Diagnostic, therapeutic and prognostic aspects of early-onset neonatal bacterial infections at Issaka Gazobi maternity hospital of Niamey

Abstract

Introduction: Early-onset neonatal bacterial infection remains one of the preventable causes of neonatal mortality worldwide. It is a medical emergency and a public health problem. The objective of this work was to study the diagnostic, therapeutic and prognostic aspects these infections at Issaka Gazobi maternity hospital of Niamey. Patients and methods: This was a prospective descriptive and analytical study at Issaka Gazobi Maternity Hospital of Niamey from April 1, 2015 to May 31, 2016 and included all infants aged 0 to 3 days having criteria of ANAES 2002 of neonatal infection. Data was analyzed using the Epi-info 3.5.1 software. The Pearson Chi² test and the Fisher exact test were used with a significance level of 5%. Results: Three hundred and fifty-six (356) newborns suspected of early-onset neonatal bacterial infection were included. The sex ratio was 1.67. Newborns under 24 hours of age accounted for 42%. The anomaly of the amniotic fluid was the predominant infectious risk with 83.1%. Low birth weight was found in 44% of cases and neonatal asphyxia in 52.2% of cases. About 54% of the mothers were between 18 and 28 years old and the majority of them were uneducated (66.8%). Fever was the most common clinical sign (38.4%). CRP was positive in 16.9% of cases and blood culture in 23.31% of cases. The main germs were Klebsiella pneumoniae (32.5%), Staphylococcus aureus (21.7%) and Staphylococcus coagulase negative (21.7%). No statistical link was found between clinical manifestations and isolated organisms. A lethality of 15.5% has been reported. Risk factors for death were low birth weight, asphyxia, and infection by Klebsiella Pneumoniae. Conclusion: Early-onset neonatal bacterial infections are still a public health problem in our regions because of their lethality. It is necessary to strengthen preventive measures, including screening and treatment of maternal infections during antenatal care