Клиники по охране здоровья матери и ребенка

Абстрактный

Management of Neonatal Infectious Risk Factors (IRF) in Senegal

Modou Gueye, Amadou Sow*, Djibril Boiro, Fall L, Diagne NR, Ndiaye AM, Nakoulima, Fall K, Goumba A, Seye M, Faye PM, Ka AS and Ndiaye O

The diagnosis of early neonatal bacterial infections (NBI) is difficult because of non-specific clinical signs. The decision to treat is often made on a bundle of anamnestic, clinical and biological arguments. The objectives of this study were to identify the infection risk factors (IRF), the germs responsible of NBI as well as their susceptibility to antibiotics and the evolution of neonates with an IRF. This is a retrospective study conducted in a hospital center in Senegal from December 2017 to August 2018. The study concerned hospitalized newborns with one or more IRF. During this period, 620 neonates were hospitalized and 192 had one or more infectious IRF, an incidence of 30.9%. The average age of mothers was 30 years old [15-46 years]. Most newborns were born premature (53.6%) and 55.2% had low birth weight. Amniotic fluid tinted (42.7%), premature rupture of membranes (25.5%) were the most frequently reported IRF. Of the 55 positive samples, Escherichia coli and Klebsiella pneumoniae were the predominant germs representing respectively 50, 9% (28/55) and 18.1% (10/55). Mortality was 28.8% in newborns. Among the IRF, only, premature rupture of membranes before labor was significantly associated with the occurrence of NBI (P=0.02). Associated IRF were significantly related to adverse evolution (P=0.035). Mortality was significantly higher in preterm infants (31.1% vs. 14.6%) (p=0.007). The recognition of the IRF is a fundamental element for a better management of NBI which constitutes a major cause of mortality.