Early neonatal bacterial infection in 2016 at the University Hospital Gabriel Toure, Bamako

Abstract

Aim: Early neonatal bacterial infection (ENBI) remains a concern of the pediatrician because challenges in diagnostic with subsequent increased morbidity and mortality. No previous work on ENBI has been done in Mali. This work was aimed to study the epidemiological, biological and bacteriological profiles of ENBI in Bamako, Mali. Methods: Longitudinal study (June 27th to September 3rd, 2016) that concerned all neonates up to 72 hours hospitalized for suspicion of ENBI in the neonatology unit at the University hospital Gabriel Toure. ENBI was defined by the presence of maternal and neonatal infectious risk factors with a germ in blood culture. Results: A total of 324 newborns were included. The sex ratio was 1.6 with 63.5% prematurity and 77.8% out-born. The main clinical signs were dysthermia and respiratory distress. Fifty-two blood cultures were positive on the 324 performed (hospital frequency of ENBI at 11.04%). The main bacteria were gram-positive cocci (Staphylococcus aureus in 55.77% and Streptococcus agalactiae 03.84 %), Gram Negative Bacilli (BGN) enterobacteriaceae (Klebsiella pneumoniae in 13.46 % and E.coli in 07. 69 %) and non-fermenting type BGNs (Pseudomonas aeruginosa and Acinetobacter baumannii in 03.84 % each) with high resistance to ceftriaxone + gentamicin (12.5% -100%) and for good sensitivity to ciprofloxacin + amikacin (100% ). The mortality was 50% and 19.2% out against medical advice. Conclusion: Early neonatal bacterial infection, a major cause of neonatal morbidity and mortality, mainly to staphylococci and enterobacteria. Screening and adequate treatment of any low genital infection in pregnant women from the second trimester would reduce this morbidity and mortality