Current problems of neonatal septicaemia in Barbados - abstract

ABSTRACT

Neonatal septicaemia is a common cause of mortality and morbidity in the neonatal period, contributing factors being rapidly changing causative organisms and increasing resistance of gram-negative organisms. In this study, current problems of neonatal sepsis at the Queen Elizabeth Hospital were analysed in 227 infants suspected of having sepsis and who were admitted to a neonatal special care unit, during a two year period. There were 134 (59 percent) males and 93 (41 percent) females, a ratio of 1.41. Most patients (131 or 61 percent) presented at less than 24 hours of age, the most related obstetric factor being spontaneous vaginal delivery in 162 patients (71 percent). One hundred and twenty-one (50 percent) were low birth weight and 53 percent mothers had ruptured membranes for less than 12 hours. There were 24 deaths, 12 (50 percent) occurring during a Klebsiella epidemic. The mean hospital stay per patient was 12 days. One hundred and sixty-one bacterial isolates were recovered - 47 (29 percent) gram-positive and 114 (71 percent) gram-negative. Staph. albus, Staph. aureus, Klebsiella and E. coli were the most frequent isolates. Bacteriological sensitivity analysis revealed gram-negatives as highly sensitive to gentamycin and tobramycin and gram-positives as highly sensitive to cloxacillin. Proven sepsis was predominantly gram-negative. We recommend practising routine surveillance, aggressive investigation and no change in antibiotic policy at this time.