Neonatal sepsis in Addis Ababa, Ethiopia: a review of 151 bacteremic neonates

Abstract

A retrospective study of 542 neonatal sepsis cases was undertaken. Bacteremia was confirmed in 151 cases. There were a total of 195 (36%) deaths. Fifty nine (39%) of the deaths were from the bacteremia cases. The incidence of sepsis was 11 per 1000 live births. Klebsiella was the leading etiologic agent (38%), with a mortality rate of 54%. Low birth weight was found to be a predisposing factor for the development of sepsis and mortality. The high incidence of sepsis, the increase in mortality rate and the spread of nosocomial infection is discussed.

PIP: Neonatal sepsis continues to be a major cause of mortality and morbidity in developing countries. A retrospective record review of the 542 infants admitted to the neonatal unit of the Ethio-Swedish Children's Hospital in Addis Ababa, Ethiopia, with sepsis in 1992-93 was conducted. There were 322 neonatal deaths (15% of total admissions) in the study period. Bacteremia was confirmed in 151 children (28%). 195 children died, for a case fatality rate of 36%. This included 59 deaths from "proven sepsis" (39%) and 136 (61%) from "presumptive sepsis." The incidence of sepsis was 11/1000 live births. The mean gestational age was 36 weeks in both groups, and low birth weight was a predisposing factor for both the development of sepsis and neonatal mortality. The most common etiologic agent was Klebsiella (38% of cases), which is resistant to most available antibiotics. Signs and symptoms most often encountered included poor feeding (83%), temperature instability (63%), and respiratory distress (33%). Rapid, accurate detection of infected infants remains the most effective means of curbing sepsis-related mortality.