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Neonatal sepsis and meningitis in Mallorca, Spain, 1977-1991
J A Hervás1, A Alomar, F Salvá
1Son Dureta Hospital, Palma de Mallorca, Spain.
Abstract:
In a retrospective study at Son Dureta Hospital (Palma de Mallorca, Mallorca, Spain) of the period 1977-1991, 334 cases of culture-proven sepsis and/or meningitis in neonates born at the facility were identified. Overall, there was an incidence rate of 4.9 cases per 1,000 live births. The case-fatality rate was 7.5%. Infection was more frequent in infants of low birth weight, with the exception of infants with meningitis and infections due to group B Streptococcus and Listeria species. The patterns of predominance among bacterial pathogens that were isolated changed during the period studied. From 1977 to 1984, Klebsiella pneumoniae was the most frequent such isolate, but this frequency declined in the following years. Group B Streptococcus organisms and Staphylococcus epidermidis replaced K. pneumoniae as the predominant pathogens in early- and Staphylococcus epidermidis replaced K. pneumoniae as the predominant pathogens in early- and late-onset infections, respectively. The frequency with which other pathogens were isolated did not vary significantly during the study period. Invasive infection caused by Candida organisms was found in two patients. The incidence of infection due to group B streptococci has increased in the last few years (to 2.4 cases per 1,000 live births in 1991) and has become a significant problem that requires a thorough epidemiological evaluation.
Insights
Neonatal sepsis and meningitis incidence was 4.9 per 1,000 live births. Pathogen patterns shifted, with Group B Streptococcus becoming a significant concern in later years.
Area of Science:
- Neonatal infectious diseases
- Pediatric epidemiology
- Bacterial pathogenesis
Background:
- Sepsis and meningitis are critical neonatal infections.
- Understanding pathogen trends is vital for effective treatment and prevention.
Purpose of the Study:
- To analyze trends in culture-proven neonatal sepsis and/or meningitis at Son Dureta Hospital from 1977-1991.
- To identify changes in predominant bacterial pathogens over time.
- To assess the incidence and case-fatality rates of these infections.
Main Methods:
- Retrospective study of 334 culture-proven cases in neonates.
- Data collected from Son Dureta Hospital between 1977 and 1991.
- Analysis of pathogen isolation patterns and incidence rates.
Main Results:
- Overall incidence rate was 4.9 cases per 1,000 live births, with a 7.5% case-fatality rate.
- Klebsiella pneumoniae was predominant from 1977-1984, later replaced by Group B Streptococcus and Staphylococcus epidermidis.
- Group B Streptococcus incidence increased significantly by 1991, posing a growing problem.
Conclusions:
- Neonatal infection patterns evolved during the study period.
- Group B Streptococcus has emerged as a significant pathogen requiring epidemiological attention.
- Low birth weight infants were more susceptible, with exceptions for specific meningitis pathogens.