Infectious disease exposures and outbreaks at a South African neonatal unit with review of neonatal outbreak epidemiology in Africa

Dramowski, Angela; Aucamp, Marina; Bekker, Adrie; Mehtar, Shaheen

doi:10.1016/j.ijid.2017.01.026

Cited by 49 publications

(42 citation statements)

References 25 publications

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“…In keeping with previous data from African neonatal units, Klebsiella species and S. aureus were dominant pathogens and exhibited high rates of antibiotic resistance (9,(17)(18)(19)(20)(21)(22)(23).Klebsiella spp were responsible for 2 outbreaks at PMH and are responsible for 50% of all reported neonatal unit outbreaks in Africa, although an outbreak source is seldom identified (24).…”

Section: J O U R N a L P R E -P R O O Fsupporting

confidence: 77%

Laboratory-confirmed bloodstream infections in two large neonatal units in sub-Saharan Africa

Gezmu

Bulabula

Dramowski

et al. 2021

International Journal of Infectious Diseases

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Section: J O U R N a L P R E -P R O O Fsupporting

confidence: 77%

Laboratory-confirmed bloodstream infections in two large neonatal units in sub-Saharan Africa

Gezmu

Bulabula

Dramowski

et al. 2021

International Journal of Infectious Diseases

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“…Neonatal outbreaks have been reported from Africa (January 1, 1996 to January 1, 2016) with pathogens such as rotavirus, influenza virus, measles virus, and multidrug-resistant bacteria ( Serratia marcescens , Acinetobacter baumannii , methicillin-resistant Staphylococcus aureus , and vancomycin-resistant enterococci). [4] Johnson et al [5] reviewed the English, French, and German language literature published between 2015 and 2017, and a total of 39 outbreaks in NICUs were reported with Gram-negative bacteria (n = 21, 54%), with 5 viral outbreaks (respiratory syncytial virus = 3). Outbreaks caused by Burkholderia cepacia , Escherichia coli , and Pseudomonas aeruginosa have also been reported.…”

Section: Introductionmentioning

confidence: 99%

Co-outbreak of multidrug resistance and a novel ST3006 Klebsiella pneumoniae in a neonatal intensive care unit

Chen

et al. 2019

Medicine

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The outbreak of carbapenem-resistant Klebsiella pneumoniae is a serious public health problem, especially in the neonatal intensive care unit (NICU).Fifteen K. pneumoniae strains were isolated from 7 neonates during June 3 to 28, 2017 in an NICU. Antimicrobial susceptibility was determined by the Vitek 2 system and microbroth dilution method. Multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE) were used to analyze the genetic relatedness of the isolates. Whole-genome sequencing and gene function analysis were performed to investigate pathogenicity and drug resistance and screen genomic islands.Three clones of K. pneumoniae were identified from 7 neonates: 7 strains of ST37, 7 of novel ST3006, and 1 of ST1224. Gene sequencing showed that the kpn1343 (ST37) strain harbored 12 resistance genes (OXA-33, TEM-1, SHV-11, AAC (6’)-IId, AAC (3)-IIa, AAC (6’)-Ib-cr, catB3, arr-3, sul1, oqxB, oqxA, CRP, and catB3) and included 15 genomic islands and 205 reduced virulence genes. The kpn1344 (ST3006) strain harbored 4 antibiotic-resistant genes (TEM-1, CTX-M-3, vgaC, and CRP) and included 19 genomic islands and 209 reduced virulence genes. MLST and PFGE showed that 15 strains of K. pneumoniae were divided into 3 groups with a high level of homology. ST1224 (kpn1362) was isolated on June 28, 2017, which was 10 days after the last isolate (kpn1359, June 18, 2017); thus, we speculated that ST1224 was not the clone that caused the outbreak.This co-outbreak of K. pneumoniae involved 2 clones: ST37 and ST3006. ST37 carried the multidrug-resistant genes, such as OXA-33, TEM-1, and SHV-11, and ST3006 was a novel K. pneumoniae ST typing. Whole-genome sequencing may be an effective method for screening bacterial-resistant genes and their functions.

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“…Most of the available data on the detection of MDR S. aureus carriage have been in hospitalized non-pregnant adults (6, 7). Despite the fact that MDR S. aureus outbreaks in infants have been linked to the infected or colonized mother, there are limited data on MDR S. aureus carriage rates among mothers or on the risk of transmission of MDR S. aureus from pregnant MDR S. aureus carriers to their newborn infants (8, 9). The maternal-infant relatedness of MDR S. aureus carriage is of particular interest.…”

Section: Introductionmentioning

confidence: 99%

Maternal-Infant Correlation of Multidrug-Resistant Staphylococcus aureus Carriage: A Prospective Cohort Study

Lin

Yao

2018

Front. Pediatr.

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Objectives: We aim to assess the correlation of multidrug-resistant Staphylococcus aureus (MDR S. aureus) carriage between mothers and their newborn infants.Materials and Methods: We conducted a prospective cohort study of mothers and their newborn infants in two hospitals in Shenzhen, China, from August to November 2015. We collected demographic and clinical information from mothers and newborn infants by face-to-face questionnaires and medical datasets. Serial swabs were collected from mothers and their newborn infants for further experiments. Maternal-infant correlation was assessed using the Poisson regression model.Results: The prevalence of MDR S. aureus vaginal carriage in mothers was 4.7% (86/1834). The incidence of MDR S. aureus carriage in newborn infants was 1.3% (23/1834). The adjusted relative risk and 95% confidence interval of maternal-infant MDR S. aureus carriage was 7.63 (2.99–19.49). Six MDR S. aureus maternal-infant pairs were concordant. The phenotypic and molecular characteristics of MDR S. aureus isolates were similar between mothers and their newborn infants.Conclusion: MDR S. aureus vaginal carriage in mothers was associated with an increased risk for MDR S. aureus carriage in their newborn infants.

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Infectious disease exposures and outbreaks at a South African neonatal unit with review of neonatal outbreak epidemiology in Africa

Cited by 49 publications

References 25 publications

Laboratory-confirmed bloodstream infections in two large neonatal units in sub-Saharan Africa

Laboratory-confirmed bloodstream infections in two large neonatal units in sub-Saharan Africa

Co-outbreak of multidrug resistance and a novel ST3006 Klebsiella pneumoniae in a neonatal intensive care unit

Maternal-Infant Correlation of Multidrug-Resistant Staphylococcus aureus Carriage: A Prospective Cohort Study

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