Bloodstream infections and perinatal mortality

Bloodstream infection is demonstrable at necropsy in 21-1 % of perinatal deaths but is almost invariably a secondary event, often terminal, contributing to death as a secondary cause. In only 3-8% is infection recorded as the primary cause of death. Escherichia coli predominates, and postmortem and antemortem studies alike confirm the tendency of this and other microbes to involve the meninges in the course of bloodstream infection. Fatal viral and fungal infections are rare, and life-threatening disease is overwhelmingly of bacterial origin. A separate, prospective study of septicaemia in the newborn is reported, and the data are tabulated. The overall incidence in inborn and outborn populations, together with the incidence of specific infections, is stated, and the relationship to birthweight is analysed. The overall mortality for treated cases is 40 7 %, the mortality being inversely proportional to birthweight, and highest at 62.5% in those born weighing less than 1000 g. The advent of meningitis (1 in 5 cases of septicaemia) aggravates the mortality (83 %). The potential hazard of nursing seriously infected babies is emphasised.