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Neonatal infections in Asia
  1. R Tiskumara1,
  2. S H Fakharee2,
  3. C Q Liu3,
  4. P Nuntnarumit4,
  5. K M Lui5,
  6. M Hammoud6,
  7. J K F Lee7,
  8. C B Chow8,
  9. A Shenoi9,
  10. R Halliday1,
  11. D Isaacs1,10,
  12. on behalf of APNIS (Asia-Pacific Neonatal Infections Study)
  1. 1
    Children’s Hospital at Westmead, Westmead, NSW, Australia
  2. 2
    Mofid Children’s Hospital, Teheran, Iran
  3. 3
    Children’s Hospital of Hebei Province, China
  4. 4
    Ramathibodi Hospital, Bangkok, Thailand
  5. 5
    Centro Hospitalar Conde Sao Januario, Macau SAR, China
  6. 6
    Ab Sarah Maternity Hospital, Kuwait
  7. 7
    Kuala Terengganu Hospital, Terengganu, Malaysia
  8. 8
    Princess Margaret Hospital HKSAR, Hong Kong
  9. 9
    Manipal Hospital, Bangalore, India
  10. 10
    University of Sydney, Sydney, NSW, Australia
  1. Dr D Isaacs, Department of Infectious Diseases, Children’s Hospital at Westmead, Locked Bag 4001, Westmead, NSW 2145, Australia; davidi{at}


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

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

Results: There were 453 episodes of sepsis affecting 394 babies. Mortality from neonatal sepsis was 10.4%, with an incidence of 0.69 deaths/1000 live births. Group B streptococcus was the most common early-onset organism causing 38% of episodes of early-onset (<48 h old) sepsis, with a rate of 0.51 episodes per 1000 live births and a mortality of 22%. Gram-negative bacillary early-onset sepsis occurred at a rate of 0.15 episodes per 1000 live births with a mortality of 12%. 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 staphylococcus caused 34.1% of episodes, whereas Staphlococcus 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, whereas 30% were resistant to both antibiotics. Meningitis occurred in 17.2% of episodes of late sepsis, with a mortality of 20%.

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

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  • Competing interests: None.

  • Ethics approval: Obtained.