Neonatal Sepsis Prevention: Literature Review
Table of Contents Research Questions Sample Populations Limitations of Studies Conclusion References The number of cases of hospital-acquired infections (HAI) and sepsis is a matter of concern worldwide. In particular, sepsis is a considerable bother for pediatric department workers since neonatal sepsis is among the primary causes of newborn mortality. The use of preventative measures, such as prevention antibiotics, handwashing strategies, and routine assessment for sepsis risk factors may be beneficial for reducing the number of HAIs and sepsis cases. The present paper offers a comprehensive literature review of the problem featuring four articles, and provides recommendations for further research. Research Questions The research questions revolve around the importance of preventative measures to reduce the number of HAIs and sepsis in particular. Gelano, Bacha, and Abate (2019) study how chlorhexidine cord application affects the development of neonatal sepsis in developing countries. They conclude that the use of the antiseptic significantly reduces morbidity and mortality among newborns and recommend the inclusion of the procedure into essential neonatal care.
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Irshad, Hayat, Parvez, Ullah, and Rehman (2019) offer a timely diagnosis as a measure to reduce morbidity and mortality among neonatal patients. The research states that the utilization of qualitative assessment of C-reactive protein (CRP) is an inexpensive test that can reduce unnecessary antibiotic administration. The two articles choose measures for the prevention of morbidity and mortality among neonates as their research subject. Apart from suggesting methods to improve patient outcomes, current research also gives significant insights into the nature of sepsis. The study conducted by Adatara et al. (2018) aimed at studying the risk factors of neonatal sepsis among newborns that were delivered via cesarean section. The authors conclude that sepsis is a significant issue among the studied population and recommend routine assessment of neonates for risk factors of sepsis. Al-Mouqdad et al. (2018) aim at studying microorganisms responsible for the development of sepsis and their susceptibility to antibiotics. The research shows that Gram-positive organisms, particularly S. epidermidis, were frequently encountered, and they had low antimicrobial resistance due to restriction of broad-spectrum antibiotic use. In brief, the research question of these two studies was to provide a better understanding of the nature and epidemiology of neonatal sepsis. Sample Populations The researchers in the four articles discussed in the present paper focus on studying neonates. Gelano et al. (2019) offer a review of a total of 129,293 participants in developing countries. The sample is large, and the conclusions have greater credibility due to this matter. Irshad et al. (2019) conduct their study analyzing a selection of 196 newborns in the Pediatric Unit of Lady Reading Hospital Peshawar Pakistan. Al-Mouqdad et al. (2018) studied a sample of 295 inborn premature infants aged ≤180 days in intensive care settings. Adatara et al. (2018) review the cases of 383 neonates at a hospital in Ghana. Apart from Gelano et al. (2019), all the other articles feature a medium sample of newborns in one healthcare facility. Additionally, all the pieces are from developing countries imposing limitations to the research results. In summary, all the articles overviewed in the present paper share some common characteristics in sample choice while differing in research questions. Limitations of Studies As stated above, some of the boundaries lie in the chosen sample for the studies. On the one hand, Gelano et al. (2019) review more than a hundred thousand cases, which is a significant sample size that supports the generalization and universality of the study. On the other hand, the results of the other three articles are limited to only one hospital and less than 400 people. These characteristics of the sample prevent the authors from generalizing the results.
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Additionally, since all the studies are conducted in developing countries, the conclusions may be questioned due to the absence of evidence from European and North American countries. Therefore, samples are the primary sources of limitations in the experimental research. There are also other issues that should be mentioned that may interfere with the credibility of the study results. First, the results apply only to neonates instead of addressing the entire population. Second, Gelano et al. (2019) mention that their systematic review included studies published only in English. Third, the inconsistency of the definition of cord infection/sepsis among different tasks may also be a source of bias. Even though the articles by Ishrad et al. (2019) and Al-Mouqdad et al. (2018) fail to include the limitations section, the critical analyses of the studies can help to identify them. In short, while the discussed articles share some characteristics, their limitations may vary due to the difference between research designs and objectives. Conclusion The conducted literature review reveals the importance of the problem of sepsis on the hospital grounds. The four articles observed in the present paper promote the idea that preventative measures are helpful to decrease morbidity and mortality among neonates. Even though the articles offer a review of more than 120,000 cases, the results of the research are limited due to the inconsistency of definitions and the characteristics of samples and research methods. The recommendation for further research is to expand the knowledge about sepsis and other HAIs in the adult population in developed countries. References Adatara, P., Afaya, A., Salia, S., Afaya, R., Kuug, A., Agbinku, E., & Agyabeng-Fandoh, E. (2018). Risk Factors for Neonatal Sepsis: A Retrospective Case-Control Study among Neonates Who Were Delivered by Caesarean Section at the Trauma and Specialist Hospital, Winneba, Ghana. Biomed Research International, 2018, 1-7. Web. Al-Mouqdad, M., Alaklobi, F., Aljobair, F., Alnizari, T., Taha, M., & Asfour, S. (2018). A retrospective cohort study patient chart review of neonatal sepsis investigating responsible microorganisms and their antimicrobial susceptibility. Journal Of Clinical Neonatology, 7(3), 141. Web. Gelano, T. F., Bacha, Y. D., & Abate, D. (2019). Effect of chlorhexidine cord application on prevention of neonatal sepsis in developing countries: Systematic review and meta-analysis. Journal of Health Sciences, 40-51. Web.
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Irshad, M., Hayat, M., Parvez, H., Ullah, I., & Rehman, Z. (2019). Neonatal sepsis; Diagnostic accuracy of C-reactive protein (CRP) in the diagnosis of neonatal sepsis. The Professional Medical Journal, 26(04). Web.