Aetiology, risk factors and immediate outcome of bacteriologically confirmed neonatal septicaemia in Mulago hospital, Uganda.
BACKGROUND
Neonatal septicaemia remains a major cause of morbidity and mortality. The aetiology, risk factors and outcome of this problem need to understood.


OBJECTIVE
To determine the aetiology, risk factors and immediate outcome of bacteriologically confirmed neonatal septicaemia in Mulago hospital.


METHODS
Blood cultures were aseptically obtained from neonates presenting with clinical sepsis by WHO criteria to Mulago during a five month period between July and November 2002. Blood was placed in Brain Heart Infusion media and incubated within 30 minutes. Subcultures were plated daily up to 7 days on blood, chocolate and MacConkey agar and incubated in aerobic and 5% carbon dioxide conditions. Pure colonies were identified by Gram stain and biochemical tests and antibiotic sensitivities were obtained.


RESULTS
Gram positive organisms were predominant (69.2%) followed by E. coli (17%) and Group B Streptococci (GBS) (7%). Staphylococcus aureus and E. coli dominated isolates in early and late onset sepsis. S. aureus was more sensitive to gentamicin than to cloxacillin. The sensitivity of E. coli to ceftriaxone was 94.1%. Factors significantly associated with neonatal septicaemia were male sex, history of convulsions, hypoglycaemia, lack of antenatal care, late onset sepsis and umbilical pus discharge. Mortality in sepsis cases was 18.1%, and 84% of deaths occurred in the first 2 days of admission. Hypoglycaemia was significantly associated with death (p < 0.01).


CONCLUSIONS
S. aureus predominates the aetiology of neonatal septicaemia followed by E.coli. Most deaths occur in the first 48 hours of admission and hypoglycaemia is significantly associated with death.
Mugalu
J
J
Department of Paediatrics and Child Health, Mulago Hospital. mugaru89@yahoo.com
Nakakeeto
M K
MK
Kiguli
S
S
Kaddu-Mulindwa
Deo H
DH
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002423:Cause of Death; D015331:Cohort Studies; D003906:Developing Countries; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D007363:Intensive Care Units, Neonatal; D016015:Logistic Models; D008297:Male; D008826:Microbial Sensitivity Tests; D011336:Probability; D012307:Risk Factors; D018805:Sepsis / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology; D012720:Severity of Illness Index; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D016019:Survival Analysis; D016896:Treatment Outcome; D014454:Uganda
D000900:Anti-Bacterial Agents