Your browser doesn't support javascript.
loading
Neonatal sepsis at Mulago national referral hospital in Uganda: Etiology, antimicrobial resistance, associated factors and case fatality risk.
Tumuhamye, Josephine; Sommerfelt, Halvor; Bwanga, Freddie; Ndeezi, Grace; Mukunya, David; Napyo, Agnes; Nankabirwa, Victoria; Tumwine, James K.
Afiliação
  • Tumuhamye J; Centre for Intervention Science for Maternal and Child Health (CISMAC), Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
  • Sommerfelt H; Centre for Intervention Science for Maternal and Child Health (CISMAC), Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
  • Bwanga F; Department of Medical Microbiology, Makerere University, Kampala, Uganda.
  • Ndeezi G; Department of Pediatrics and Child Health, Makerere University, Kampala, Uganda.
  • Mukunya D; Centre for Intervention Science for Maternal and Child Health (CISMAC), Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
  • Napyo A; Centre for Intervention Science for Maternal and Child Health (CISMAC), Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
  • Nankabirwa V; Department of Public Health, Busitema University, Mbale, Uganda.
  • Tumwine JK; Centre for Intervention Science for Maternal and Child Health (CISMAC), Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
PLoS One ; 15(8): e0237085, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32776958
ABSTRACT

BACKGROUND:

Sepsis is the third most common cause of death among neonates, with about 225,000 newborns dying every year globally. Data concerning the microbial etiology of neonatal sepsis and antimicrobial resistance profiles of its causative agents are necessary to inform targeted and effective treatment and prevention strategies.

OBJECTIVE:

To determine the proportion of newborns with symptoms and signs of sepsis who had a positive blood culture, its bacterial etiology, the antimicrobial resistance patterns as well as the factors associated with culture-positivity and case fatality at Mulago national referral hospital in Uganda.

METHODS:

We conducted a cross-sectional study among 359 neonates with symptoms and signs of sepsis who presented to the pediatric emergency care unit of Mulago national referral hospital from mid-January to end of December 2018. We performed blood culture and antimicrobial susceptibility testing, and conducted polymerase chain reaction to identify methicillin-resistant Staphylococcus aureus (MRSA) isolates. We used multivariable logistic regression to estimate the association between potential risk factors and culture-positive neonatal sepsis.

FINDINGS:

Of the 359 neonates recruited, 46 (12.8%; 95% CI 9.5%, 16.7%) had a positive blood culture. The predominant isolated bacteria were Staphylococcus aureus in 29 (63.0%), Escherichia coli in seven (15.2%), and Klebsiella pneumoniae in five (10.9%). Of the 46 pathogens, 73.9% were resistant to ampicillin, 23.9% to gentamicin and 8.7% to ceftriaxone. We isolated MRSA from the blood specimens of 19 (5.3%) of the 359 neonates, while 3 (0.8%) grew extended spectrum beta lactamase producers. The case fatality risk among neonates with neonatal sepsis was 9.5% (95% CI 6.6%, 13.0%). Cesarean section delivery was strongly associated with culture-positive sepsis (adjusted odds ratio 3.45, 95% CI 1.2, 10.1).

CONCLUSION:

One in eight neonates with clinical signs of sepsis grew a likely causative bacterial pathogen. S. aureus was the main pathogen isolated and a third of these isolates were MRSA. A significant proportion of the isolated bacterial pathogens were resistant to the first and second line antibiotics used for the treatment of neonatal sepsis. There is need to revisit the current treatment guidelines for neonatal sepsis.
Assuntos
Texto completo: Disponível Coleções: Bases de dados internacionais Contexto em Saúde: ODS3 - Saúde e Bem-Estar Tema em saúde: Meta 3.2: Reduzir as mortes de recém nascidos e crianças com menos de 5 anos Base de dados: MEDLINE Assunto principal: Infecções Estafilocócicas / Sepse Neonatal Tipo de estudo: Estudo de etiologia / Estudo prognóstico / Fatores de risco Limite: Feminino / Humanos / Masculino / Recém-Nascido País/Região como assunto: África Idioma: Inglês Revista: PLoS One Assunto da revista: Ciência / Medicina Ano de publicação: 2020 Tipo de documento: Artigo País de afiliação: Noruega

Similares

MEDLINE

...
LILACS

LIS

Texto completo: Disponível Coleções: Bases de dados internacionais Contexto em Saúde: ODS3 - Saúde e Bem-Estar Tema em saúde: Meta 3.2: Reduzir as mortes de recém nascidos e crianças com menos de 5 anos Base de dados: MEDLINE Assunto principal: Infecções Estafilocócicas / Sepse Neonatal Tipo de estudo: Estudo de etiologia / Estudo prognóstico / Fatores de risco Limite: Feminino / Humanos / Masculino / Recém-Nascido País/Região como assunto: África Idioma: Inglês Revista: PLoS One Assunto da revista: Ciência / Medicina Ano de publicação: 2020 Tipo de documento: Artigo País de afiliação: Noruega