Klebsiella septicaemia, osteomyelitis and septic arthritis in neonates in Ibadan, Nigeria.

An outbreak of skeletal infections associated with neonatal Klebsiella septicaemia seen over a 6-month period at the Special Care Baby Unit, University College Hospital, Ibadan is reported. It involved 12 neonates, and the significant antecedent events included perinatal asphyxia, fetal distress and prolonged rupture of membranes. All the babies had septic arthritis and ten cases had osteomyelitis in addition: multiple joint involvement occurred in 50% of cases. All the babies exhibited severe systemic disturbance and the Klebsiella isolated demonstrated multiple antibiotic resistance. The epidemic coincided with a period of severe water shortage which affected the hospital. The probable nosocomial acquisition of the infection is highlighted.