[Neonatal urinary tract infections in Abidjan: the problem of bacterial resistance]

Neonatal infection is frequent with rate of lethality between 20 to 70% in the developing countries. Among these neonatal infections, urinary infection is serious .The diagnosis of urinary infection is based on cytobacteriological exam. But it is rarely done for economic reasons. Principal objective of this survey was to identify the germs responsible for the urinary infections at the newborn in order to propose an adequate therapeutic algorithm.

From July to December 2004, 720 newborns hospitalized in neonatalogy for neonatal infection were enrolled. Specimens of urines were collected in view of cytobacteriological exam. Culture was positive for 136 samples (18,9%). About etiology of urinary infections, enterobacteria were predominant with 77,5% against 26,5% for cocci Gram positive. The frequency of isolation of the enterobacteria was following: Escherichia coli, Klebsiella pneumoniae, Enterobacter and Levinea with respectively 32%, 28%, 28% and 12%. The rates of global resistance of the enterobacteria to the usual antibiotics varied from 66,7% to 85,7% for the amoxicilline associated to the clavulanic acid; of 25% to 66,7% for the ceftriaxone; and of 0 to 33,3% for the amikacine.