Neonatal infections in Asia
- Ramesha Tiskumara (ramesha.tiskumara{at}sswahs.nsw.gov.au)
Abstract
Objective: To study the epidemiology of neonatal unit infections in countries in Asia, including incidence, antibiotic sensitivity and mortality.
Methods: One year prospective study of neonatal infections in 8 neonatal units in Asia.
Results: There were 453 episodes of sepsis affecting 394 babies. The mortality from neonatal sepsis was 10.4%, with an incidence of 0.69 deaths/1000 live births.
Group B Streptococcus (GBS) was the commonest early-onset organism causing 38.3% of episodes of early-onset sepsis (<48 hours old), with a rate of 0.51 episodes per 1000 live births and a mortality of 22.2%. Gram negative bacillary early onset sepsis occurred at a rate of 0.15 episodes per 1000 live births with a mortality of 12.5%.
There were 406 episodes of late onset sepsis. The incidence was high at 11.6 per 1000 live births and mortality was 8.9%. Coagulase negative staphylococci caused 34.1% of episodes, while S. aureus caused only 5.4%. Gram negative bacilli caused 189 episodes (46.6%). Only 44% of Gram negative bacilli were sensitive to both gentamicin and a third generation cephalosporin, while 30% were resistant to both antibiotics. Meningitis occurred in 17.2% of episodes of late sepsis, and had a mortality of 20%.
Conclusion: The incidence of late-onset sepsis was higher in Asia than in resource-rich countries, but the organisms isolated and the mortality rates were similar. Over half of all Gram negative bacilli were antibiotic resistant.
