Neonatal septicemia in high risk babies in South-Eastern Nigeria
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Juliana U. Ojukwu
Abstract
Background: Septicemia is one of the major causes of morbidity and mortality in the neonatal period and it often has a rapid and fulminant course.
Aims: To determine the incidence, predisposing factors, clinical features, bacteriologic pattern and antibiotic sensitivity of neonatal septicemia.
Design: A prospective study was undertaken over a 1½-year period in the neonatal unit of Ebonyi State University Teaching Hospital, Abakaliki, Southeastern Nigeria.
Methods: All newborns (age 0–28 days) admitted with clinical features and/or risk factors suggestive of neonatal septicemia were selected and screened for septicemia.
Results: The study identified 33 septicemic neonates of the 138 neonates (23.9%) screened, 19/92 (20.7%) for inborns and 14/46 (30.4%) for outborns, representing an incidence of 7.98/1000 live births. Prolonged/obstructed labor, severe birth asphyxia, maternal pre-partum/peripartum pyrexia and home/traditional birth attendant deliveries were the main predisposing perinatal factors. Respiratory distress, fever and jaundice were the predominant presenting clinical findings. Gram-positive organisms were cultured from 18 neonates with Staphylococcus aureus accounting for 45.5% of the cases, while Escherichia coli was the predominant Gram-negative organism accounting for 18.2% of the cases. Group B streptococcus accounted for only one case and there was no case of Listeria monocytogenes. Early onset septicemia was commoner in in born while late onset septicemia was commoner with out born (χ2=10.45, P<0.05). The bacterial isolates showed a high degree of in vitro antimicrobial resistance to conventional antibiotics and the antibiotic sensitivity pattern of the organisms indicated the use of ceftriaxone and gentamicin as initial therapy while awaiting culture results. The overall mortality rate was 26.7%. Early onset septicemia and concomitant meningitis were associated with high mortality.
Conclusion: Neonatal septicemia is a major cause of morbidity and mortality in the study site. Most of the predisposing factors were due to poor obstetric care and unsterile delivery practices which could be avoided and prevented, and the causative organisms were different from those in the developed countries. There was appreciable resistance to commonly used antibiotics. Simple and sustainable interventions such as promotion of clean and timely deliveries, modern newborn care and specialized diagnostic facilities, hand washing and barrier nursing, and restriction of antibiotics may help reduce the burden of neonatal infection in the study community.
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©2005 by Walter de Gruyter Berlin New York
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- Congress Calendar
Artikel in diesem Heft
- Intrapartum fetal monitoring today
- Placental Doppler velocimetry in gestational diabetes mellitus
- Induction of labor with oral misoprostol in nulliparous mothers of twins
- Is the nausea and vomiting of early pregnancy really feto-protective?
- Tele-virtual sonography
- The effect of betamethasone administration on uterine motility in pregnancy. A prospective study using four-channel tocography
- Perinatal outcomes of spontaneous twins compared with twins conceived through intracytoplasmic sperm injection
- Doppler sonography of the uterine and the cubital arteries in normal pregnancies, preeclampsia and intrauterine growth restriction: evidence for a systemic vessel involvement
- The efficacy of first-trimester PAPP-A and free βhCG levels for predicting adverse pregnancy outcome
- Sonographic monitoring of systemic and local methotrexate (MTX) therapy in patients with intact interstitial pregnancies
- The Northwestern twin chorionicity study: testing the ‘placental crowding’ hypothesis
- Combined first trimester screening for trisomy 21: lack of agreement between risk calculation methods
- Neonatal septicemia in high risk babies in South-Eastern Nigeria
- Maternal antenatal administration of vitamin K1 results in increasing the activities of vitamin K-dependent coagulation factors in umbilical blood and in decreasing the incidence rate of periventricular-intraventricular hemorrhage in premature infants
- Antenatal diagnosis of velocardiofacial syndrome by 3D ultrasonography
- Congress Calendar
