<strong>Background</strong><b><span style="font-family:Verdana;">: </span></b><span style="font-family:Verdana;">Neonatal sepsis is a global health problem...<strong>Background</strong><b><span style="font-family:Verdana;">: </span></b><span style="font-family:Verdana;">Neonatal sepsis is a global health problem that mainly affects low- and middle-income countries. We have previously shown that early neonatal mortality is high at the Ho Teaching Hospital (HTH) of Ghana. We sought to determine the prevalence of neonatal sepsis, sepsis-related mortality, and bacterial species patterns in neonatal and young infant sepsis in this hospital.</span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Methods</span></b><b><span style="font-family:Verdana;">:</span></b><b><span style="font-family:;" "=""> </span></b><span style="font-family:;" "=""><span style="font-family:Verdana;">A hospital-based study was conducted in the hospital’s neonatal intensive care unit (NICU) from March to June 2018. Blood samples from 96 babies clinically diagnosed with or at risk of sepsis were cultured using the BACTEC 9050<span style="white-space:nowrap;"><sup>®</sup> </span>machine. Clinical data including gravida, parity and antibiotic medication before delivery of mother and delivery type, gestation, birth weight and antibiotic medication status were collected for analysis. MALDI-TOF MS identified bacterial isolates, and their identities were confirmed via </span><i><span style="font-family:Verdana;">tuf</span></i><span style="font-family:Verdana;"> gene sequence typing. The data were analyzed using GraphPad Prism 8.0.2.</span></span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Results</span></b><b><span style="font-family:Verdana;">: </span></b><span style="font-family:;" "=""><span style="font-family:Verdana;">Blood cultures were positive in 28 of the babies, with 14 and 12 representing early-onset and late-onset neonatal sepsis, respectively, and two cases of unknown sepsis type. Of the bacterial species that caused sepsis in the babies, coagulase-negative staphylococcus (CoNS) was the most prevalent isolate in 22 cases, followed by </span><i><span style="font-family:Verdana;">Klebsiella pneumoniae </span></i><span style="font-family:Verdana;">in </span><span style="font-family:Verdana;">two and </span><i><span style="font-family:Verdana;">Staphylococcus aureus</span></i><span style="font-family:Verdana;">, </span><i><span style="font-family:Verdana;">Streptococcus agalactiae</span></i><span style="font-family:Verdana;">, the </span><i><span style="font-family:Verdana;">Acinetobacter</span><span> </span></i><span style="font-family:Verdana;">species</span><span style="font-family:Verdana;">, and </span><i><span style="font-family:Verdana;">Escherichia coli</span></i><span style="font-family:Verdana;"> in the rest (one each). Of the CoNS, </span><i><span style="font-family:Verdana;">S. haemolyticus</span></i><span style="font-family:Verdana;"> and </span><i><span style="font-family:Verdana;">S. epidermidis</span></i><span style="font-family:Verdana;"> were the most prevalent species, found in eight and six cases, respectively. Thirteen neonates died, of whom seven had positive blood cultures, and two were referred. A case fatality rate of 7/26 was estimated. Neonatal mortality caused by Gram-negative bacterial infection was higher than that caused by Gram-positive bacteria. </span><b><span style="font-family:Verdana;">Conclusions</span></b></span><b><span style="font-family:Verdana;">: </span></b><span style="font-family:Verdana;">These data suggest a significant burden of sepsis among neonates and young infants and are associated with substantial morbidity and mortality at the HTH. There is a need to investigate risk factors associated with the increased sepsis rate in this hospital to inform measures to reduce the neonatal sepsis rate.</span>展开更多
Objectives: Current study sought to determine an association between Low Birth Weight (LBW) and early neonatal mortality at a resource limited country’s referral hospital and to determine relationship between materna...Objectives: Current study sought to determine an association between Low Birth Weight (LBW) and early neonatal mortality at a resource limited country’s referral hospital and to determine relationship between maternal age and birth outcomes. Method: A retrospective study analyzing data on births in the Volta Regional Hospital, Ghana from the period of November 2011 to June 2016. A total of 8279 births were analyzed. Results: Results suggest that teenage mothers (8.60%) are more likely to give birth to pre-term babies than the elderly (6.60%) and the adult mothers (4.61%). LBW is highest among the teenage mothers (12.69%) followed by the elderly mothers (7.87%) and then the least among the adult mothers (6.48%). Extremely Low Birth Weight (ELBW) and Macrosomia births were more observed among the elderly mothers (0.90%;2.17%) than the teenage (0.28%;0.14%) and adult mothers (0.34%;1.61%) respectively. Data suggest that 100% of the ELBW were pre-term birth, 88.28% Very Low Birth Weight (VLBW), 34.56% LBW and only 1.06% of the pre-term birth were with Normal Birth Weight (NBW). Death rate ranges from 50% for ELBW, 33.59% for VLBW, 8.22% for LBW, 5.43% for Macrosomia and 1.5% for NBW. However, death rate distribution among the various age groups was statistically not significant (P 0.106). Conclusions: Our study suggests that early neonatal death, especially deaths among ELBW and VLBW is still high at the VRH of Ghana and therefore there is the need for further studies into interventions to reduce death among neonates born with VLBW and ELBW.展开更多
文摘<strong>Background</strong><b><span style="font-family:Verdana;">: </span></b><span style="font-family:Verdana;">Neonatal sepsis is a global health problem that mainly affects low- and middle-income countries. We have previously shown that early neonatal mortality is high at the Ho Teaching Hospital (HTH) of Ghana. We sought to determine the prevalence of neonatal sepsis, sepsis-related mortality, and bacterial species patterns in neonatal and young infant sepsis in this hospital.</span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Methods</span></b><b><span style="font-family:Verdana;">:</span></b><b><span style="font-family:;" "=""> </span></b><span style="font-family:;" "=""><span style="font-family:Verdana;">A hospital-based study was conducted in the hospital’s neonatal intensive care unit (NICU) from March to June 2018. Blood samples from 96 babies clinically diagnosed with or at risk of sepsis were cultured using the BACTEC 9050<span style="white-space:nowrap;"><sup>®</sup> </span>machine. Clinical data including gravida, parity and antibiotic medication before delivery of mother and delivery type, gestation, birth weight and antibiotic medication status were collected for analysis. MALDI-TOF MS identified bacterial isolates, and their identities were confirmed via </span><i><span style="font-family:Verdana;">tuf</span></i><span style="font-family:Verdana;"> gene sequence typing. The data were analyzed using GraphPad Prism 8.0.2.</span></span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Results</span></b><b><span style="font-family:Verdana;">: </span></b><span style="font-family:;" "=""><span style="font-family:Verdana;">Blood cultures were positive in 28 of the babies, with 14 and 12 representing early-onset and late-onset neonatal sepsis, respectively, and two cases of unknown sepsis type. Of the bacterial species that caused sepsis in the babies, coagulase-negative staphylococcus (CoNS) was the most prevalent isolate in 22 cases, followed by </span><i><span style="font-family:Verdana;">Klebsiella pneumoniae </span></i><span style="font-family:Verdana;">in </span><span style="font-family:Verdana;">two and </span><i><span style="font-family:Verdana;">Staphylococcus aureus</span></i><span style="font-family:Verdana;">, </span><i><span style="font-family:Verdana;">Streptococcus agalactiae</span></i><span style="font-family:Verdana;">, the </span><i><span style="font-family:Verdana;">Acinetobacter</span><span> </span></i><span style="font-family:Verdana;">species</span><span style="font-family:Verdana;">, and </span><i><span style="font-family:Verdana;">Escherichia coli</span></i><span style="font-family:Verdana;"> in the rest (one each). Of the CoNS, </span><i><span style="font-family:Verdana;">S. haemolyticus</span></i><span style="font-family:Verdana;"> and </span><i><span style="font-family:Verdana;">S. epidermidis</span></i><span style="font-family:Verdana;"> were the most prevalent species, found in eight and six cases, respectively. Thirteen neonates died, of whom seven had positive blood cultures, and two were referred. A case fatality rate of 7/26 was estimated. Neonatal mortality caused by Gram-negative bacterial infection was higher than that caused by Gram-positive bacteria. </span><b><span style="font-family:Verdana;">Conclusions</span></b></span><b><span style="font-family:Verdana;">: </span></b><span style="font-family:Verdana;">These data suggest a significant burden of sepsis among neonates and young infants and are associated with substantial morbidity and mortality at the HTH. There is a need to investigate risk factors associated with the increased sepsis rate in this hospital to inform measures to reduce the neonatal sepsis rate.</span>
文摘Objectives: Current study sought to determine an association between Low Birth Weight (LBW) and early neonatal mortality at a resource limited country’s referral hospital and to determine relationship between maternal age and birth outcomes. Method: A retrospective study analyzing data on births in the Volta Regional Hospital, Ghana from the period of November 2011 to June 2016. A total of 8279 births were analyzed. Results: Results suggest that teenage mothers (8.60%) are more likely to give birth to pre-term babies than the elderly (6.60%) and the adult mothers (4.61%). LBW is highest among the teenage mothers (12.69%) followed by the elderly mothers (7.87%) and then the least among the adult mothers (6.48%). Extremely Low Birth Weight (ELBW) and Macrosomia births were more observed among the elderly mothers (0.90%;2.17%) than the teenage (0.28%;0.14%) and adult mothers (0.34%;1.61%) respectively. Data suggest that 100% of the ELBW were pre-term birth, 88.28% Very Low Birth Weight (VLBW), 34.56% LBW and only 1.06% of the pre-term birth were with Normal Birth Weight (NBW). Death rate ranges from 50% for ELBW, 33.59% for VLBW, 8.22% for LBW, 5.43% for Macrosomia and 1.5% for NBW. However, death rate distribution among the various age groups was statistically not significant (P 0.106). Conclusions: Our study suggests that early neonatal death, especially deaths among ELBW and VLBW is still high at the VRH of Ghana and therefore there is the need for further studies into interventions to reduce death among neonates born with VLBW and ELBW.
