Burden of bacterial resistance among neonatal infections in low income countries: how convincing is the epidemiological evidence?

June 21, 2015 at 7:42 pm

BMC Infect Dis. 2015 Mar 15;15:127.

Huynh BT1, Padget M2, Garin B3, Herindrainy P4, Kermorvant-Duchemin E5, Watier L6, Guillemot D7, Delarocque-Astagneau E8.

Author information

1Pharmacoepidemiology and Infectious diseases Unit, Institut Pasteur, UVSQ, EA 4499, Versailles, INSERM Unit 657, 25,28 rue du Docteur Roux, 75724, Paris, France. bich-tram.huynh@pasteur.fr.

2Pharmacoepidemiology and Infectious diseases Unit, Institut Pasteur, UVSQ, EA 4499, Versailles, INSERM Unit 657, 25,28 rue du Docteur Roux, 75724, Paris, France. Michael.padget@pasteur.fr.

3Experimental Bacteriology Laboratory, Institut Pasteur, Antananarivo, Madagascar. bgarin@pasteur.mg.

4Epidemiology Unit Institut Pasteur, Antananarivo, Madagascar. perlinot@pasteur.mg.

5Necker Hospital, Department of Neonatal medicine, Paris Descartes University, Paris, France. elsa.kermorvant@nck.aphp.fr.

6Pharmacoepidemiology and Infectious diseases Unit, Institut Pasteur, UVSQ, EA 4499, Versailles, INSERM Unit 657 Paris, France AP-HP, Hospital Raymond-Poincaré, Garches, France. laurence.watier@inserm.fr .

7Pharmacoepidemiology and Infectious diseases Unit, Institut Pasteur, UVSQ, EA 4499, Versailles, INSERM Unit 657 Paris, France AP-HP, Hospital Raymond-Poincaré, Garches, France. didier.guillemot@pasteur.f .

8Pharmacoepidemiology and Infectious diseases Unit, Institut Pasteur, UVSQ, EA 4499, Versailles, INSERM Unit 657, 25,28 rue du Docteur Roux, 75724, Paris, France. elisabeth.delarocque-astagne@pasteur.fr

Abstract

BACKGROUND:

Antibiotic resistance is a threat in developing countries (DCs) because of the high burden of bacterial disease and the presence of risk factors for its emergence and spread. This threat is of particular concern for neonates in DCs where over one-third of neonatal deaths may be attributable to severe infections and factors such as malnutrition and HIV infection may increase the risk of death. Additional, undocumented deaths due to severe infection may also occur due to the high frequency of at-home births in DCs.

METHODS:

We conducted a systematic review of studies published after 2000 on community-acquired invasive bacterial infections and antibiotic resistance among neonates in DCs. Twenty-one articles met all inclusion criteria and were included in the final analysis.

RESULTS:

Ninety percent of studies recruited participants at large or university hospitals. The majority of studies were conducted in Sub-Saharan Africa (n=10) and the Indian subcontinent (n=8). Neonatal infection incidence ranged from 2.9 (95% CI 1.9-4.2) to 24 (95% CI 21.8-25.7) for 1000 live births. The three most common bacterial isolates in neonatal sepsis were Staphylococcus aureus, Escherichia coli, and Klebsiella. Information on antibiotic resistance was sparse and often relied on few isolates. The majority of resistance studies were conducted prior to 2008. No conclusions could be drawn on Enterobacteriaceae resistance to third generation cephalosporins or methicillin resistance among Staphylococcus aureus.

CONCLUSIONS:

Available data were found insufficient to draw a true, recent, and accurate picture of antibiotic resistance in DCs among severe bacterial infection in neonates, particularly at the community level. Existing neonatal sepsis treatment guidelines may no longer be appropriate, and these data are needed as the basis for updated guidelines. Reliable microbiological and epidemiological data at the community level are needed in DCs to combat the global challenge of antibiotic resistance especially among neonates among whom the burden is greatest.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4364576/pdf/12879_2015_Article_843.pdf

Entry filed under: Antimicrobianos, Bacterias, Bacteriemias, Epidemiología, Metodos diagnosticos, Resistencia bacteriana, REVIEWS, Update. Tags: .

CD64-Neutrophil expression and stress metabolic patterns in early sepsis and severe traumatic brain injury in children. Utility of Hepatitis C Viral Load Monitoring on Direct-Acting Antiviral Therapy


Calendar

June 2015
M T W T F S S
« May   Jul »
1234567
891011121314
15161718192021
22232425262728
2930  

Most Recent Posts


%d bloggers like this: