A three year descriptive study of early onset neonatal sepsis in a refugee population on the Thailand Myanmar border

Turner, Claudia; Turner, Paul; Hoogenboom, Gabie; Thein, Naw Aye Mya; McGready, Rose; Phakaudom, Kawalee; Zoysa, Aruni De; Efstratiou, Androulla; Heath, Paul T; Nosten, François

doi:10.1186/1471-2334-13-601

Cited by 13 publications

(10 citation statements)

References 30 publications

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“…Our incidence estimate is lower than the 44.8 early-onset infections/1,000 live births found by Turner et al on the Thailand–Myanmar border; their estimate was based on a clinical definition of infections and was thus possibly overestimated ( 18 ). Also, our incidence risk (1.6%, 16/981) is lower than the pooled incidence risk for possible severe bacterial infection (7.6%) estimated by Seale et al in a metaanalysis of 22 studies ( 5 ).…”

Section: Discussioncontrasting

confidence: 81%

Bacterial Infections in Neonates, Madagascar, 2012–2014

Huynh¹,

Kermorvant‐Duchemin²,

Herindrainy³

et al. 2018

Emerg. Infect. Dis.

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Severe bacterial infections are a leading cause of death among neonates in low-income countries, which harbor several factors leading to emergence and spread of multidrug-resistant bacteria. Low-income countries should prioritize interventions to decrease neonatal infections; however, data are scarce, specifically from the community. To assess incidence, etiologies, and antimicrobial drug–resistance patterns of neonatal infections, during 2012–2014, we conducted a community-based prospective investigation of 981 newborns in rural and urban areas of Madagascar. The incidence of culture-confirmed severe neonatal infections was high: 17.7 cases/1,000 live births. Most (75%) occurred during the first week of life. The most common (81%) bacteria isolated were gram-negative. The incidence rate for multidrug-resistant neonatal infection was 7.7 cases/1,000 live births. In Madagascar, interventions to improve prevention, early diagnosis, and management of bacterial infections in neonates should be prioritized.

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Section: Discussioncontrasting

confidence: 81%

Bacterial Infections in Neonates, Madagascar, 2012–2014

Huynh¹,

Kermorvant‐Duchemin²,

Herindrainy³

et al. 2018

Emerg. Infect. Dis.

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“…17 A 3-year prospective cohort study of neonatal sepsis diagnosed according to clinical criteria in neonates aged 0 to 7 days in a refugee population on the Thailand-Myanmar border during 2009 to 2012 found an incidence of 44.8 per 1,000 live births (187/4,173; 95% CI: 38.7-51.5). 18 However, these incidences of EOS cannot be compared due to different definitions used in each study.…”

Section: Discussionmentioning

confidence: 99%

Early-Onset Neonatal Sepsis and Antibiotic Use in Northeast Thailand

et al. 2018

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Objective Antibiotics are commonly prescribed in neonatal intensive care units (NICUs) for suspected sepsis because of the nonspecific clinical symptoms of sepsis. The overuse of antibiotic is associated with adverse outcomes. This study aimed to determine the rate of early-onset sepsis (EOS) and antibiotic use in neonates admitted to three NICUs in Northeast Thailand Study Design This is a descriptive study using the data collected in the South East Asia—Using Research for Change in Hospital-acquired Infection in Neonates project. Neonates admitted within 3 days of life were included. EOS was defined as neonates who presented with three or more clinical signs or laboratory results suggested sepsis and received antibiotics for at least 5 days. Those with positive blood culture were culture-proven EOS. Antibiotic use within 3 days of life and up to 28 days was described. Results Among 1,897 neonates, 160 cases were classified as EOS (8.4%) with culture-proven EOS in 4 cases (0.2%). The median durations of antibiotic use in culture-proven and culture-negative EOSs were 15 and 8 days, respectively. Conclusion The rate of culture-proven EOS was low, but there was a high rate of antibiotic use. Antibiotic stewardship should be emphasized.

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“…Heterogeneity may also be driven by different definitions. Applied sepsis definitions are mostly adaptations of the clinical consensus criteria, 9 such as when laboratory testing was unavailable, 31 or relied on selected clinical symptoms of neonatal sepsis. Currently, there is no sepsis definition for the neonatal age group in line with the current sepsis definition, 48 which can be applied in all resource settings and also in preterm neonates.…”

Section: Global Child Healthmentioning

confidence: 99%

Global incidence and mortality of neonatal sepsis: a systematic review and meta-analysis

et al. 2021

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BackgroundNeonates are at major risk of sepsis, but data on neonatal sepsis incidence are scarce. We aimed to assess the incidence and mortality of neonatal sepsis worldwide.MethodsWe performed a systematic review and meta-analysis. 13 databases were searched for the period January 1979–May 2019, updating the search of a previous systematic review and extending it in order to increase data inputs from low-income and middle-income countries (LMICs). We included studies on the population-level neonatal sepsis incidence that used a clinical sepsis definition, such as the 2005 consensus definition, or relevant ICD codes. We performed a random-effects meta-analysis on neonatal sepsis incidence and mortality, stratified according to sepsis onset, birth weight, prematurity, study setting, WHO region and World Bank income level.ResultsThe search yielded 4737 publications, of which 26 were included. They accounted for 2 797 879 live births and 29 608 sepsis cases in 14 countries, most of which were middle-income countries. Random-effects estimator for neonatal sepsis incidence in the overall time frame was 2824 (95% CI 1892 to 4194) cases per 100 000 live births, of which an estimated 17.6% 9 (95% CI 10.3% to 28.6%) died. In the last decade (2009–2018), the incidence was 3930 (95% CI 1937 to 7812) per 100 000 live births based on four studies from LMICs. In the overall time frame, estimated incidence and mortality was higher in early-onset than late-onset neonatal sepsis cases. There was substantial between-study heterogeneity in all analyses. Studies were at moderate to high risk of bias.ConclusionNeonatal sepsis is common and often fatal. Its incidence remains unknown in most countries and existing studies show marked heterogeneity, indicating the need to increase the number of epidemiological studies, harmonise neonatal sepsis definitions and improve the quality of research in this field. This can help to design and implement targeted interventions, which are urgently needed to reduce the high incidence of neonatal sepsis worldwide.

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A three year descriptive study of early onset neonatal sepsis in a refugee population on the Thailand Myanmar border

Cited by 13 publications

References 30 publications

Bacterial Infections in Neonates, Madagascar, 2012–2014

Bacterial Infections in Neonates, Madagascar, 2012–2014

Early-Onset Neonatal Sepsis and Antibiotic Use in Northeast Thailand

Global incidence and mortality of neonatal sepsis: a systematic review and meta-analysis

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