NEONATAL SEPSIS IN PUNJAB, PAKISTAN: A COMPREHENSIVE STUDY

Abstract

Background: Neonatal sepsis remains a leading cause of neonatal morbidity and mortality in low- and middle-income countries, including Pakistan. In Punjab, the most populous province, limited data exists on the prevalence, causative organisms, and outcomes associated with neonatal sepsis. This study aimed to investigate the clinical profile, risk factors, microbiological patterns, and treatment outcomes of neonatal sepsis in tertiary care settings across Punjab. Methods: A prospective observational study was conducted over six months in three tertiary hospitals in Punjab. A total of 350 neonates presenting with clinical signs of sepsis and confirmed by positive blood cultures were enrolled. Demographic data, maternal and perinatal risk factors, laboratory findings, and treatment outcomes were recorded. Microbiological isolates were identified, and antibiotic sensitivity testing was performed. Data were analyzed using SPSS version 25, with chi-square and logistic regression analyses used to determine associations. Results: Of the 350 neonates, 60% were male and 40% female, with a mean birth weight of 2.5 kg. Gram-negative organisms were the predominant cause (60%), with Klebsiella pneumoniae and Escherichia coli being most common. Gram-positive organisms, particularly Staphylococcus aureus, accounted for 40% of infections. Resistance to commonly used antibiotics such as ampicillin and gentamicin was high, while sensitivity to imipenem and vancomycin remained preserved. Identified risk factors included preterm birth, low birth weight, prolonged rupture of membranes, and maternal infections. The overall mortality rate was 14.9%. Conclusion: Neonatal sepsis in Punjab poses a critical health challenge with high rates of antimicrobial resistance and mortality. Early diagnosis, risk-based screening, and targeted antibiotic stewardship are vital to improving neonatal outcomes in the region.