Clinical observation of neonatal sepsis

ABSTRACT

Ninety two cases of culture proved neonatal sepsis who had been admitted to pediatric department, National medical Center, during 7 years from Jan. 1984 to Dec. 1990 were reviewed clinically and the following results were obtained. 1) The frequency of neonatal sepsis was 3.1% and male to female sex ratio was 1.91, Sepsis was more prevalent in premature infants (9.9%) than in full term infants (1.9%). 2) The seasonal incidence was more prevalent in summer (32.6%). 3) The weight distribution showed 50 cases with the weight less than 2500 gram and 42 cases more than 2500 gram. 4) In 76 cases the onset was before 7 days old and in 16 cases were developed after 7 days old. 5) The major associated perinatal conditions in neonatal sepsis were institutional baby (23.9%), premature rupture of membranes (11.9%) and placenta previa (4.3%) in the order of frequency. The clinical manifestations on admission were jaundice (50.0%), poor activity (46.7%), respiratory difficulty (35.9%), poor feeding (22.8%), cyanosis (22.7%), gastrointestional symptoms (21.5%), fever (15.2%) and convulsion (13.0%) in the order of frequency. 6) The associated diseases were urinary tract infection (31.5%), hyaline membrane disease (19.6%), congenital disorder (18.5%), pneumonia (15.2%), anemia (13.0%), meningitis (9.8%), omphalitis (7.6%), DIC (6.5%), necrotizing enterocolitis (5.4%) and intracranial hemorrhage (5.4%) in the order of frequency. 7) Causative organisms were gram positive organisms in 27 cases (25.7%) and gram negative organisms in 79 cases (74.3%). The main organisms were Serratia marcescens (18.5%). Enterobacter spp (17.4%), Klebsiella pneumoniae (12.0%), Staphylococcus aureus (10.9%), Acinetobactor calcoaceticus (8.7%), Coagulase (-) staphylococcus (8.7%), E. coli (8.7%), Enterococcus (6.5%), Group B beta-hemolytic streptococcus (5.4%) and Pseudomonas (5.4%) in the order of frequency. The sensitivity to antibiotics were Serratia marcescens 70.6% sensitive to Amikacin 58. 9% sensitive to Cefotaxime 59. Enterobacter spp 87.5% sensitive to Amikacin 68.8% sensitive to Cefotaxime Klebsiella pneumoniae 100% sensitive to Amikacin 91. 0% sensitive to Cefotaxime Staphylococcus aureus 100% sensitive to Cefazolin 90. 0% sensitive to Cefotaxime Acinetobacter calcoaceticus 88.9% sensitive to Amikacin Coagulase (-) Staphylococcus 100% sensitive to Amikacin 87. 5% sensitive to Cefotaxime E. coli 100% sensitive to Amikacin, Cefotaxime Enterococcus 50% sensitive to Gentamicin, Ampicillin, Amikacin Group B beta-hemolytie Streptococcus 100% sensitive to Ampicillin, Penicillin Pseudomonas 100% sensitive to Amikacin, Gentamicin, Tobarmycin 8) Mortality cases were 32 cases (34.8%).