[Early-onset neonatal bacterial infections: a series of 144 cases]

Early-onset neonatal bacterial infections continue to be a major cause of morbidity and mortality in the newborn. The aim of this study was to determine the incidence, the risk factors and bacterial epidemiology of these infections. All cases of early-onset neonatal bacterial infections were identified for the years 2001-2003 using data from obstetric and neonatal reports at the neonatal unit of Charles Nicolle Hospital. 144 cases were identified over 11 201 live births, that is an incidence of 12.85%, of which 22 cases of sepsis infections. 22.9% of all newborns were premature and 18% had a low birth weight. Membrane rupture occurred more than 12 hours before delivery in 63.2% of cases and an intra-partum fever in 57.7% of cases. Half of newborns were symptomatic with a mean age of 7.5 hours at onset of symptomatology. The principal etiologic agents were Group B Streptococcus [GBS] and Escherichia coli [E.coli], responsible respectively of 50% and 29.1% of proved infections. GBS had been recognised as the most prevalent agent in term newborn [58.9%] and the E.coli in premature newborn [38.5%]. The neonatal mortality before discharge was 2.77% of all cases. Neonatal bacterial infections continue to be a major cause of morbidity in the newborn. The most common etiologic agents remain GBS and E.coli