Neonatal sepsis and mortality in a regional hospital in Trinidad: aetiology and risk factors

Abstract

A total of 132 neonatal deaths among 627 infants admitted to the neonatal ward of the San Fernando General Hospital, Trinidad over a 2-year period were reviewed. The most common cause of death was prematurity (43.9%). Infection was the second most common cause (21.2%). Pseudomonas aeruginosa and Staphylococcus aureus were the most frequently isolated organisms (43%). The major drugs used empirically in suspected cases of sepsis were ampicillin or ceftazidime plus gentamicin. About 85% of S. aureus were resistant to ampicillin, and P. aeruginosa resistance to ceftazidime and gentamicin was 76.7% and 72.1%, respectively. Significant risk factors in maternal history were infrequent antenatal care and prolonged rupture of membranes. The incidence of infection among low birthweight infants was 85.6%. Early-onset sepsis (86.4%) seemed to have a nosocomial origin because of the type of pathogens seen. There is an urgent need to improve the staff-to-patient ratio in the neonatal unit and for staff to be constantly reminded to employ simple infection control practices such as proper hand-washing to reduce cross-infections.

Gender Differentials and Disease-Specific Cause of Infant Mortality: A Case Study in an Urban Hospital in Accra, Ghana

“…In 2006, the under-five mortality rate for sub-Saharan Africa was 160 per 1,000 live births, meaning that roughly 1 in every 6 children failed to reach his/her fifth birthday 3 . This represented a 14% reduction since 1990 but remains by far the highest rate of under-five African Journal of Reproductive Health June 2016; 20 (2): 105 mortality in the world 4 . West Africa has been hit the hardest with under-five mortality in Africa and the world at large.…”

Risk Factors for Neonatal Sepsis and Method for Reduction of Blood Culture Contamination

“…Ananthakrishnan et al . Pseudomonas aeruginosa and Staphylococcus aureus were the most frequently isolated pathogens in neonates with sepsis in a research of Orrett et al 4 . It is known that Acinetobacter is an opportunistic bacteria and that it is not a common cause of infections in healthy individuals, but in prematurely born infants, who do not have mature immune system, Acinetobacter may cause fetal infections because it is highly resistant microorganism.…”

“…Beaufort et al conducted research in the neonatal intensive unit and designated Acinetobacter spp as the most common cause of late sepsis in preterm infants 6 . Orrett et al found that Acinetobacter spp was isolated only sporadically, in septic patients 4 . In our study, the most common cause of early and late sepsis was Acinetobacter spp.…”

“…Early neonatal sepsis is associated with acquisition of microorganism from mother (transplacental infection, ascending infection from cervix and the newborn can acquire the microorganisms as it passes through the birth canal at delivery). Late neonatal sepsis usually occurs due to the lack of aseptic working conditions during the placement and maintenance of intravenous cannulas, central venous catheters, umbilical catheters, thoracic and lumbar puncture, application of parenteral therapy and infusion [3][4][5] . Having in mind that nurses participate in these medico-technical procedures, either individually or as a member of the multidisciplinary team, the occurrence of late sepsis is considered an important indicator of quality of care.…”

Incidence of Bacteremia and Septicemia in patients attending in tertiary care center, Nepal

“…Bloodstream infection are an important cause of serious morbidity and leading cause of mortality and among the most common healthcare associated infection 2,3 .Study in United States shows it as 10 th leading cause of death 4 .They are associated with the syndrome requiring admission to intensive care unit such as sepsis and septic shock [5][6][7] .They are not only considered as leading cause of death also causing disability ,worsening of quality of life especially for millions of people in developing countries [8][9][10] .Study carried out in United States shows mortality rates as 14 days mortality averaged 26%,28days mortality 42% 11 . It has impact on economy of nation as well again study in US, shows during management of Bacteraemia & Septicaemia they found expense of cost around US$ 16 billion per year 11 .…”