title: Neonatal sepsis in Pakistan. Presentation and pathogens.
abstract: The case records of all neonates admitted to the neonatal unit at Aga Khan University Hospital (Karachi) in a 30 month period (Nov. 86-April 89) were analysed. Of 60 neonates with confirmed sepsis, 33 (55%) had non-nosocomial infection (NNC) whereas 27 (45%) had nosocomial sepsis (NC). The most common organisms causing early-onset NNC sepsis were Klebsiella species (53%) and Escherichia coli (10%), whereas the organisms causing late-onset NNC sepsis included Salmonella parathypi (21%), Group A Streptococcus (21%), Escherichia coli (14%) and Pseudomonas species (14%). Klebsiella was the most common organism causing NC sepsis, others being Staphylococcus aureus (15%) and Serratia species (15%). The mortality in NC sepsis, early-onset and late onset NNC sepsis was 44%, 26% and 43%, respectively. Risk factors associated with NNC sepsis included low birthweight, prematurity and prolonged and complicated deliveries. There was a high incidence of drug resistance to ampicillin and gentamicin among gram-negative organisms causing sepsis (mean 67%).
authors.affiliation: Department of Paediatrics and Microbiology, Aga Khan University Hospital, Karachi, Pakistan.
authors.forename: Z A
authors.initials: ZA
authors.lastname: Bhutta
authors.forename: S H
authors.initials: SH
authors.lastname: Naqvi
authors.forename: T
authors.initials: T
authors.lastname: Muzaffar
authors.forename: B J
authors.initials: BJ
authors.lastname: Farooqui
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D004352:Drug Resistance, Microbial; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D010154:Pakistan / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents