Ninety two cases of culture proved neonatal sepsis who had been admitted to pediatric department, National medical Center, during 7 years from Jan. 1984 to Dec. 1990 were reviewed clinically and the following results were obtained.
1) The frequency of neonatal sepsis was 3.1% and male to female sex ratio was 1.9:1, Sepsis was more prevalent in premature infants (9.9%) than in full term infants (1.9%).
2) The seasonal incidence was more prevalent in summer (32.6%).
3) The weight distribution showed 50 cases with the weight less than 2500 gram and 42 cases more than 2500 gram.
4) In 76 cases the onset was before 7 days old and in 16 cases were developed after 7 days old.
5) The major associated perinatal conditions in neonatal sepsis were institutional baby (23.9%), premature rupture of membranes (11.9%) and placenta previa (4.3%) in the order of frequency. The clinical manifestations on admission were jaundice
(50.0%), poor activity (46.7%), respiratory difficulty (35.9%), poor feeding (22.8%), cyanosis (22.7%), gastrointestional symptoms (21.5%), fever (15.2%) and convulsion (13.0%) in the order of frequency.
6) The associated diseases were urinary tract infection (31.5%), hyaline membrane disease (19.6%), congenital disorder (18.5%), pneumonia (15.2%), anemia (13.0%), meningitis (9.8%), omphalitis (7.6%), DIC (6.5%), necrotizing enterocolitis (5.4%)
and
intracranial hemorrhage (5.4%) in the order of frequency.
7) Causative organisms were gram positive organisms in 27 cases (25.7%) and gram negative organisms in 79 cases (74.3%). The main organisms were Serratia marcescens (18.5%). Enterobacter spp (17.4%), Klebsiella pneumoniae (12.0%), Staphylococcus
aureus
(10.9%), Acinetobactor calcoaceticus (8.7%), Coagulase (-) staphylococcus (8.7%), E. coli (8.7%), Enterococcus (6.5%), Group B β-hemolytic streptococcus (5.4%) and Pseudomonas (5.4%) in the order of frequency.
@ES The sensitivity to antibiotics were:
@EN Serratia marcescens: 70.6% sensitive to Amikacin
58. 9% sensitive to Cefotaxime
59. Enterobacter spp: 87.5% sensitive to Amikacin
68.8% sensitive to Cefotaxime
Klebsiella pneumoniae: 100% sensitive to Amikacin
91. 0% sensitive to Cefotaxime
Staphylococcus aureus: 100% sensitive to Cefazolin
90. 0% sensitive to Cefotaxime
Acinetobacter calcoaceticus: 88.9% sensitive to Amikacin
Coagulase (-) Staphylococcus: 100% sensitive to Amikacin
87. 5% sensitive to Cefotaxime
E. coli: 100% sensitive to Amikacin, Cefotaxime
Enterococcus: 50% sensitive to Gentamicin, Ampicillin, Amikacin
Group B β-hemolytie Streptococcus: 100% sensitive to Ampicillin, Penicillin
Pseudomonas: 100% sensitive to Amikacin, Gentamicin, Tobarmycin
8) Mortality cases were 32 cases (34.8%)
|