Population-based incidence and etiology of community-acquired neonatal bacteremia in Mirzapur, Bangladesh: an observational study.

Journal article

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.

Authors: Darmstadt, G; Saha, S; Choi, Y; El Arifeen, S; Ahmed, N

• Publication status: Published
• Journal: Journal of infectious diseases
• Volume: 200
• Issue: 6
• Pages: 906-915
• Publication date: 2009-09-01
• DOI: 10.1086/605473
• EISSN: 1537-6613
• ISSN: 0022-1899
• Language: English
• Keywords: Staphylococcus aureus; Bangladesh; Bacteremia; Incidence; Female; Community-Acquired Infections; Hospitalization; Humans; Bangladesh Projahnmo-2 (Mirzapur) Study Group; Bacteria; Male; Anti-Bacterial Agents; Drug Resistance, Bacterial; Infant, Newborn