A case-control study of antecedents of neonatal septicaemia was performed using 50 cases of neonatal septicaemia and 73 comparison infants from a Malaysian hospital nursery. Multivariate analysis indicated the following independent risk factors: maternal primiparity, pre-eclampsia, prolonged rupture of membranes, twin pregnancy, prematurity, assisted ventilation, umbilical catheterization, and formula feeding. Although the spectrum of causative organisms varied between our study and past studies from Western countries, the risk factors for developing neonatal septicaemia were strikingly similar. Therefore, preventative guidelines based on risk factors described in Western countries, should help reduce the incidence of neonatal septicaemia at this Malaysian hospital.
Discriminatory typing methods are invaluable in the investigation of outbreaks of infectious diseases. Single primers were used to generate randomly amplified polymorphic DNA (RAPD) profiles from Klebsiella pneumoniae isolates of various serotype and K. pneumoniae isolates from cases of sepsis at a Malaysian hospital and two English hospitals. RAPD profiles of acceptable reproducibility, a maximum of three minor band variations, were produced using a rapid DNA extraction method. RAPD typing of K. pneumoniae was shown to be as discriminatory as restriction fragment length polymorphism analysis using pulsed field gel electrophoresis yet quicker and less costly. The findings suggest that RAPD typing may be a useful tool for the epidemiological typing of K. pneumoniae.