Abstract

Background: Late-onset neonatal infection (LONI) remains a leading cause of neonatal morbidity and mortality, especially in developing countries. Despite advances in neonatal care, its diagnosis and management continue to be challenging due to non-specific clinical manifestations. This study aims to describe the clinical and laboratory characteristics and identify risk factors associated with late-onset neonatal infection in hospitalized newborns.

Methods: A cross-sectional descriptive study was conducted on 166 neonates diagnosed with late-onset infection admitted to the Department of Neonatal Intensive Care – Center for Pediatrics, Hue Central Hospital, from May 2022 to June 2024. Demographic, clinical, laboratory, and microbiological data were collected. Statistical analysis was performed using SPSS 22.0, with chi-square and Fisher’s exact tests to determine associations (p < 0.05 considered significant).

Results: The study included 56.6% males and 84.9% term newborns. Pneumonia was the most common clinical presentation (50.6%), followed by sepsis (13.9%), omphalitis (10.2%), and gastrointestinal infection (10.2%). Fever (56.6%) and poor feeding (75.3%) were the most frequent symptoms. Elevated CRP was observed in 16.3% of patients, while positive blood cultures were found in 3.7%. Staphylococcus aureus (including MRSA) was the predominant isolate from pus and umbilical samples. Exclusive breastfeeding reduced the risk of sepsis (OR = 0.14, p < 0.05). Contact with respiratory infections and frequent milk aspiration increased the risk of pneumonia (OR = 3.9 and 1.9, respectively). Improper umbilical care tripled the risk of skin and umbilical infections (OR = 3.46, p < 0.05).

Conclusions: Late-onset neonatal infection commonly presents as pneumonia or sepsis. Exclusive breastfeeding and proper postnatal care significantly reduce infection risk, whereas exposure to respiratory infections and poor feeding practices increase vulnerability. Strengthening caregiver education and infection control can improve neonatal outcomes.