Neonatal bacteraemia in Wesley Guild Hospital, Ilesa, Nigeria

Abstract

In a study on neonatal bacteraemia among the high-risk neonates admitted into our neonatal unit at Wesley Guild Hospital, Ilesha, the incidence of bacteraemia in babies born in the hospital was 17/1000 live births and 71.6/1000 total admissions into the unit. Gram-negative bacteria accounted for about 58.1% of bacteria isolated and Staphylococcus aureus for 62% of the isolated Gram-positive bacteria. Among the commonly used antibiotics, gentamicin is the most favoured by the sensitivity test. S. aureus appeared more sensitive to erythromycin than to cloxacillin or ampicillin. The present policy of using the combination of gentamicin and cloxacillin and/or ampicillin is adequate for most agents encountered and therefore should continue. It is suggested that proper antenatal care, adequate supervision of delivery, better neonatal care and provision of better laboratory facilities will help to reduce the incidence of neonatal bacterial infection, improve the management of neonatal infection and reduce the morbidity and mortality from bacterial infection.

Incidence of bacterial Septicaemia in Ile-Ife Metropolis, Nigeria

“…S. aureus was still the leading cause of Septicemia. This observation is in agreement with the work of some authors (Owa et al, 1988;Alausa et al, 1984;Olusanya et al, 1991;Ayliffe et al, 1977;Ako-Nai et al, 1999) but deviates from the reports from some hospitals from undeveloped countries by some authors. Gorbach and his colleagues (1992) reported that E. coli was the preponderant microbe.…”

“…This is contrary to the earlier reports by Owa et al (1988) at Wesley Guild Hospital, Ilesa, Alausa et al 1984 at Ibadan andDawodu et al (1980) but conforms with those of Antia-Obong et al (1990), Njokanma et al (1990), Olusanya et al (1991) Ako-Nai et al (1999 and Angyo et al (2001). Of the Gram-positive bacteria, the three common microbes were S. aureus, S. albus and Streptococcus faecalis among which Staphylococcus aureus had the highest occurrence while Klebsiella sp.…”

“…This difference in age distribution of the infection was statistically significant (P< O). The higher occurrence in childhood septicaemia has been reported from different parts of Nigeria (Akuse et al, 1998;Akpede et al, 1996, Ako-Nai et al, 1999, Angyo et al, 2001Owa et al, 1988;Olusanya et al, 1991). The high occurrence of neonatal septiceamia in Ile-Ife may probably be adduced to their low immune response, socio-economic status of the parents, poor hygiene practices, bottle feeding and high incidence of delivery at home.…”

Neonatal Septicaemia in Poor Resource Settings

“…The reason for this is unknown. Suprapubic bladder aspiration for urine collection is preferred to a clean catch and mid-stream collection in neonates [34,53]. In addition, cultures of other body fluids like umbilical and eye discharge, joint effusion are routinely done while investigating septicaemia [12,29].…”

“…Examination of the cerebrospinal fluid in neonatal septicaemia is mandatory since meningeal involvement occurs in about 30% of affected neonates, and the choice and the duration of antimicrobial therapy is modified in the presence of meningitis [14,34]. Cerebrospinal fluid cell count, Gram stain, protein and glucose concentration should be assessed in addition to culture as the results when taken together confirm or exclude meningitis [14].…”