Increase of staphylococci in neonatal septicaemia: a fourteen‐year study

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Abstract
All cases of neonatal septicaemia during 1981‐94 were studied at Örebro Medical Centre Hospital, Sweden. One hundred and thirty‐two children fulfilled laboratory and clinical criteria for neonatal septicaemia and were included. Staphylococcus aureus (n= 41), Group B streptococcus (GBS) (n= 32) and coagulase‐negative staphylococci (CoNS) (n= 27) were the dominating aetiologies. The annual incidence of septicaemia increased significantly, from 2.3 cases during the first 7‐year period to 3.3 per 1000 live births during 1988‐94. This increase was caused by S. aureus and CoNS, which mainly affected premature children and had an onset more than 48 h after delivery. GBS, on the other hand, slightly decreased and affected full‐term children within 48 h. The overall mortality was 11%. CoNS isolated during the latter 7‐year period were more resistant to antibiotics than those isolated during 1981‐87; resistance to methicillin increased from 14 to 45% and to gentamicin from 0 to 20%. These changes in aetiology and antibiotic susceptibility should be considered when selecting antibiotic treatment in neonatal septicaemia.