Septicaemia and meningitis in neonates and during early infancy in the Goteborg area of Sweden

In a retrospective study of neonatal septicaemia and meningitis carried out in 1987-1996 in the Goteborg area of Sweden, 305 cases during the first 28 d of life were found. The incidence was 3.7/1000 live births, which was higher than that found in a study from 1975 to 1986 in the same area, 2.8/1000 live births. The most common pathogens were group B streptococci, aerobic Gram-negative rods, Staphylococcus aureus and enterococci. The cases were approximately equally divided between very early, early and late onset infections. The case-fatality rate was lower in the present study (9%) than that in the previous study (15%). The case-fatality rate varied between 23% in neonates with a gestational age of less than or equal to29 wk and 3% in full-term neonates. Eighty-three very late onset infections occurred between days 28 and 120 after birth, corresponding to an incidence of 1.0/1000 live births. Of those, 47 occurred in preterm neonates. The most common organisms were aerobic Gram-negative rods. Coagulase-negative staphylococci (CoNS) were studied separately. This organism was isolated in 60 and 32 cases during the first 28 d of life and between days 28 and 120, respectively, in neonates fulfilling the criteria of the Yale-New Haven Hospital for infections caused by commensal species. The incidence rates of CoNS infections were 0.7 and 0.4/1000 live births, respectively. Conclusion: The incidence of neonatal infections increased and the case-fatality rate decreased in the Goteborg area compared to the findings of a previous study. Very late onset infections should be added to the total burden of neonatal infections. CoNS are important pathogens but their role is difficult to determine since they are both pathogens and contaminants of cultures from blood and cerebrospinal fluid.