The Clinical and Bacteriogical Spectrum of Neonatal Sepsis in a Tertiary Hospital in Yaounde, Cameroon

authors:

avatar Madeleine Ghoyap 1 , avatar Thérèse Nkoa 2 , avatar Pierre Fernand Tchokoteu 3 , avatar Joseline Zafack 1 , avatar Lawrence Mbuagbaw 4 , avatar Marlene Djoupomb 5 , avatar Evelyne Mah 3 , avatar Seraphin Nguefack 3 , avatar Andreas Chiabi 3 , *

Yaounde Gynaeco-Obstetric and Pediatric Hospital, Cameroon
Yaounde Gynaeco-Obstetric and Pediatric Hospital & Department of Clinical Microbiology, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Cameroon
Yaounde Gynaeco-Obstetric and Pediatric Hospital & Department of Pediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Cameroon
Centre for the Development of Best Practices in Health, Yaounde, Cameroon
Institut Supérieur des Sciences de la Santé, Bangangté, Cameroon

how to cite: Ghoyap M, Nkoa T, Fernand Tchokoteu P, Zafack J, Mbuagbaw L, et al. The Clinical and Bacteriogical Spectrum of Neonatal Sepsis in a Tertiary Hospital in Yaounde, Cameroon. Iran J Pediatr. 2014;24(6): 441-448. 

Abstract

Objective: Sepsis is an important cause of morbidity and mortality in neonates especially in developing countries where identification of the germs and treatment is often unsatisfactory. The aim of the study was to assess the clinical presentation, and bacteriological profile of neonatal infections, and the sensitivity of the causative germs to antibiotics.
Methods: We carried out a prospective analytic study in the Yaounde Gynaeco-Obstetric and Pediatric Hospital in Cameroon over a 6 months period from 18th November 2008 to 18th May 2009. On the basis of history and/or clinical findings and paraclinical investigations, 218 neonates out of a total of 628 admissions were investigated and managed for neonatal infection.
Findings: The most frequent symptoms were fever (44.95%), refusal to feed/irritability (32.11%), and respiratory distress/cough (28.90%). Premature birth and prolonged rupture of membranes were the most frequent risk factors. Klebsiella spp, Escherichia coli and Enterobacter spp were the most frequent germs identified in respectively 28.6%, 21.4% and 14.3% of the positive samples. Overall sensitivity of the cultures to ampicillin, netilmicin and gentamycin was poor at 29.4%, 31.4% and 18.9% respectively, whereas imipenem, ofloxacin, ciprofloxacin and ceftazidime had the best sensitivities in 91.7%, 90%, 85.3% and 69.4% of the cultures respectively. The mortality rate was 22%, and low birth weight, premature birth and septicemia were significant risk factors for death.
Conclusion: Mortality from neonatal sepsis in this context is still high and there is an upsurge of multi-resistant germs to currently used antibiotics, calling for the need for rational use of antibiotics in the management of these infections.
 

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