Bacterial profile of sepsis in a neonatal unit in south India.

ABSTRACT

OBJECTIVE: To study the pattern of sepsis in a neonatal unit in south India and assess the influence of maternal factors on early onset sepsis (EOS). DESIGN: Prospective survey from 1995-1996. SETTING: Medical College Hospital. SUBJECTS: All inborn babies who had clinical signs of sepsis or were born to mothers with potential risk factors for infection were screened for sepsis. Neonatal septicemia was defined as a disease of infants who were younger than 1 month of age, were clinically ill, and had positive blood cultures. RESULTS: Among 13,367 live births in the study period, there were 131 episodes of neonatal septicemia among 125 newborn infants, 18 (14.4%) of whom died. Thirty (24%) had EOS (< or = 48 hours) and 95 (76%) had late onset sepsis (LOS) (> or = 48 hours). Sepsis occurred in 9.8 per 1000 livebirths and 4.4% of all nursery admissions. E. coli and E. fecalis were the predominant organisms causing EOS, while Klebsiella and E. fecalis were the predominant organisms in LOS. The mean gestational age (GA) and birth weight (BW) of babies with EOS was significantly higher than those with LOS. Maternal factors significantly associated with EOS were meconium staining of liquor and multiple vaginal examinations. CONCLUSIONS: The incidence of neonatal bacterial sepsis is 9.8 per 1000 livebirths. E. coli and Klebsiella were the most common organisms causing EOS and LOS, respectively. E. fecalis was also a major pathogen, both in EOS and LOS.