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Rachma F. Boedjang
Department of Child Health, University of Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta
Health Professions Medicine & Pharmacology

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Nosocomial septicemia in neonates Rachma F. Boedjang
Paediatrica Indonesiana Vol 39 No 1-2 (1999): January - February 1999
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi39.1-2.1999.14-9

Abstract

This study reports the prevalence of nosocomial septicemia (NS) and the relative risk (RR) of NS in neonates with intravenous (IV) line as well as in low birth weight infant, and the role of C-reactive protein (CRP) in detecting septisemia. We evaluated a prospective cohort of 182 out of 541 neonates admitted to the Special Care Unit of Cipto Mangunkusumo General Hospital, Jakarta, during a 12 months period (October 1996 to September 1997). Information was recorded on each baby's indentity including primary diagnosis. On the basis of clinical evidence they were divided into two groups: neonates with IV line (92) and non IV line (90). Neonates in whom clinical was suspected when they were more than 72 hours of admittance were eligible for study. Clinical diagnosis of septicemia was confirmed by CRP and proven by blood culture. There were 182 newborn infants, 106 boys of them were boys. 66 out of 182 (36.3%) were diagnosed as septicemia clinically. Among them (81.8%) were CRP positive and 85.2% were proven by blood culture. The overall prevalence of septicemia was 25.3% of evaluation and was most common in IV line with a prevalence of 36.9%, while in non IV line was 13.3%. The RR of NS in IV line and low birth weight infants were 2,74 and 2.67 respectively. The etiologic agents were mostly gram negative: E. coli (49.1%), Pseudomonas sp. (16.4%), Enlorobacter sp. (19.1%). The only gram positive cocci was Staphylococcus aureus (12.7%). NS almost always occurs in Special Care Unit. CRP was a valuable adjunct for diagnosing septicemia. The RR was higher in IV line and low birth weight infants. The most common pathogens in this study was gram negative.
Neonatal Tetanus: Risk Factors and Prognosis Rachma F. Boedjang
Paediatrica Indonesiana Vol 35 No 1-2 (1995): January - February 1995
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2390.974 KB) | DOI: 10.14238/pi35.1-2.1995.1-7

Abstract

Neonatal tetanus (NT) remains a common cause of morbidity among neonates in Indonesia. A retrospective study was made on 83 cases on NT seen in Cipto Mangunkusumo Hospital, Jakarta over the period of 1991 -1993. The purpose of this study was to know the factors which might contributed to NT. The number of cases on NT admitted per year was almost the same; 91.6%-of cases were residents inside Jakarta and came from low socioeconomic level with low educational level. Almost 3/4 of cases were delivered by traditional birth attendants who cut the umbilical cord with uncleaned instruments or dressed it with herbal mixtures, ashes, etc. Non'e of the mothers had had tetanus immunization when they were pregnant The ratio of male to female was 1.24 : 1. All cases presented the symptoms within the first 14 days of life,  mostly at 5-8 days of life. The overall mortality was 63.8%. The most frequently found complications were omphalitis (36%) and sepsis (24%). It is concluded that low socioeconomic level, low educational level, absence of tetanus immunization during pregnancy and poor umbilical cord dressing may contribute to the development of NT.
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