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Neonatal septicaemia in Kelantan, Malaysia
K E Choo1, W A Wan Ariffin, S P Chua
1Department of Paediatrics, University Sains Malaysia School of Medical Sciences.
Abstract:
A retrospective study of 84 cases of neonatal septicaemia admitted into a neonatal unit in a rural area of Malaysia for 1 year between 1st September 1985 to 31st August 1986 was carried out to determine the spectrum of micro-organisms and predisposing factors in relation to early and late onset septicaemia. The incidence of neonatal septicaemia was 2.13 per 1,000 live-births per year and the case fatality was 41.7% with higher case fatality in those who were premature, those who presented as early onset and those who had gram negative septicaemia. The mean age of onset of septicaemia was 7.8 days (range from 2 hours to 27 days). Forty four (52%) neonates had early onset septicaemia with mean age of onset at 2.7 days; forty (48%) neonates had late onset septicaemia presenting at 13.6 days of life. Gram negative organisms such as Klebsiella, Pseudomonas, sp., E. coli and Streptococcus, especially group B Streptococcus were the major organisms in the early onset septicaemia. Staphylococcus aureus and Staphylococcus epidermidis were the major organisms responsible for the late onset septicaemia. Obstetrical factors played an important role in early onset septicaemia. Prematurity was the most common predisposing factor. Invasive diagnostic and therapeutic procedures including surgery highlighted once again the importance of these procedures in predisposing the newborn to infection.
Insights
Neonatal septicaemia in Malaysia showed a 2.13/1,000 live-birth incidence with 41.7% fatality. Gram-negative bacteria were common in early-onset cases, while Staphylococcus species predominated in late-onset infections.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Microbiology
Background:
- Neonatal septicaemia poses a significant threat to newborns, particularly in resource-limited settings.
- Understanding causative organisms and risk factors is crucial for effective management and prevention.
Purpose of the Study:
- To investigate the spectrum of microorganisms and predisposing factors in early- and late-onset neonatal septicaemia.
- To determine the incidence and case fatality rates of neonatal septicaemia in a Malaysian rural neonatal unit.
Main Methods:
- A retrospective study analyzing 84 cases of neonatal septicaemia over one year (1985-1986).
- Data collected included onset of septicaemia, causative organisms, predisposing factors, and outcomes.
Main Results:
- The incidence was 2.13 per 1,000 live births with a 41.7% case fatality rate.
- Early-onset septicaemia (52% of cases) was linked to Gram-negative bacteria (Klebsiella, Pseudomonas, E. coli, Streptococcus spp.), while late-onset septicaemia (48%) was associated with Staphylococcus aureus and S. epidermidis.
- Prematurity and obstetric factors were significant predisposing factors for early-onset septicaemia.
Conclusions:
- Gram-negative bacteria and prematurity are key concerns in early neonatal septicaemia.
- Staphylococcus species are significant in late-onset infections, emphasizing the need for vigilance with invasive procedures.