Evaluation of neonatal sepsis screening in a tropical area - Part I: Majorrisk factors for bacterial carriage at birth in Guadeloupe

This prospective study reports on screening for neonatal sepsis among 3,372 live births out of 6,060 consecutive deliveries at the University Hospital of Pointe-a-Pitre, Guadeloupe, during a 30-month period Group B Streptococ cus (GBS) was the most common pathogen, representing 46% (89/194) of positi ve blood cultures, and 52% (335/637) of positive gastric aspirates. Althoug h only 3,372 (55%) of all live births were screened, 637 (10%) had gastric bacterial carriage at birth; of those, 335 (5.5%) involved GBS. Similarly, there were 194 (3.2%) positive blood cultures, of which 89 (1.5%) involved GBS. In this report, all newborns who presented with a positive GBS blood c ulture had at least one of the external tests positive for GBS (gastric, ea r canal, rectum and placenta). Thirty-seven percent (14/38) of positive neo natal blood cultures occurred in newborns with foetid liquor while in deliv eries with intrapartum fever 16.5% (32/195) of blood cultures were positive . In our clinical practice, characteristics that were evident in the delive ry room (without knowledge of prenatal follow-up) such as foetid liquor, in trapartum fever, prolonged rupture of membranes, foetal tachycardia and mec onium staining were associated with the great majority of neonatal sepsis.