Background Neonatal septic shock is a devastating condition associated with high morbidity and mortality.

Methods A retrospective study was conducted in children’s hospital Tunisian PICU between 2005 to 2013. All neonates (<28 days) treated for septic shock with bacterial proof were included. Nosocomial infection was an exclusion critéria. The chart review relieved demographics, length of stay, therapies and outcomes.

Results A total of 40 neonates were included. Mean age on admission was 34 h±3.7. Mean SNAPP score was 25 ± 17. Materno-fetal infection was observed in 37 cases, staphylococcal pneumonia in 2 cases and bacterial coinfection with bronchiolitis in the last case. The bacteriological study showed a notable predominance of streptococcus B (40%) and E.coli (35%). All patients required mechanical ventilation (mean duration: 85 ± 556 h) and haemodynamic support (mean duration 49 ± 335 h). Mortality rate was 19% in full term infants, 12.5% in near term infants and 27% in extremely preterm infants.

Conclusions Our results would indicate a high mortality rate in neonatal septic shock. A goal –directed therapy for septic shock, implanted in our PICU, could improve outcomes for this vulnerable population.