of 213). It varied markedly among the study sites, ranging from 0 to 51.1%, and between inborn and outborn neonates,” the study said.
Culture-positive sepsis refers to a diagnosis of sepsis where a bacterial pathogen has been identified through a laboratory culture taken from a patient’s blood or other relevant bodily fluids, meaning a positive result on a culture test confirming the presence of bacteria causing the infection.
The study stressed the need to strengthen infection prevention and control measures while implementing programmes that ensure a judicious use of antibiotics.
Neonatal sepsis results in more than 5,50,000 deaths globally every year. India accounts for nearly one-fourth of the global burden of infection-related deaths. Sepsis remains a major hurdle to lowering neonatal mortality rates in low- and middle-income countries (LMICs).
For the study, neonates were enrolled to five special newborn care units (SNCUs) of district hospitals located across India— Government Hospital, Cuddalore, T.N.; District Hospital, Mahasamund, Chhattisgarh; Regional Hospital, Una, Himachal Pradesh; Civil Hospital, Sivasagar, Assam; and Government Nahata Hospital, Balotra, Rajasthan.
The study titled “Multidrug-resistant sepsis in special newborn care units in five district hospitals in India: a prospective cohort study’’ found that data of sepsis in newborns at district hospitals in LMICs was scarce. It added that antibiotic resistance, in which infection-causing germs become immune to the drugs designed to kill them, was a major challenge in managing sepsis.
It further noted that unlike tertiary hospitals, SNCUs in district hospitals do not cater for neonates who are critically ill, require invasive ventilation, or who are born extremely premature.
“The high burden of sepsis in these facilities, despite caring for relatively stable neonates, is worrisome,’’ notes the study.
Published – February 27, 2025 07:56 pm IST
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