| Title | Population-Based Incidence and Etiology of Community-Acquired Neonatal Bacteremia in Mirzapur, Bangladesh: An Observational Study. | | Author(s) | Darmstadt GL, Saha SK, Choi Y, Arifeen SE, Ahmed NU, Bari S, Rahman SM, Mannan I, Crook D, Fatima K, Winch PJ, Seraji HR, Begum N, Rahman R, Islam M, Rahman A, Black RE, Santosham M, Sacks E, Baqui AH, Bangladesh Projahnmo‐2 (Mirzapur) Study Group | | Institution | Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland; 2Department of Microbiology, Bangladesh Institute of Child Health, Dhaka Shishu Hospital, and 3Public Health Sciences Division, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, and 4Department of Pediatrics, Kumudini Women's Medical College, Mirzapur, Tangail, Bangladesh; 5Department of Microbiology, John Radcliffe Hospital, Oxford University, Oxford, United Kingdom. | | Source | J Infect Dis 2009 Sep 15; 200(6):906-915. | | Abstract | Background. To devise treatment strategies for neonatal infections, the population-level incidence and antibiotic susceptibility of pathogens must be defined. Methods. Surveillance for suspected neonatal sepsis was conducted in Mirzapur, Bangladesh, from February 2004 through November 2006. Community health workers assessed neonates on postnatal days 0, 2, 5, and 8 and referred sick neonates to a hospital, where blood was collected for culture from neonates with suspected sepsis. We estimated the incidence and pattern of community-acquired neonatal bacteremia and determined the antibiotic susceptibility profile of pathogens.
Results. The incidence rate of community-acquired neonatal bacteremia was 3.0 per 1000 person-neonatal periods. Among the 30 pathogens identified, the most common was Staphylococcus aureus ([Formula: see text]); half of all isolates were gram positive. Nine were resistant to ampicillin and gentamicin or to ceftiaxone, and 13 were resistant to cotrimoxazole.
Conclusion. S. aureus was the most common pathogen to cause community-acquired neonatal bacteremia. Nearly 40% of infections were identified on days 0-3, emphasizing the need to address maternal and environmental sources of infection. The combination of parenteral procaine benzyl penicillin and an aminoglycoside is recommended for the first-line treatment of serious community-acquired neonatal infections in rural Bangladesh, which has a moderate level of neonatal mortality. Additional population-based data are needed to further guide national and global strategies. Trial registration. ClinicalTrials.gov identifier: NCT00198627 . | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19671016 |
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