The prevalence and some clinical characteristics of bacterial infections in preterm neonates having respiratory distress at Kenyatta National Hospital

Citation:
Awuor CY. The prevalence and some clinical characteristics of bacterial infections in preterm neonates having respiratory distress at Kenyatta National Hospital.; 1990.

Abstract:

Fifty eight preterm neonates having respiratory distress within the
first forty eight hours of life were studied. Seven had positive
blood cultures for bacteria giving a prevalence rate for infection
of 12.1%.
Nineteen infants (32.8%) were suspected to have sepsis based on
clinical and laboratory criteria .. The remaining thirty two (56%)
had no evidence of sepsis.
These infants were studied with respect to their maternal antenatal
clinic attendances, maternal fever, duration of rupture of
membranes, Iiquor characteristics and mode of del ivery. Al so
studied were their clinical examination findings, degree of
respiratory distress, hematological, radiological and
bacteriological characteristics.
Seventy six percent (76%) of the mothers were below 25 years (age
range 15-45 years). A majori ty of the mothers (65.5%) attended
antenatal clinics. Twenty eight (42.2%) of the mothers had
ruptured membranes for less than eleven hours before delivery while
13 (22.4%) and 17 (29.4%) had ruptured membranes between eleven and
twenty four hours, and for greater than 24 hours respectively.
Forty six infants (79.3%) were delivered in clear liquor; of these
6 (13.1%) had positive bacterial cultures. Seven infants (12.1%)
delivered in offensive liquor had suspected infection. Of the five
(8.6%) delivered in meconium stained liquor, two had some evidence
of infection.
Spontaneous vertex delivery was the commonest mode of delivery in
all the three groups of infants; occurring in 5 (71%) of the
infants with proven sepsis, 14 (73.7%) of the infants with

suspected sepsis and 24 (75%) of those with no sepsis. None of
the infants delivered by caesarian section had confirmed sepsis.
Infants del ivered by breech extraction had either suspected or
confirmed sepsis.Maternal fever and infant Apgar scores did not
appear to affect the outcome of the infants in this study.
On hematology the ratio of immature to total polymorphs
correlated best with sepsis as higher values of more than 0.2 were
seen mainl y in infants with confirmed sepsis. Total whi te cell
counts were also useful since normal range of counts were only seen
in infants with no evidence of sepsis.
Infant chest radiology helped eliminate other causes of
respiratory distress like pneumothorax, congenital heart disease
and lung collapse. None of the infants with confirmed sepsis had
normal radiological findings.
The orqanisms isolated were of high virulence and multipleantibiotic
resistance. Amikacin and cefotaxin enjoyed higher
sensitivity rates of 71.4% and 88.8% respectively.

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