OBJECTIVE: To estimate the
incidence of neonatal septicaemia, and to identify
risk factors , clinical presentations and causal organisms.
DESIGN: A
cross-sectional study .
SETTING: Neonatal Care Unit,
University Paediatric Unit, Colombo North
Teaching Hospital .
SUBJECTS: Neonates admitted from January to December 1996 with clinical evidence of septicaemia.
METHOD: Gestational age ,
birth weight and mode of delivery were evaluated as
risk factors for septicaemia. Although
diagnosis of septicaemia was made on clinical grounds,
blood cultures were performed in all babies. Data was analysed by using Epi Info version 6.
RESULTS: 98 babies had septicaemia.
Incidence of septicaemia was 24.4 per 1000
live births and
case fatality rate was 11.2%.
Incidence was significantly higher in preterm babies, babies with
low birth weight (LBW) and those born following instrumental delivery. 21.4% developed septicaemia on the first day of
life , 74.5% between 2 and 7 days and 4.1% after the first week. Common presenting features were
fever 61.2%,
jaundice 52%,
lethargy 37.8% refusal of feeds 25.5%,
coffee grounds
vomiting 22.4%, and fits 12.2%. Common
bacteria identified were
Klebsiella 26.5%,
Staphylococcus aureus 15.3%,
coliform bacilli 9.2% and
spore forming bacilli 9.2%. Common sensitive
antibiotics were
amikacin 88.9%,
amoxycillin +
clavulanic acid 83%,
ceftriaxone 78.1% and
netilmicin 63.9%.
CONCLUSIONS: Septicaemia is an important cause of
morbidity , particularly in preterm babies, in babies with LBW and those with
instrumentation at
birth . The high
incidence of late onset septicaemia together with the findings of
Klebsiella and
Staphylococcus aureus as common and resistant pathogens for septicaemia indicate that the majority were
nosocomial infections .