Neonatal sepsis and mortality in a regional hospital in Trinidad: aetiology and risk factors.
A total of 132 neonatal deaths among 627 infants admitted to the neonatal ward of the San Fernando General Hospital, Trinidad over a 2-year period were reviewed. The most common cause of death was prematurity (43.9%). Infection was the second most common cause (21.2%). Pseudomonas aeruginosa and Staphylococcus aureus were the most frequently isolated organisms (43%). The major drugs used empirically in suspected cases of sepsis were ampicillin or ceftazidime plus gentamicin. About 85% of S. aureus were resistant to ampicillin, and P. aeruginosa resistance to ceftazidime and gentamicin was 76.7% and 72.1%, respectively. Significant risk factors in maternal history were infrequent antenatal care and prolonged rupture of membranes. The incidence of infection among low birthweight infants was 85.6%. Early-onset sepsis (86.4%) seemed to have a nosocomial origin because of the type of pathogens seen. There is an urgent need to improve the staff-to-patient ratio in the neonatal unit and for staff to be constantly reminded to employ simple infection control practices such as proper hand-washing to reduce cross-infections.
Pathology and Microbiology Unit, Department of ParaClinical Sciences, Faculty of Medical Sciences, University of The West Indies, Trinidad and Tobago, West Indies.
F A
FA
Orrett
S M
SM
Shurland
D000667:Ampicillin / Q000627:therapeutic use; D001424:Bacterial Infections / Q000401:mortality*; D002442:Ceftazidime / Q000627:therapeutic use; D003428:Cross Infection / Q000401:mortality*; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D005839:Gentamicins / Q000627:therapeutic use; D017052:Hospital Mortality; D006780:Hospitals, Rural; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D011552:Pseudomonas Infections / Q000401:mortality; D013203:Staphylococcal Infections / Q000401:mortality; D014300:Trinidad and Tobago / Q000453:epidemiology
D005839:Gentamicins; D000667:Ampicillin; D002442:Ceftazidime