Aetiologies and risk factors for neonatal sepsis and pneumonia mortality among Alaskan infants.
We evaluated all fatal neonatal sepsis and pneumonia cases occurring in Alaska during 1992-2000. Risk factors were evaluated using a database of all births occurring during the study period. Of 32 cases, group B streptococcus (GBS) was isolated from 21% (all 7 days of age), non-GBS Gram-positive bacteria from 50% (53% <7 days of age), and Gram-negative infections from 38% (58% <7 days of age). Infants born at <37 weeks gestation accounted for 72% of cases and had an increased risk of GBS [rate ratio (RR) 9.1, 95% confidence interval (CI) 2.0-41] and non-GBS (RR 40, 95% CI 16-101) disease. Neonatal sepsis mortality has become an outcome concentrated among pre-term infants. Aetiologies include GBS during the early neonatal period, Candida spp. during the late neonatal period, and other bacteria during both periods.
Gessner
B D
BD
Alaska Division of Public Health, Section of Epidemiology, Anchorage, Alaska 99524, USA. Brad_Gessner@health.state.ak.us
Castrodale
L
L
Soriano-Gabarro
M
M
D000413:Alaska / Q000453:epidemiology; D002175:Candida / Q000302:isolation & purification; D002177:Candidiasis / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology / Q000401:mortality; D016208:Databases, Factual; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology / Q000401:mortality; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology / Q000401:mortality; D006801:Humans; D015994:Incidence; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D011014:Pneumonia / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology* / Q000401:mortality; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology* / Q000401:mortality