The role of immunodeficiency in the development of postoperative bacterial sepsis and wound infections in neonates

Audit of antibiotic therapy in surgical neonates in a tertiary hospital in Benin City, Nigeria

“…[1,14] Overall rates recorded in this study for postoperative wound infection 11.8%, sepsis 9.9% and sepsis-related deaths 3.7% approached reports from studies in developed countries despite the unique challenges. [1,4,9] This could be attributable to adequate culture and sensitivity testing that influenced combinations of antibiotics which gave the best coverage against bacteria earlier reported [2,6,[10][11][12][13] as major causes of neonatal sepsis and postoperative wound infections in this subregion. Although wound infection and sepsis were commonly associated with gastrointestinal and cardiothoracic surgeries, and among babies delivered outside the study centres, there were no significant statistical differences observed when wound infection and sepsis were compared between preterm and term neonates.…”

“…Postoperative infections have been reported [1][2][3] to significantly increase morbidity and mortality rates of surgical patients, especially the neonates. Many authors have drawn attention to the adverse impacts of surgical site infections.…”

“…[4] Also, unlike in the adults and older children, the poorly developed humoral and cell-mediated responses in neonates often lead to the occurrence of polymicrobial infections, with a large proportion caused by normally harmless commensal organisms. [1,5,6] Consequently, the use of a broad spectrum antibiotic that takes care of both gram positive and negative aerobic as well as anaerobic bacterial infections is important when managing surgical neonates. Despite the emergence of newer broad spectrum antibiotics, no single agent has been discovered to give equally effective coverage against all the possible infective bacteria.…”

“…Despite the emergence of newer broad spectrum antibiotics, no single agent has been discovered to give equally effective coverage against all the possible infective bacteria. [1,4,7,8] This is notably so in many developing countries where the rarity of such a single agent requires combinations of antibiotic(s) with proven effectiveness against aerobic and anaerobic bacteria that often cause polymicrobial infections. [2,3,7] Intrauterine diagnoses of surgical pathologies, foetal intervention and planned delivery in hygienic environment with prompt and appropriate surgical management of affected neonates are feasible in many centres.…”

“…[1][2][3] This is compounded by the presence of surgical pathology that may require invasive intervention which exposes the neonate to infection and makes the use of antibiotics a necessity during management. [4] Also, unlike in the adults and older children, the poorly developed humoral and cell-mediated responses in neonates often lead to the occurrence of polymicrobial infections, with a large proportion caused by normally harmless commensal organisms.…”