NEONATAL E. COLI
INFECTIONS IN CASABLANCA- MOROCCO
S. Benomar, N. Nejjari, M.
Belbachir
Residence Fida3, Imm6,
App3, Route Makro Sidimaarouf, Casablanca, Morocco
The principal pathogens involved in neonatal sepsis varie with time and
centers. The
most reported is Streptococcus B, followed by gram-negative enteric
organisms, especially E.coli.
Patients And Methods: All neonates with E.coli
infection who were admitted at Neonatology and Intensive Care of Casablanca
Children's Hospital from January 1,1990 through December 31, 2000,were
identified from a register of all hospitalized neonates.
Objectives: We studied clinical characteristics of
infected neonates, microbiological sensitivities of E.coli isolates and its
place in neonate infection.
Results: E.coli infection was diagnosed in 54 of about
neonates admitted. Thirty-seven cases were early (EOD)(68,5%) and seventeen
cases were late onset disease (LOD) (31,5%). This pathogen represents 13,6%
of the neonatal bacterial infections confirmed during the same period.
Respiratory distress was common in EOD, but behavior and neurologic
disorders were found in LOD. In the EOD, E.coli was isolated from blood
cultures (33 cases), cerebro spinal fluid (CSF) (8 cases), and in urine
specimen (2 cases). In the LOD, E.coli was isolated from blood cultures (7
cases), in the urine specimen (11 cases), and CSF (1case). Infection was
due to E.coli ampicillin-resistant in 14 cases (30%). Overall nighteen
percent newborns died. It was especially in EOD.
Conclusion: Infected neonates had a clinical
syndrome that was indistinguishable from group B streptococcal infection.
E.coli ampicillin-resistant is frequent in our unit and appropriate
antibiotic treatment must be based on third generation cephalosporin plus
aminoglycoside. Prematurity and severity of initial score are factors of
bad prognosis.