Frequency of Meningitis and Associated Risk Factors in Neonates with Late-Onset Sepsis at NESCOM Hospital, Islamabad

Abstract

Objective: To determine the frequency of meningitis and its associated risk factors among neonates with late-onset sepsis (LOS), defined as sepsis occurring after the first 72 hours of life.

Methodology: This cross-sectional study was conducted in the Department of Paediatrics, NESCOM Hospital, Islamabad, from March 2025 to September 2025. A total of 105 neonates aged >72 hours to 28 days who were admitted with a diagnosis of late-onset sepsis (LOS) were consecutively enrolled in the study. All neonates underwent lumbar puncture for cerebrospinal fluid (CSF) analysis. Meningitis was diagnosed using pre-defined CSF criteria. Demographic, perinatal, and socioeconomic data were recorded on a structured proforma. 

Results: The median age was 18 days (IQR 11) with female predominance (54.3%). Meningitis was diagnosed in 26 of 105 neonates (24.8%; 95% CI 16.9–32.7%). 

Conclusion: Nearly one in four neonates with LOS in our cohort had meningitis, with a strong, statistically robust association with low birth weight and preterm birth. Lumbar puncture should be performed with a low threshold in suspected LOS particularly in preterm or LBW neonates and obstetric care plus hospital infection control must be strengthened to prevent this serious complication.