Department of Paediatrics, Federal Medical Centre Bida, Niger State, Nigeria.
Department of Family Medicine, Federal Medical Centre Bida, Niger State, Nigeria.
West Afr J Med. 2023 Aug 28;40(8):792-798.
Neonatal septicaemia (NNS) occurs during the first 28 days of life and is characterized by systemic bacterial infection proven by blood culture. It is a leading cause of morbidity and mortality in neonates. Determinants of NNS vary between locations forming the basis for this study.
To determine the prevalence and the predisposing factors to neonatal septicaemia among neonates admitted to the neonatal intensive care unit (NICU) of Federal Medical Centre, Bida (FMC Bida).
This was a one-year prospective observational study, 167 neonates admitted to the neonatal intensive care unit (NICU) of FMC Bida, were selected by purposive sampling method to participate in the study from 13th May, 2015 to 30th April, 2016. A structured questionnaire was filled out by consenting parents and blood samples were collected for laboratory analysis. The data was analyzed using SPSS version 20 (2016). The data were summarized using frequency distributions, means, standard deviation, charts and tables while statistical significance was determined using the chisquare test and Fisher's exact test at a 5% level of significance as well as Odd's Ratio (OR) as appropriate.
Of the 167 neonates recruited, 97(58.1%) were males, 70(41.9%) were females and a male: female ratio of 1.4:1. Outborns were 100 (60%), inborns were 67(40%). Mean age was 4.3 ± 1.5 days and the mean weight of 2589 ± 743.9g. The overall prevalence of neonatal sepsis was 2.33% while the blood culture's positive rate was 9.58%. Risk factors identified in the neonates in this study were prolonged rupture of membranes (PROM), chorioamnionitis, meconium-stained liquor, foul-smelling vaginal discharge, being an outborn, having a low birth weight, inability to cry at birth and prematurity but, PROM was the only risk factor significantly associated with septicaemia (OR 5.4; 95% CI 2.2-13.5) while Escherichia coli was the leading bacterial isolate.
In conclusion, prolonged rupture of membrane was mostly responsible for neonatal septicaemia in this study.
新生儿败血症（NNS）发生在生命的头 28 天内，其特征是通过血培养证实存在全身细菌感染。它是新生儿发病率和死亡率的主要原因。NNS 的决定因素因地理位置而异，这也是本研究的基础。
确定比达联邦医疗中心新生儿重症监护病房（NICU）入院的新生儿败血症的患病率和易患因素。
这是一项为期一年的前瞻性观察研究，2015 年 5 月 13 日至 2016 年 4 月 30 日，通过目的性抽样方法选择比达联邦医疗中心新生儿重症监护病房（NICU）入院的 167 名新生儿参与研究。由同意的父母填写了一份结构式问卷，并采集了血液样本进行实验室分析。使用 SPSS 版本 20（2016 年）分析数据。使用频率分布、平均值、标准差、图表和表格对数据进行总结，使用卡方检验和 Fisher's 确切检验（在 5%的显著性水平下）以及适当的优势比（OR）确定统计学意义。
在招募的 167 名新生儿中，97 名（58.1%）为男性，70 名（41.9%）为女性，男女比例为 1.4:1。外出出生者 100 人（60%），本地出生者 67 人（40%）。平均年龄为 4.3 ± 1.5 天，平均体重为 2589 ± 743.9g。新生儿败血症的总患病率为 2.33%，而血培养阳性率为 9.58%。本研究中新生儿的危险因素有延长的胎膜破裂（PROM）、绒毛膜羊膜炎、胎粪污染羊水、阴道排出恶臭分泌物、外出出生、低出生体重、出生时无法哭泣和早产，但胎膜破裂是唯一与败血症显著相关的危险因素（OR 5.4；95%CI 2.2-13.5），而大肠杆菌是主要的细菌分离株。
总之，在这项研究中，延长的胎膜破裂是导致新生儿败血症的主要原因。
