In hospital settings in Africa the many other concerns of sanitary officials and the lack of available resources often make hospital hygiene and nosocomial infection secondary problems. To illustrate the importance of these issues in an African pediatric setting, this report describes a series of 32 cases of nosocomial septicemia that occurred within a 2-month period in the Pediatric Department of Principal Hospital in Dakar. There were 10 deaths. The infecting organisms were similar to those observed in industrial countries. Klebsiella Pneumoniae was identified in 16 cases, Escherichia coli in 5, and an association of both bacteria in 5. A profile of beta-lactamase enzymes with a classic epidemiologic spectrum was observed in 15 of 21 strains of Klebsiella pneumoniae and in 3 of 10 strains of Escherichia coli. The authors discuss the conditions that may have encouraged the outbreak of septicemia, regret the lack of a service to monitor hospital hygiene, and propose prophylactic measures using laboratory tests that are feasible in a hospital setting in Africa.