Incidence and Management of Neonatal Sepsis at the University of Calabar Teaching Hospital, South South Nigeria

Neonatal sepsis is a major contributor to neonatal mortality globally and represents a significant clinical challenge in resource-limited settings. This descriptive retrospective study examines the incidence, causative organisms, clinical presentations, and management outcomes of neonatal sepsis at the University of Calabar Teaching Hospital (UCTH), Cross River State, South South Nigeria. Medical records of 215 neonates admitted to the neonatal unit with a diagnosis of sepsis between January 2021 and December 2023 were reviewed. Data extracted included gestational age, birth weight, mode of delivery, maternal risk factors, blood culture results, antibiotic regimens used, and clinical outcomes. The incidence of neonatal sepsis was 24.6 per 1,000 live births. Early-onset sepsis accounted for 58.2% of cases, while late-onset sepsis represented 41.8%. Gram-negative organisms, particularly Klebsiella pneumoniae and Escherichia coli, were the most frequently isolated pathogens. Case fatality rate was 21.4%, with prematurity and low birth weight as significant mortality predictors. First-line empirical therapy with ampicillin and gentamicin was initiated in 89% of cases. Challenges identified included delayed laboratory turnaround times and antibiotic resistance patterns. The findings highlight the need for improved infection prevention measures in the delivery suite, rational antibiotic prescribing, and investment in rapid diagnostic capabilities. Keywords: neonatal sepsis, incidence, Calabar, causative organisms, neonatal mortality.