C Suresh Kumar1, Sreeram Subramanian2, Srinivas Murki3, J V Rao4, Meera Bai5, Sarguna Penagaram5, Himabindu Singh6, Nirupama Padmaja Bondili7, Alimelu Madireddy6, Swapna Lingaldinna6, Srikanth Bhat4, Bharadwaj Namala6. 1. Department of Pediatrics, Institute of Child Health, Niloufer Hospital, Osmania Medical College, Hyderabad, Telangana. 2. Department of Neonatology, Paramitha and NeoBBC Children Hospital, Hyderabad, Telangana. Correspondence to: Dr Sreeram Subramanian, Neonatologist, Paramitha and NeoBBC Children Hospital, Hyderabad, Telangana. drsreeraman@yahoo.co.in. 3. Department of Neonatology, Fernandez Hospital, Hyderabad, Telangana. 4. Department of Pediatrics, Gandhi Hospital and Medical College, Hyderabad, Telangana. 5. Department of Microbiology, Osmania Medical College and SRRIT and CD, Hyderabad, Telangana. 6. Department of Neonatology, Niloufer Hospital and Osmania Medical College, Hyderabad, Telangana. 7. Department of Microbiology, Fernandez Hospital, Hyderabad, Telangana.
Abstract
BACKGROUND: Neonatal pneumonia contributes significantly to mortality due to pneumonia in the under-five age group, but the predictors of mortality are largely unknown. OBJECTIVES: To evaluate the clinical and microbiological characteristics and other risk factors that predict mortality in neonates admitted with pneumonia in tertiary care centres. STUDY DESIGN: Prospective observational cohort study. PARTICIPANTS: Term and preterm (32 weeks to 36 6/7 weeks) neonates (<28 days of life) admitted with clinical and radiological features suggestive of pneumonia. INTERVENTION: Baseline sociodemographic data, clinical details, blood culture and nasopharyngeal swabs for virologic assay (RT PCR for RSV, Influenza) were collected at admission and the neonates were observed throughout their hospital stay. OUTCOME: The primary outcome was predictors of mortality in neonatal pneumonia. RESULTS: Five hundred neonates were enrolled in the study. Out of 476 neonates with known outcomes, 39 (8.2%) died. On multivariate analysis, blood culture positive sepsis was independently associated with mortality (adjusted OR 2.51, 95% CI1.23 to 5.11; P-0.01). CONCLUSIONS: Neonates with blood culture positive pneumonia positive are at a higher risk of death.
BACKGROUND: Neonatal pneumonia contributes significantly to mortality due to pneumonia in the under-five age group, but the predictors of mortality are largely unknown. OBJECTIVES: To evaluate the clinical and microbiological characteristics and other risk factors that predict mortality in neonates admitted with pneumonia in tertiary care centres. STUDY DESIGN: Prospective observational cohort study. PARTICIPANTS: Term and preterm (32 weeks to 36 6/7 weeks) neonates (<28 days of life) admitted with clinical and radiological features suggestive of pneumonia. INTERVENTION: Baseline sociodemographic data, clinical details, blood culture and nasopharyngeal swabs for virologic assay (RT PCR for RSV, Influenza) were collected at admission and the neonates were observed throughout their hospital stay. OUTCOME: The primary outcome was predictors of mortality in neonatal pneumonia. RESULTS: Five hundred neonates were enrolled in the study. Out of 476 neonates with known outcomes, 39 (8.2%) died. On multivariate analysis, blood culture positive sepsis was independently associated with mortality (adjusted OR 2.51, 95% CI1.23 to 5.11; P-0.01). CONCLUSIONS: Neonates with blood culture positive pneumonia positive are at a higher risk of death.