Globally, sepsis is still one of the major causes of morbidity and mortality in neonates, in spite of recent advances in health care system. The major burden of neonatal sepsis occurs in developing world, but most evidence is derived from developed countries. Hospital based prospective cross sectional study was conducted from April 2016 to May 2017. Neonates with clinical sepsis using inclusion criteria were included in the study. Blood sample was taken aseptically and culture process was done per the standard. Data were analyzed using EPI-INFO 3.5 and SPSS version 17. Frequencies, proportion and summary statistics were used to describe the study population in relation to relevant variables. Binary logistic regressions were used to assess risk factors associated with neonatal sepsis. P value of < 0.05 was taken to be statistically significant. A total of 890 neonatal admissions of which 303 neonates were admitted with diagnosis of suspected neonatal sepsis making the prevalence of clinical neonatal sepsis to be 34%. Males accounted for 198 (65.3%) of neonates with clinical sepsis. Positive blood culture results were reported in 88(29.3%) suspected neonatal sepsis of which gram positive bacteria accounted for 47(53.4%) of all bacteria growth, and majority of positive blood culture were reported from late onset neonatal sepsis. Coagulase negative staphylococcus (CoNS) account for 22(25%) followed by E.coli, S.aureus and Klebsiella spp each contributing 18(20.3%), 16(18.2%) and 11(12.5%) respectively. Prolonged PROM, low fifth Apgar score, prematurity and low birth weight were strongly associated with neonatal sepsis. Neonates born to mothers who received antibiotics during labor and delivery were at significantly lower risk of acquiring neonatal sepsis. The prevalence of neonatal sepsis was high and most identified bacteria causing neonatal sepsis were gram positive bacteria and most bacteria were identified from late onset sepsis. Obstetric risk factors were strongly associated with neonatal sepsis. Intrapartal antibiotic administration significantly reduces neonatal sepsis.

Keywords: Neonatal sepsis, gram positive, gram negative