Comparison of clinical characteristics and outcomes of neonates with culture-negative versus culture-positive sepsis: a prospective cohort study

Neonatal sepsis causes high morbidity and mortality in NICUs worldwide especially in low and middle income countries like India where 51 to 56.7 percent of cases are culture negative despite clinical signs. The Delhi Neonatal Infection Study found sepsis incidence at 14.3 percent with culture negative cases at 8.1 percent or 56.7 percent of total sepsis and mortality risks of 8.6 percent for culture negative and 27.7 percent for culture positive. Data on culture negative sepsis outcomes and management is limited and inconsistent. This study will measure its proportion in NICU admissions compare demographics risk factors presentation and outcomes with culture positive sepsis and test if culture negative cases have shorter recovery less severity and different antibiotic use to guide better care and stewardship.