TY - JOUR
T1 - Population-Based Incidence and Etiology of Community-Acquired Neonatal Bacteremia in Mirzapur, Bangladesh
T2 - An Observational Study
AU - Darmstadt, Gary L.
AU - Saha, Samir K.
AU - Choi, Yoonjoung
AU - Arifeen, Shams El
AU - Ahmed, Nawshad Uddin
AU - Bari, Sanwarul
AU - Rahman, Syed M.
AU - Mannan, Ishtiaq
AU - Crook, Derrick
AU - Fatima, Kaniz
AU - Winch, Peter J.
AU - Seraji, Habibur Rahman
AU - Begum, Nazma
AU - Rahman, Radwanur
AU - Islam, Maksuda
AU - Rahman, Anisur
AU - Black, Robert E.
AU - Santosham, Mathuram
AU - Sacks, Emma
AU - Baqui, Abdullah H.
N1 - Funding Information:
Financial support: Wellcome Trust–Burroughs Wellcome Fund Infectious Disease Initiative 2000 and the Office of Health, Infectious Diseases, and Nutrition, Global Health Bureau, United States Agency for International Development, through the Global Research Activity cooperative agreement with the Johns Hopkins Bloomberg School of Public Health (award HRN-A-00-96-90006-00); Saving Newborn Lives program (support for data analysis and manuscript preparation through a grant from the Bill and Melinda Gates Foundation to Save the Children–US).
PY - 2009/9/15
Y1 - 2009/9/15
N2 - 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 (n = 10); 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.
AB - 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 (n = 10); 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.
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U2 - 10.1086/605473
DO - 10.1086/605473
M3 - Article
C2 - 19671016
AN - SCOPUS:70349422296
SN - 0022-1899
VL - 200
SP - 906
EP - 915
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 6
ER -