Pattern and etiology of culture-proven early-onset neonatal sepsis: a five-year prospective study

Int J Infect Dis. 2011 Sep;15(9):e631-4. doi: 10.1016/j.ijid.2011.05.004. Epub 2011 Jun 28.


Objectives: To investigate the incidence of early-onset neonatal sepsis and identify the main pathogens over a 5-year period in Kuwait.

Methods: Blood samples were collected from all infants with any clinical or laboratory feature suggestive of sepsis, at the main maternity hospital in Kuwait. Cases of early-onset neonatal infection were defined as culture of a single potentially pathogenic organism from blood or cerebrospinal fluid from infants younger than 7 days of age, in association with clinical or laboratory findings consistent with infection.

Results: The overall incidence of early-onset neonatal infection was 2.7 (95% confidence interval (CI) 2.3-3.2) episodes per 1000 live-births. The case-fatality was 13.1% (95% CI 8.6-18.9%). Group B Streptococcus (GBS) accounted for 17.6% of infections among infants younger than 7 days (incidence 0.48 per 1000 live-births), but 38.1% of infections in the first 2 days of life. Neither the incidence of early-onset infection by GBS nor by Escherichia coli changed significantly over the study period.

Conclusions: Although the incidence of GBS infections was relatively low, GBS accounted for most early-onset infections. Intrapartum antibiotic prophylaxis against GBS should be strengthened. There was no evidence to suggest that early-onset infection due to non-GBS organisms such E. coli has increased in the last 5 years.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age of Onset
  • Humans
  • Incidence
  • Infant, Newborn
  • Kuwait / epidemiology
  • Prospective Studies
  • Sepsis / epidemiology*
  • Sepsis / microbiology*