Association between neutropenia and death rate of bacterial neonatal sepsis

Abstract

Background Neonatal sepsis remains a crucial problem with high morbidity and mortality. Not less than four million neonates die every year, 99% of which occur in developing countries with infection as the main cause (36%) of death. The prognostic factors of bacterial neonatal sepsis vary. However the death rate in neonatal sepsis with neutropenia is suspected to be higher than that in non-neutropenic condition. Objectives The purpose of this study was to identify whether neutropenia would increase the death risk of bacterial neonatal sepsis. Methods We conducted a retrospective cohort study. Subjects were neonates at Instalasi Maternal Perinatal (IMP) of Dr. Sardjito Hospital in Yogyakarta who met the eligibility criteria. During the five-year period Qanuary 2002- January 2007), out of 1821 cases of suspected neonatal sepsis, 365 (16.7%) were found to have bacterial cause in the culture of body's fluid (blood, urine, and cerebrospinal). Out of these 16.7% patients suffering from neutropenia, 39.6% patients died, whereas 9.1 o/o patients were survive [RR 4.72, (95% CI: 2.49 to 8.93), P < 0.01]. Conclusion Neonates suffering bacterial sepsis with neutropenia had death risk 4.7 times higher than those who did not have neutropenia.

Keywords

• bacterial neonatal sepsis
• neutropenia
• death rate