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Neonatal infections in Asia
  1. Ramesha Tiskumara (ramesha.tiskumara{at}sswahs.nsw.gov.au)
  1. Children's Hospital at Westmead, Australia
    1. S H Fakharee
    1. Mofid Children's Hospital, Teheran, Iran, Islamic Republic of
      1. Cuiqing Lui (cuiqingliu{at}yahoo.com)
      1. Children's Hospital of Hebei Province, China
        1. Pracha Nuntnarumit (tepnt{at}mahidol.ac.th)
        1. Ramathibodi Hospital, Bangkok, Thailand
          1. Kin Man Lui (luikm{at}ssm.gov.mo)
          1. Centro Hospitalar Conde Sao Januario, Macau SAR, Macau
            1. Majeeda Hammoud (m.hammoud{at}hsc.edu.kw)
            1. Ab Sarah Maternity Hospital, Kuwait
              1. Jimmy KF Lee (jkflee{at}tm.net.my)
              1. Kuala Terengganu Hospital, Terengganu, Malaysia
                1. C B Chow (chowcb{at}netvigator.com)
                1. Princess Margaret Hospital HKSAR, Hong Kong
                  1. Arvind Shenoi (mpvs19{at}vsnl.com)
                  1. Manipal Hospital, Bangalore, India
                    1. Robert Halliday (roberth{at}chw.edu.au)
                    1. Children's Hospital at Westmead, Australia
                      1. David Isaacs (davidi{at}chw.edu.au)
                      1. Children's Hospital at Westmead, Australia

                        Abstract

                        Objective: To study the epidemiology of neonatal unit infections in countries in Asia, including incidence, antibiotic sensitivity and mortality.

                        Methods: One year prospective study of neonatal infections in 8 neonatal units in Asia.

                        Results: There were 453 episodes of sepsis affecting 394 babies. The mortality from neonatal sepsis was 10.4%, with an incidence of 0.69 deaths/1000 live births.

                        Group B Streptococcus (GBS) was the commonest early-onset organism causing 38.3% of episodes of early-onset sepsis (<48 hours old), with a rate of 0.51 episodes per 1000 live births and a mortality of 22.2%. Gram negative bacillary early onset sepsis occurred at a rate of 0.15 episodes per 1000 live births with a mortality of 12.5%.

                        There were 406 episodes of late onset sepsis. The incidence was high at 11.6 per 1000 live births and mortality was 8.9%. Coagulase negative staphylococci caused 34.1% of episodes, while S. aureus caused only 5.4%. Gram negative bacilli caused 189 episodes (46.6%). Only 44% of Gram negative bacilli were sensitive to both gentamicin and a third generation cephalosporin, while 30% were resistant to both antibiotics. Meningitis occurred in 17.2% of episodes of late sepsis, and had a mortality of 20%.

                        Conclusion: The incidence of late-onset sepsis was higher in Asia than in resource-rich countries, but the organisms isolated and the mortality rates were similar. Over half of all Gram negative bacilli were antibiotic resistant.

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