Etiology of serious infections in young Gambian infants

Mulholland, E. Kim; Ogunlesi, O; Adegbola, Richard A.; Weber, Martin; Sam, B; Palmer, Ayo; Manary, Mark; Secka, Ousman; Aidoo, Michael; Hazlett, D. T. G.; Whittle, Hilton; Greenwood, Brian

doi:10.1097/00006454-199910001-00007

Cited by 97 publications

(73 citation statements)

References 12 publications

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“…The etiologic findings of the WHO young infant study showed that S. pneumoniae was a significant pathogen, which has driven subsequent maternal vaccination studies and other interventions sponsored by the WHO. 37,38 In our study, S. pneumoniae was also the most common Gram-positive isolate, accounting for 15% of all isolates and was the most important pathogen in the CSF. Neonatal pneumococcal infection is uncommonly reported; a recent review identified only 171 cases of neonatal sepsis owing to S. pneumoniae in a 32-year period.…”

Section: Discussionmentioning

confidence: 55%

Serious community-acquired neonatal infections in rural Southeast Asia (Bohol Island, Philippines)

et al. 2007

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Objective: To determine the bacterial etiology, clinical presentation and risk factors for outcome of serious community-acquired infections in young infants.Study Design: Infants younger than 60 days, admitted for severe pneumonia or suspected sepsis/meningitis were prospectively evaluated using complete blood count, blood culture, chest radiograph, cerebrospinal fluid (CSF) culture in suspected meningitis. w 2 or Fisher's exact test and stepwise logistic regression were used for analysis.Results: Thirty-four of 767 enrolled infants had a positive blood or CSF culture. Gram-negative bacteria were more frequent than Gram positive: overall (P ¼ 0.004), in those below 7 days of age (P ¼ 0.002) and among home deliveries (P ¼ 0.012). Case fatality rates were higher among infants below 1 week old (OR 4.14, P<0.001), those with dense (OR 2.92, P<0.001) or diffuse radiographic infiltrates (OR 2.79, P ¼ 0.003).Conclusions: Gram-negative enteric bacteria are the predominant causes of community-acquired infections in Filipino infants below 2 months old. Age below 7 days and radiographic pneumonia predicted death.

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Section: Discussionmentioning

confidence: 55%

Serious community-acquired neonatal infections in rural Southeast Asia (Bohol Island, Philippines)

et al. 2007

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“…One further study reported data that were duplicated by a larger report included in the review (the Gambian component of the multi-country Young Infant Study18) and another19 reported data contained within a more recent study from the same site in Malawi 12. This left 19 studies from 13 countries.…”

Section: Resultsmentioning

confidence: 99%

Community-acquired neonatal and infant sepsis in developing countries: efficacy of WHO's currently recommended antibiotics--systematic review and meta-analysis

Downie

Armiento

Subhi

et al. 2012

Archives of Disease in Childhood

161

143

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The high rate of community-acquired resistant sepsis-especially that caused by Klebsiella spp. and S aureus-is a serious global public health concern. In vitro susceptibility data suggest that third-generation cephalosporins are not more effective in treating sepsis than the currently recommended antibiotics, benzylpenicillin and gentamicin; however, with either regimen a significant proportion of bacteraemia is not covered. Revised recommendations for effective second-line antibiotics in neonatal and infant sepsis in developing countries are urgently needed.

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“…Beyond the first week of life, 41.9% of CSF isolates were identified as pneumococcus [13]. A comparable study aiming to identify the aetiology of invasive infection in Gambian infants over the first three months of life reported that 47% of cases of culture-proven meningitis were caused by pneumococcus [14]. Finally, an association has also been demonstrated, in indigenous Australian infants, between the nasopharyngeal pneumococcal carriage and the occurrence of chronic suppurative ear infections [10]; a condition which is also reported with variable prevalence in sub-Saharan Africa and South and East Asia [15].…”

Section: Pneumococcal Carriage and Disease In Early Infancymentioning

confidence: 99%

Maternal and neonatal pneumococcal vaccination - where are we now?

Clarke

Kampmann

2016

Expert Review of Vaccines

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Pneumococcus is a significant pathogen in neonates and in early infancy, particularly as a cause of invasive disease in sub-Saharan Africa where nasopharyngeal carriage rates are also exceptionally high. The pneumococcal-conjugate vaccines have now been rolled out in many high income settings and an increasing number of low and middle income countries. They have been highly effective at preventing vaccine serotype disease in infants. However, a window of susceptibility remains prior to the first vaccination at around six weeks of age. This paper summarizes the data available on both maternal and neonatal vaccination to prevent disease in newborns and early infancy and considers the key challenges and next steps for research in the field

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Etiology of serious infections in young Gambian infants

Abstract: The most important causes of serious infections in young Gambian infants are Staphylococcus aureus, S. pneumoniae and Salmonella spp.

Cited by 97 publications

References 12 publications

Serious community-acquired neonatal infections in rural Southeast Asia (Bohol Island, Philippines)

Serious community-acquired neonatal infections in rural Southeast Asia (Bohol Island, Philippines)

Community-acquired neonatal and infant sepsis in developing countries: efficacy of WHO's currently recommended antibiotics--systematic review and meta-analysis

Maternal and neonatal pneumococcal vaccination - where are we now?

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