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  • ISSN: 2373-9312
    Early Online
    Volume 6, Issue 4
    Research Article
    Hamufare Mugauri, Owen Mugurungi, Sithabiso Dube, Tapuwa Magure, Tsitsi Juru*, Notion Tafara Gombe, Gerald Shambira, and MufutaTshimanga
    Background: Neonatal sepsis is among the leading causes of morbidity and mortality among term and preterm infants particularly in Neonatal Intensive Care Units (NICU). Pathogens implicated are mostly hospital-acquired. Parirenyatwa NICU experienced a surge in neonatal sepsis incidences, recording 108 cases and 41 deaths in five months. We determined the source and the factors that facilitated the infection.
    Methods: A cohort study of neonates admitted from 1 June to 31 October 2016 using secondary data, key informant interviews and checklists were conducted. Environmental and hand swabs were collected for laboratory analyses. Neonatal sepsis was defined as a clinical syndrome resultant from systemic infection. Epi Info was used to compute proportions, relative risks, attributable risks at 5% significance level.
    Results: All 641 clinical records of admitted neonates were reviewed. One hundred and two (94%) of neonate sepsis patients were hospital-acquired. Suctioning (RR=9.6; 95%CI, 5.4-17.1) increased the risk for neonatal sepsis and 80.6% neonatal sepsis cases were attributable to mechanical ventilation (95%CI, 71.5-89.6). Klebsiella and Pseudomonas Species were isolated from ward equipment and sinks. Hand swabs yielded Pseudomonas and Staphylococci Species. Among neonatal sepsis patients, 78.2% (n=101) yielded positive Klebsiella cultures [RR 2.0; (95%CI 1.5-2.8), AR% 48.4; (95%CI 33.4-63.4)]. The excess risk of death from neonatal sepsis was 34.2 per 100.
    Conclusion: Outbreak was driven by Klebsiella induced, hospital-acquired sepsis, from a common-continuous source and spread through cross infection. Suspending mechanical ventilation and thorough disinfection controlled the outbreak. Compliance with infection control protocol and surveillance of neonatal infections were considered for prevention of similar outbreaks.
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