Neonatal Septicaemia in a Rural Nigerian Hospital: Aetiology, Presentation and Antibiotic Sensitivity Pattern
Ogundare Ezra Olatunde *
Department of Paediatrics, Ekiti State University, Ado-Ekiti, Nigeria.
Akintayo Akinyemi Akinsoji
Department of Obstetrics and Gynaecology, Ekiti State University, Ado-Ekiti, Nigeria
Dedeke Iyabode Olabisi Florence
Department of Paediatrics, Federal Medical Centre, Abeokuta, Nigeria.
Okeniyi John Akintunde
Department of Paediatrics and Child Health, Obafemi Awolowo University, Ile-Ife, Nigeria.
Adeyemi Lateef Ademola
Department of Medical Microbiology, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria
Ogunlesi Tinuade Adetutu
Department of Paediatrics, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria.
Oyelami Oyeku Akibu
Department of Paediatrics and Child Health, Obafemi Awolowo University, Ile-Ife, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background: Neonatal Septicaemia (NNS) remains a major cause of morbidity and mortality in neonates despite advances in antimicrobial therapy, life support measures and the early detection of risk factors. This study aimed at determining the risk factors, aetiologic agents and antibiotic sensitivity pattern of NNS in Wesley Guild Hospital, Ilesa.
Methods: This was a prospective study involving 360 neonates admitted into Wesley Guild hospital, Ilesa over a period of seven months. Socio-demographic data and clinical characteristics of the neonates were collected using a standard proforma. Blood culture was done on admission and bacterial isolates were identified using standard procedures. Antibiotic susceptibility testing was done using disc diffusion method.
Results: The prevalence of neonatal septicaemia (NNS) was 16.0% in this study. Multivariate regression model of significant risk factors revealed prolonged labour (AOR 2.2(1.036 - 4.912) p=0.041) as the only independent risk factor for NNS. Staphylococcus aureus was the predominant isolate (70%). The case fatality rate from the study was 25%. Ciprofloxacin (86.7%), Cefuroxime (82.7%) and Ceftriaxone (81.3%) were the antibiotics with the highest sensitivity, while the infective organisms were most resistant to Cloxacillin (80%) and Ampicillin (77.3%).
Conclusion: Neonatal septicaemia remains a significant cause of neonatal mortality. S. aureus was the predominant bacterial isolate in this study. Cephalosporins should be considered as first-line antibiotics in its management. Prevention of preterm deliveries and encouraging good antenatal care and supervised deliveries will help in reducing the high incidence.
Keywords: Neonatal septicaemia, risk factors, antibiotic resistance, neonatal mortality, rural hospital, Nigeria