Aetiological agents, clinical features and outcome of septicaemia in infants in Ibadan

Abstract

The present study sought to determine the prevalence, clinical features and bacterial aetiological agents of septicaemia in post-neonatal infants (age 1-12 months) presenting with fever at the University College Hospital, Ibadan, Nigeria.

Study setting: It was carried out at the Otunba Tunwase Children Emergency Ward (OTCHEW) (a 40 bedded ward) of the Department of Paediatrics, University College Hospital, Ibadan, Nigeria.

Patients: All postneonatal infants aged 1-12 months presenting with fever and who had not had antibiotic treatment in the week prior to presentation during the period June to November 1998 were enrolled in the study. Each child had a full clinical evaluation followed by a blood culture.

Results: The infants comprised 56 (54.9%) males and 46 (45.1%) females. The mean age was 5.6 (SD 0.3) months. The prevalence of septicaemia in the infants studied was 38.2%. Clinical features associated with increased risk of septicaemia among these infants were age < or = 6 months, restlessness and a total white cell count > or = 15000/mm3. The organisms isolated in the infants studied were Escherichia coli (35.9% of positive cultures). Staphylococcus aureus (33.3%), Klebsiella species (10.3%), Streptococcus species (7.7%), Proteus species (5.1%), Pseudomonas species (5.1%) and Salmonella species (2.6%). Mortality was significantly higher in patients with septicaemia (25.7% compared with those without septicaemia (7.9%).

Conclusions: Thirty eight percent of febrile infants presenting in this study had positive bacteria blood cultures, the most common organisms being Escherichia coli and Staphylococcus aureus. Few clinical features distinguished febrile infants with septicaemia from those without. It is recommended that febrile infants in our setting with clinical features associated with increased risk of septicaemia should be treated emprically with antibiotics since the probability of having septicaemia is significant.