title: Pattern and etiology of culture-proven early-onset neonatal sepsis: a five-year prospective study.
abstract: OBJECTIVE
  To investigate the incidence of early-onset neonatal sepsis and identify the main pathogens over a 5-year period in Kuwait.
  
  
  METHODS
  Blood samples were collected from all infants with any clinical or laboratory feature suggestive of sepsis, at the main maternity hospital in Kuwait. Cases of early-onset neonatal infection were defined as culture of a single potentially pathogenic organism from blood or cerebrospinal fluid from infants younger than 7 days of age, in association with clinical or laboratory findings consistent with infection.
  
  
  RESULTS
  The overall incidence of early-onset neonatal infection was 2.7 (95% confidence interval (CI) 2.3-3.2) episodes per 1000 live-births. The case-fatality was 13.1% (95% CI 8.6-18.9%). Group B Streptococcus (GBS) accounted for 17.6% of infections among infants younger than 7 days (incidence 0.48 per 1000 live-births), but 38.1% of infections in the first 2 days of life. Neither the incidence of early-onset infection by GBS nor by Escherichia coli changed significantly over the study period.
  
  
  CONCLUSIONS
  Although the incidence of GBS infections was relatively low, GBS accounted for most early-onset infections. Intrapartum antibiotic prophylaxis against GBS should be strengthened. There was no evidence to suggest that early-onset infection due to non-GBS organisms such E. coli has increased in the last 5 years.
authors.affiliation: Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Al-Taiar
authors.forename: Majeda S
authors.initials: MS
authors.lastname: Hammoud
authors.forename: Lukman
authors.initials: L
authors.lastname: Thalib
authors.forename: David
authors.initials: D
authors.lastname: Isaacs
mesh_terms: D017668:Age of Onset; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007730:Kuwait / Q000453:epidemiology; D011446:Prospective Studies; D018805:Sepsis / Q000453:epidemiology* / Q000382:microbiology*