Changing trends in newborn sepsis in Sagamu, Nigeria: Bacterial aetiology, risk factors and antibiotic susceptibility.
Summary of "Changing trends in newborn sepsis in Sagamu, Nigeria: Bacterial aetiology, risk factors and antibiotic susceptibility."
Aim:  Sepsis is a major contributor to newborn deaths in the developing world. The objective is to determine the prevalence of newborn sepsis, the bacterial pathogens and antibiotic sensitivity pattern of the isolates. Method:  A study of consecutive babies hospitalised in Sagamu, Nigeria, with risk factors for or clinical features of sepsis was retrospectively done between January 2006 and December 2007, and prospectively between January and December 2008. Positive blood culture defined neonatal sepsis, and the antibiotic sensitivity pattern of the organisms was also determined. Results:  There were 1050 admissions, and 174 (16.5%) babies had positive blood culture. Of the 527 babies with risk factors and clinical features of sepsis, 174 (33.3%) had confirmed sepsis: 119 (22.5%) had early-onset sepsis, while 55 (10.4%) had late-onset sepsis. The incidence of neonatal sepsis in the hospital was 51.3/1000 live births. Weight less than 1.5 kg, prolonged labour, prolonged rupture of membranes and lower socio-economic status were risk factors for sepsis. Staphylococcus aureus (31.0%), Klebsiella (23.0%), and coagulase-negative Staphylococcus (12.6%) and Escherichia coli (11.0%) were the leading aetiologies. The isolates were most sensitive to levofloxacin (95.7%), ofloxacin (95.1%), cefotaxime (86.7%) and ceftazidime (81.3%). Their sensitivity was 56.4% to cefuroxime and gentamicin, which are commonly used. Conclusion:  The prevalence of sepsis was high in this cohort of high-risk infants. The low in vitro sensitivity of the leading microbes to commonly used drugs is challenging. Guidelines on the reduction of emergence of drug resistance must be provided and instituted in newborn units.
Affiliation
Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria.
Journal Details
This article was published in the following journal.
Name: Journal of paediatrics and child health
ISSN: 1440-1754
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20973858
- DOI: http://dx.doi.org/10.1111/j.1440-1754.2010.01882.x
Medical and Biotech [MESH] Definitions
Sepsis
Systemic inflammatory response syndrome with a proven or suspected infectious etiology. When sepsis is associated with organ dysfunction distant from the site of infection, it is called severe sepsis. When sepsis is accompanied by HYPOTENSION despite adequate fluid infusion, it is called SEPTIC SHOCK.
Bacterial Translocation
The passage of viable bacteria from the gastrointestinal tract to extra-intestinal sites, such as the mesenteric lymph node complex, liver, spleen, kidney, and blood. Factors that promote bacterial translocation include overgrowth with gram-negative enteric bacilli, impaired host immune defenses, and injury to the intestinal mucosa resulting in increased intestinal permeability. These mechanisms can act in concert to promote synergistically the systemic spread of indigenous translocating bacteria to cause lethal sepsis.
Kernicterus
A term used pathologically to describe BILIRUBIN staining of the BASAL GANGLIA; BRAIN STEM; and CEREBELLUM and clinically to describe a syndrome associated with HYPERBILIRUBINEMIA. Clinical features include athetosis, MUSCLE SPASTICITY or hypotonia, impaired vertical gaze, and DEAFNESS. Nonconjugated bilirubin enters the brain and acts as a neurotoxin, often in association with conditions that impair the BLOOD-BRAIN BARRIER (e.g., SEPSIS). This condition occurs primarily in neonates (INFANT, NEWBORN), but may rarely occur in adults. (Menkes, Textbook of Child Neurology, 5th ed, p613)
Live Birth
The event that a FETUS is born alive with heartbeats or RESPIRATION regardless of GESTATIONAL AGE. Such liveborn is called a newborn infant (INFANT, NEWBORN).
Benin
A republic in western Africa, south of NIGER and between TOGO and NIGERIA. Its capital is Porto-Novo. It was formerly called Dahomey. In the 17th century it was a kingdom in the southern area of Africa. Coastal footholds were established by the French who deposed the ruler by 1892. It was made a French colony in 1894 and gained independence in 1960. Benin comes from the name of the indigenous inhabitants, the Bini, now more closely linked with southern Nigeria (Benin City, a town there). Bini may be related to the Arabic bani, sons. (From Webster's New Geographical Dictionary, 1988, p136, 310 & Room, Brewer's Dictionary of Names, 1992, p60)
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