Changing trends in newborn sepsis in Sagamu, Nigeria: Bacterial aetiology, risk factors and antibiotic susceptibility

Ogunlesi, TA; Ogunfowora, OB; Osinupebi, OA; Olanrewaju, Durotoye M

doi:10.1111/j.1440-1754.2010.01882.x

Cited by 52 publications

(64 citation statements)

References 22 publications

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“…The rates of sepsis in this study are comparable to those in units in Taiwan that reported rates ranging from 3% to 4% [18,19], but lower compared with data from other countries such as the Philippines, The Netherlands, and Nigeria, where sepsis rates have been reported to range from 15.1% to 19.6% [20][21][22]. Furthermore, at 2.68 cases per 1,000 live births, the rate of sepsis for inborn infants was lower than that reported in other countries including Korea (5.9 cases per 1,000 live births) [23], the USA (6.1 cases per 1,000 live births) [4], and India (14.8 cases per 1,000 live births) [24].…”

Section: Discussionsupporting

confidence: 63%

Brief communication (Original). Trends in neonatal sepsis in a neonatal intensive care unit in Thailand before and after construction of a new facility

et al. 2014

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Background: Neonatal sepsis is a cause of mortality and long-term morbidity worldwide. Objectives: To describe longitudinal trends in the cumulative incidence of early-and late-onset sepsis (EOS and LOS), mortality, and causative organisms in a Thai Hospital before and after construction of a new neonatal intensive care unit (NICU). Methods: Review of NICU admissions with blood cultures positive for bacteria or fungi for the periods 1995 to 2002 (preconstruction) and 2004 to 2010 (postconstruction). Sepsis was categorized into EOS (within first 3 days of life) and LOS (after first 3 days of life). Results: Of 5,570 admissions, 241 (4.3%) neonates with 276 episodes of sepsis were identified. There was no difference in the rate of sepsis overall (P = 0.90), LOS (P = 0.30), or sepsis-related mortality (P = 0.61) over the two periods, but the rate of EOS increased significantly from 0.34% to 0.81% (P = 0.04). Rates of Klebsiella species and Escherichia coli sepsis increased from 13.6% to 25.6% (P = 0.01) and from 5.3% to 12.2% (P = 0.04), respectively, while rates of Staphylococcus aureus sepsis decreased from 12.9% to 4.3% (P < 0.007). Sepsisrelated mortality was 1.8%. Conclusions: Although direct causality cannot be proven, the rate of EOS and the pattern of causative organisms changed following construction of the new NICU. Building a new unit does not necessarily result in a reduction in the rate of sepsis. This data may provide a baseline for implementing evidence-based infection control strategies to prevent/reduce sepsis and improve neonatal care.

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Section: Discussionsupporting

confidence: 63%

Brief communication (Original). Trends in neonatal sepsis in a neonatal intensive care unit in Thailand before and after construction of a new facility

et al. 2014

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“…This is not unexpected, as Escherichia coli is a genital tract organism, which would likely be transmitted perinatally. Escherichia coli has not been as commonly reported as Klebsiella in Nigerian studies in recent times [9,13,18], but this may be because most studies did not differentiate between EOS and LOS. That no GBS was found in this study further buttresses the fact that it is not as common in this environment [10] as in developed countries, where it is the major cause of EOS [19,20].…”

Section: Discussionmentioning

confidence: 76%

“…Organisms causing EOS are usually maternally acquired before or during delivery, whereas organisms causing LOS are acquired from the environment, which could be the community or nosocomial in hospitalized patients [6]. Over the years, there have been increasing reports from developing countries, of changing patterns of the etiology of NNS [7][8][9]; however, these studies hardly diffentiated between EOS and LOS. The trend in etiology of EOS remains the same in developed countries.…”

Section: Introductionmentioning

confidence: 99%

Etiology of early onset septicemia among neonates at the University College Hospital, Ibadan, Nigeria

Akindolire

Tongo

Dada-Adegbola

et al. 2016

J Infect Dev Ctries

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Introduction: Neonatal septicemia remains a major cause of newborn deaths in developing countries. Its burden is further compounded by the emergence of multidrug-resistant pathogens, which is related to a lack of antibiotic protocols resulting in unrestricted use of antibiotics. The absence of reliable antibiotic sensitivity testing makes the formulation of antibiotic guidelines and judicious use of antibiotics difficult. This study sought to identify the current bacterial agents associated with early onset septicemia (EOS; age <72 hours) and their antibiotic susceptibility patterns among neonates at the University College Hospital, Ibadan, Nigeria. Methodology: A total of 202 inborn and outborn neonates with risk factors for or clinical features of septicemia in the first 72 hours of life had samples for blood cultures and antibiotic sensitivity patterns taken prior to treatment. Results: Of the subjects, 95 (47.0%) were inborn and 107 (53.0%) outborn, with a M:F ratio of 1.3:1; 12.5% were culture positive, and the prevalence of EOS was 8.8/1,000 live births. The isolates were Staphylococcus aureus (52%), 30.7% of which were methicillin-resistant Staphylococcus aureus (MRSA), Klebsiella pneumoniae (12%), Enterobacter aerogenes (8%), Enterococcus spp. (8%), Eschericia coli (4%), and other Gram-negatives (12%). All the isolates except Staphylococcus aureus were susceptible to ampicillin, ampicillin/sulbactam, amikacin, gentamicin, and third-generation cephalosporins. All MRSA were sensitive to amikacin, ciprofloxacin, and chloramphenicol, while all methicillin-sensitive Staphylococcus aureus were sensitive to ampicillin/sulbactam. Conclusions: Staphylococcus aureus was the commonest cause of EOS in our setting, with 30.7% of the Staphylococcus aureus isolates being MRSA. Only MRSA demonstrated multidrug resistance.

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“…Thus, over one decade the organisms causing neonatal sepsis had shifted from a predominance of gram negatives to gram positives. Previous studies have also established the predominance of gram positives in this decade (13)(14)(15)(16)(17). While bacteria are known to vary temporally, we postulate other reasons for this shift to more S. aureus in particular and consequently gram positive bacteria as a group; one postulate is that this may have resulted from a change in the type of bacteria colonizing the ano-genital region of the mother to mainly staphylococci and consequent newborn colonization with these organism; a future study assessing the maternal ano-genital colonization and newborn colonization with S aureus could answer this question.…”

Section: Discussionmentioning

confidence: 99%

Trends in profiles of bacteria causing neonatal sepsis in Central Nigeria Hospital

Medugu¹,

Iregbu²

2016

Af J Clin Exp Micro

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Developing countries suffer from a huge burden of neonatal sepsis. Neonatal mortality and long term sequelae or morbidity portends huge costs for the poor Nigerian economy. We identified trends in bacterial agents implicated in neonatal sepsis and their antibiotic susceptibility profiles at the National Hospital Abuja over two periods of three years each a decade apart. A retrospective study of bacterial agents of sepsis from 2013-2015 was carried out and this was compared to an already published study from the same hospital ten years earlier (2002)(2003)(2004) to determine changing trends using standard statistical methods.We identified a significant shift to predominance of gram positive organisms especially Staphylococcus aureus (59% vs 40%) as against the predominance of gram negative organisms especially Klebsiella pneumoniae (11% vs 44%) in the previous decade. Almost all antibiotics tested (92%) had reduced susceptibility in the later review compared to the former.Surveillance of bacterial agents of neonatal sepsis is vital for the detection of trends in causative organisms and their susceptibilities. This is important to direct empiric therapy and also to encourage implementation and monitoring of antibiotic stewardship programs. Nous avons identifié un changement significatif vers la prédominance des organismes gram négative, en particulier le Staphylococcus aureus (59% vs 40%) au contraire de la prédominance des organismes gram -négatifs, en particulier la Klebsiella pneumoniae (11% vs 44%)au cours de la décennieprécédente. LES TENDANCES DES PROFILS DE BACTERIES CASANT LA SEPTICEMIE NEONATALE DANS L'HOPITAL AU CENTRELa surveillance des agents bactériens du sepsisnéonatal est vitale pour la direction des tendances des organismes causatif set de leurs susceptibilités. Il est important de diriger la thérapie empirique et d'encourager la mise en oeuvre et la surveillance des programmes d'intendance des antibiotiques.

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Changing trends in newborn sepsis in Sagamu, Nigeria: Bacterial aetiology, risk factors and antibiotic susceptibility

Abstract: The prevalence of sepsis was high in this cohort of high-risk infants. The low in vitro sensitivity of the leading microbes to commonly used drugs is challenging. Guidelines on the reduction of emergence of drug resistance must be provided and instituted in newborn units.

Cited by 52 publications

References 22 publications

Brief communication (Original). Trends in neonatal sepsis in a neonatal intensive care unit in Thailand before and after construction of a new facility

Brief communication (Original). Trends in neonatal sepsis in a neonatal intensive care unit in Thailand before and after construction of a new facility

Etiology of early onset septicemia among neonates at the University College Hospital, Ibadan, Nigeria

Trends in profiles of bacteria causing neonatal sepsis in Central Nigeria Hospital

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