PATTERN OF NEONATAL SEPTICAEMIA AT THE UNIVERSITY OF MAIDUGURI TEACHING HOSPITAL, MAIDUGURI, NORTH -EASTERN NIGERIA

PATTERN OF NEONATAL SEPTICAEMIA AT THE UNIVERSITY OF MAIDUGURI TEACHING HOSPITAL, MAIDUGURI, NORTH -EASTERN NIGERIA

Abstract

Neonatal septicaemia is a leading cause of morbidity and mortality worldwide, especially in
the tropics. The risk factors vary, and the clinical features of neonatal septicaemia may be
vague and nonspecific, therefore a high index of suspicion is vital to early diagnosis and
treatment. The aetiological agents and their antibiotic sensitivity pattern have continued to
change (in the same centre over time), hence the need to have undertaken this study.
The primary objective of the study was to determine the incidence, aetiological agents, and the
pattern of antibiotic sensitivity at the UMTH. The study was prospective and neonates that had
clinical diagnosis of neonatal septicaemia were enrolled consecutively and admitted to the
special care baby unit of the Department of Paediatrics of University of Maiduguri Teaching
Hospital (UMTH). The patients were appropriately investigated including blood cultures, CSF
cultures and urine among others. Data were entered and analysed with SPSS version 16
software. Of this 46(42.0%) had positive blood culture, while 64 (58.0%) were blood culture
negative. Eighteen (39.1%) of the septicaemic neonates were inborn, while 28 (60.9%) were
out born. The incidence of neonatal septicaemia among babies delivered at UMTH was
5.9/1000 live births. The male to female ratio among septicaemic neonates was 2.2:1. The
common risk factors for NNS were prolonged rupture of membrane (PROM), prematurity and
low socio-economic status of parents among others. Clinical features, fever (87%), poor
feeding (64 %), excessive crying (33%), tachypnoea, hepatomegaly were some of the common
findings. Haematological parameters such as low packed cell volume, high absolute neutrophil
count, high I:M ratio, I:T neutrophil ratio, micro-ESR and low absolute platelet count have
significant associations with neonatal septicaemia. Staphylococcus aureus 16(69.6%) and
Streptococcus pyogenes 5(21.8%) were the predominant Gram positive organisms isolated
while Escherichia coli 9(39.1%) and Klebsiella Pneumoniae 7(30.4%) were the predominant
Gram negative organisms isolated. Mortality was high in infection associated with Gram

negative organisms and in the presence of conditions/complications like urinary tract
infections, tetanus and meningitis.
Staphylococcus aureus was sensitive to cephalosporins and Quinolones but resistant to
Penicillins. Escherichia coli and Klebsiella Pneumoniae showed high resistance (16.7% and
25.6% respectively) to commonly used aminoglycoside Gentamycin. However, a combination
of empirical therapy of cephalosporins such as Cefuroxime and Gentamycin in neonatal
septicaemia is good choice.

PATTERN OF NEONATAL SEPTICAEMIA AT THE UNIVERSITY OF MAIDUGURI TEACHING HOSPITAL, MAIDUGURI, NORTH -EASTERN NIGERIA

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