Profile of Newborns Hospitalized for Maternal Fetal Infection and Having a Positive CRP in the Pediatric Department of the Gabriel Tour&amp;#233; CHU in Bamako, Mali

Oumar Coulibaly,Mariam Sylla,Abdoul Karim Doumbia,Issa Amadou Touré,Traoré Fatoumata Dicko Traoré,Bourama Kané,Abdoul Aziz Diakité,Fousseyni Traoré,Yacouba Coulibaly ,Leyla Maïga ,Adama Dembélé ,Hawa Diall ,Fatoumata Léonie Diakité ,Mohamed Cissé ,Aminata Doumbia ,Belco Maïga ,Pierre Togo ,Guediouma Dembélé ,Karamoko Sacko ,Lala Ndrayni Sidibé ,Mamary Coulibaly ,Djenèba Konaté ,Ibrahima Ahamadou ,Amadou Touré ,Boubacar Togo

doi:10.4236/ojped.2021.114064

Abstract

Objective: Early bacterial neonatal infection (INBP) or maternofetal infection (early neonatal sepsis) remains a concern of the pediatrician due to diagnostic difficulties and its increased morbidity and mortality. No study has been done in Mali on the profile of newborns admitted for INBP with positive CRP, hence the initiation of this work with the aim of studying the epidemiological, biological and bacteriological profile of newborns with a bacterial maternal-fetal infection. Method: Longitudinal study descriptive (from 27 June to 3 September 2016) which concerned all newborns aged from 0 to 72 hours of life hospitalized for confirmed early bacterial neonatal infection with a positive C-reactive protein (CRP) in the neonatal department of the CHU Gabriel Touré. INBP was defined by the presence of maternal and neonatal infectious risk factors, positivity of CRP with a germ in the blood culture. Results: During the study period we included 244 newborns for probable maternofetal infection and who benefited from the CRP assay, 43 had a positive CRP, i.e. a frequency of 17.62%. The sex ratio was 2.30. The majority had a low birth weight ( g) in 69.8% of cases. Mothers were aged 18 to 35 in 93%. The majority were out of school (43.8%) and housewives in 74.4%. The main reasons for consultations were prematurity and/or low birth weight, respiratory distress and neonatal distress, i.e. 46.5%, 25.6% and 11.6% respectively. Among the 43 newborns with a positive CRP, the blood culture returned positive in 79.1% (n = 34). We deplore 2 deaths (4.7%). The main bacteria were gram-positive cocci (Staphylococcus aureus 53.01% and Streptococccus agalactiae 4.10%), gram-negative bacilli (GNB) type Enterobacteriaceae (Klebsiella pneumoniae 11.25% and E. coli at 5.70%) and non-fermentative GNBs (Pseudomonas aeruginosa 2.80% and Acinetobacter baumannii complex 2.24%). Conclusion: Maternal-fetal infection is a hospital pathology frequently encountered in the neonatal period. Its clinical presentation is dominated by respiratory distress, neurological disorders and low birth weight.

Highlights

Neonatal mortality remains a major public health challenge in the world with 2.7 million annual deaths, eighty percent of these deaths occur in the developing world in particular sub-Saharan Africa and South and South Asia [1] [2]
No study has been done in Mali on the profile of newborns admitted for INBP with positive C-reactive protein (CRP), the initiation of this work with the aim of studying the epidemiological, biological and bacteriological profile of newborns with a bacterial maternal-fetal infection
Longitudinal study descriptive which concerned all newborns aged from 0 to 72 hours of life hospitalized for confirmed early bacterial neonatal infection with a positive C-reactive protein (CRP) in the neonatal department of the CHU Gabriel Touré

Summary

Introduction

Neonatal mortality remains a major public health challenge in the world with 2.7 million annual deaths, eighty percent of these deaths occur in the developing world in particular sub-Saharan Africa and South and South Asia [1] [2]. Neonatal bacterial infections are the third leading cause of newborn death worldwide, behind prematurity and childbirth-related mortality, and account for 10% of deaths before the age of 5. The mortality gap between high- and low/middle-income countries may be explained by inadequate monitoring of some pregnancies, the lack of systematic screening for pre- and per-partum risk factors of INBP, and immediate postnatal surveillances of the newborn in poorly done maternity hospitals are factors that increase the morbidity and mortality of INBP in developing countries [3]. Early neonatal bacterial infections (INBP) are mainly caused by multidrug-resistant gram-negative bacilli with increased neonatal mortality rate, Escherichia coli and Klebsiella spp. In the African context, knowledge of an epidemiological and clinical profile of confirmed neonatal bacterial infection is necessary to ensure rapid treatment, especially in regions where the performance of con-

Methods

Results

Conclusion