Early-onset neonatal sepsis in Pakistan : a case control study of risk factors in a birth cohort
We prospectively evaluated risk factors for early-onset neonatal (EON) sepsis in a case-control study among inborn patients at the Aga Khan University Medical Centre in Karachi between 1990-1993. A total of 38 cases with blood culture proven bacterial sepsis were identified within 72 hr of birth (prevalence 5.6 of 1000 live births) and matched with two consecutive gender matched births with no complications. The most common isolates were Staphylococcus aureus (18%), group B Streptococci (13%), and Klebsiella pneumoniae (13%). Univariate analysis of maternal risk factors revealed a significant association between maternal urinary tract infection (UTI) (odds ratio [OR]20, 95% confidence interval [CI]2.4-166.9), maternal pyrexia (P < 0.0001), vaginal discharge (P < 0.05), vaginal examinations during labor (P = 0.03), and EON sepsis. The infected newborns also had significantly lower apgar scores at birth (P < 0.0001) and a significantly greater number were intubated at birth (Fisher's exact test P = 0.04). Infected newborn infants were transferred out of the labor room earlier than noninfected controls and significantly fewer received exclusive breastfeeds (OR 0.33, 95% CI 0.1-0.8). Our data suggest the possibility that both vertical transmission from the mother as well as postnatal acquisition of infection from the environment may be of importance in the pathogenesis of EON sepsis in Karachi. Preventive measures should focus at recognition of high-risk infants, strict asepsis during labor, and early institution of exclusive breastfeeding.
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
1997 |
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| Erschienen: |
1997 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:14 |
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| Enthalten in: |
American journal of perinatology - 14(1997), 9 vom: 14. Okt., Seite 577-81 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Bhutta, Z A [VerfasserIn] |
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| Anmerkungen: |
Date Completed 10.02.1998 Date Revised 08.04.2022 published: Print Citation Status MEDLINE |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM093379471 |
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| 100 | 1 | |a Bhutta, Z A |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Early-onset neonatal sepsis in Pakistan |b a case control study of risk factors in a birth cohort |
| 264 | 1 | |c 1997 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ohne Hilfsmittel zu benutzen |b n |2 rdamedia | ||
| 338 | |a Band |b nc |2 rdacarrier | ||
| 500 | |a Date Completed 10.02.1998 | ||
| 500 | |a Date Revised 08.04.2022 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a We prospectively evaluated risk factors for early-onset neonatal (EON) sepsis in a case-control study among inborn patients at the Aga Khan University Medical Centre in Karachi between 1990-1993. A total of 38 cases with blood culture proven bacterial sepsis were identified within 72 hr of birth (prevalence 5.6 of 1000 live births) and matched with two consecutive gender matched births with no complications. The most common isolates were Staphylococcus aureus (18%), group B Streptococci (13%), and Klebsiella pneumoniae (13%). Univariate analysis of maternal risk factors revealed a significant association between maternal urinary tract infection (UTI) (odds ratio [OR]20, 95% confidence interval [CI]2.4-166.9), maternal pyrexia (P < 0.0001), vaginal discharge (P < 0.05), vaginal examinations during labor (P = 0.03), and EON sepsis. The infected newborns also had significantly lower apgar scores at birth (P < 0.0001) and a significantly greater number were intubated at birth (Fisher's exact test P = 0.04). Infected newborn infants were transferred out of the labor room earlier than noninfected controls and significantly fewer received exclusive breastfeeds (OR 0.33, 95% CI 0.1-0.8). Our data suggest the possibility that both vertical transmission from the mother as well as postnatal acquisition of infection from the environment may be of importance in the pathogenesis of EON sepsis in Karachi. Preventive measures should focus at recognition of high-risk infants, strict asepsis during labor, and early institution of exclusive breastfeeding | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Asia | |
| 650 | 4 | |a Biology | |
| 650 | 4 | |a Case Control Studies | |
| 650 | 4 | |a Developing Countries | |
| 650 | 4 | |a Diseases | |
| 650 | 4 | |a Family And Household | |
| 650 | 4 | |a Family Characteristics | |
| 650 | 4 | |a Family Relationships | |
| 650 | 4 | |a Mothers | |
| 650 | 4 | |a Neonatal Diseases And Abnormalities--etiology | |
| 650 | 4 | |a Pakistan | |
| 650 | 4 | |a Parents | |
| 650 | 4 | |a Physiology | |
| 650 | 4 | |a Research Methodology | |
| 650 | 4 | |a Research Report | |
| 650 | 4 | |a Risk Factors | |
| 650 | 4 | |a Southern Asia | |
| 650 | 4 | |a Studies | |
| 650 | 4 | |a Urogenital Effects--women | |
| 650 | 4 | |a Urogenital System | |
| 650 | 4 | |a Vaginal Abnormalities | |
| 650 | 4 | |a Vertical Transmission | |
| 700 | 1 | |a Yusuf, K |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t American journal of perinatology |d 1993 |g 14(1997), 9 vom: 14. Okt., Seite 577-81 |w (DE-627)NLM013020544 |x 1098-8785 |7 nnns |
| 773 | 1 | 8 | |g volume:14 |g year:1997 |g number:9 |g day:14 |g month:10 |g pages:577-81 |
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| 951 | |a AR | ||
| 952 | |d 14 |j 1997 |e 9 |b 14 |c 10 |h 577-81 | ||