Bloodstream infections among children living in rural settings in Uganda and predictors of mortality outcome

Šuvada, J.; Tumbu, P.; Iriso, Robert; Rüssel, H; Namagala, Elizabeth; Kawanguzi, P.; Kiyaga, Charles; Akol, Zainab; Mikolasova, G.; Sokolova, J.; Kulkova, N.; Silharova, B.; Bartošová, Michaela; Meciakova, M.; Namonyo, J.

doi:10.1016/j.ijid.2014.03.643

Cited by 2 publications

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“…Precise data on the mortality and morbidity rate (79) of fragile pediatric patients after hospitalization is almost impossible, if not wholly absent from previous work. A last review on a similar topic affirms that researchers agree that AMR increases mortality and length of hospital stay in about 50 % of the studies (79)(80)(81)(82)(83)(84)(85). Researchers seem to be convinced that there is an evident increase in mortality among this patient group (hospitalized children).…”

Section: Discussionmentioning

confidence: 91%

Surveillance of the Impact of Antimicrobial Resistant infections in Immunosuppressed Children’s therapy: A systematic review

Domo

Woogeng

2023

Preprint

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Background: Antimicrobial resistance (AMR) is a global problem. Resistant bacteria, for many reasons, do not cease to emerge and re-emerge. The impact of AMR on patient therapy is not scares in literature to date, but there is still much to do, mainly in pediatric settings. It is vital to assess the necessity of observing the impact of such infections on the clinical care trends to which some kids may already be subject, strengthening, improving, and, where necessary, implementing new age policies and regulations that may help contain the spread of AMR. Method: We performed a yearlong review of literature on antimicrobial resistance in paediatrics immunosuppressed patients until September 2022. We draw-up a protocol of the review, to which we adhered rigorously, following the prescribed including and excluding criteria. Results: From the 110 articles finally selected following the PRISMA workflow diagram, from which 29% of them were in majority randomized controlled trials studies, the remaining selection ranged from case controls to cohort studies, systematic reviews, controlled before and after reports trials , matched case-control and placebo reports trials and few not clearly reported research article types (15%). Conclusion: The process yielded to the confirmation that there are literally good evidences of the serious lethal impact of resistant microbiological infections among immunocompromised children in and out of hospitals settings. What lacks the most are practical evidences of such damages both to the patient and to the public health sector, which can be conquer though, through well-programmed cohort-based studies.

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Section: Discussionmentioning

confidence: 91%

Surveillance of the Impact of Antimicrobial Resistant infections in Immunosuppressed Children’s therapy: A systematic review

Domo

Woogeng

2023

Preprint

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“…In contrast, a survey of pediatric BSIs within rural settings highlighted that the predominant causative agents were Klebsiella pneumoniae, E. coli, and Staphylococcus aureus (26). These findings, along with other anecdotal evidence from literature, suggest that these syndromes represent the greatest burden of AMR in Uganda which the National Action Plans (NAPs) together with the associated surveillance plans for both drug-bug resistance and antimicrobial use and consumption aim to address.…”

Section: (Which Was Not Certified By Peer Review)mentioning

confidence: 95%

“…A recent study predominantly focusing on sepsis among adults revealed that the prevailing sources of bloodstream infections (BSIs) are mainly due to cytomegalovirus , Mycobacterium tuberculosis , Plasmodium , and Streptococcus pneumoniae (25). In contrast, a survey of pediatric BSIs within rural settings highlighted that the predominant causative agents were Klebsiella pneumoniae , E. coli , and Staphylococcus aureus (26). These findings, along with other anecdotal evidence from literature, suggest that these syndromes represent the greatest burden of AMR in Uganda which the National Action Plans (NAPs) together with the associated surveillance plans for both drug-bug resistance and antimicrobial use and consumption aim to address.…”

Section: Introductionmentioning

confidence: 99%

The epidemiology of antibiotic-resistant clinical pathogens in Uganda

Namusoosa,

Mugerwa,

Kasozi

et al. 2023

Preprint

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BackgroundAntibiotic resistance (ABR) is silent global pandemic. Our current global control strategies are informed by evidence primarily from surveillance strategies. Here, we use a national surveillance dataset to demonstrate how such evidence can be systematically generated, in so doing we characterize ABR profiles of priority clinical pathogens and identify potential drivers in addition to inferences on antibiotic usage in Uganda.Resultsof the 12,262 samples cultured between 2019-2021, 9,033 with complete metadata were analyzed, Female patients accounted for 57.8% of the patients who were between 1 to 104 years. The isolated bacteria (69%) were clustered into twelve clinical pathogens and eight syndromes. This includedEscherichia coli26%(n=1620),Klebsiella spp.11% (n=685),Acinetobacter spp. 4%(n=250),Citrobacter spp. 4% (n=250),Pseudomonas spp. 3% (n=187), andEnterobacter spp. 2% (n=124), as well asSalmonella spp. 1% (n=62). Among gram-positive bacteria,Staphylococcus aureus10% (n=623),Enterococcus spp. 8% (n=498), andStreptococcus spp. 2% (n=124) were predominant.Acinetobacter baumanniiwas predominantly multi drug resistant (MDR) and mostly recovered from septic wound infection (SWI).Pseudomonas aeruginosa,Escherichia coli,Klebsiella pneumoniae, andStaphylococcus aureuswere also linked to ABR SWIs & urinary tract infections (UTIs). Male patients were more likely to carry ABR pathogens OR=1.14, 95% CI [1.12-1.42], p<0.001), within specific age groups (51-60, OR=1.16, 95% CI [0.88-1.28], p=0.001). Seasonality also influences ABR associated to clinical syndromes, for example, the second quarter, OR=2.1, 95% CI [1.9-2.6], p<0.001), is associated with resistance to narrow spectrum antibiotics OR=1,64, 95% CI [1.39-1.94], p<0.001) targeting respiratory tract infections (RTIs). ABR associated bloodstream infections (BSIs) were significantly more common than UTIs and RTIs.ConclusionsABR across clinical pathogens was increasing at a rate of 2.8% per year, with an upsurge in 2021. SWIs account for the disproportionately high prevalence of ABR and MDR mostly caused byAcinetobacter spp. Staphylococcus aureusincluding MRSA is main driver of BSIs. Male patients are far more likely to carry ABR in their adult life. Encouragingly, carbapenem resistance remains relatively low in-line with the predicted antibiotic use. Such evidence is critical for effective implementation and evaluation AMR National action plans, therefore national public health institutes (NPHIs) ought to invest in building capacity for surveillance and data analysis to support informed decision-making.

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Bloodstream infections among children living in rural settings in Uganda and predictors of mortality outcome

Cited by 2 publications

References 0 publications

Surveillance of the Impact of Antimicrobial Resistant infections in Immunosuppressed Children’s therapy: A systematic review

Surveillance of the Impact of Antimicrobial Resistant infections in Immunosuppressed Children’s therapy: A systematic review

The epidemiology of antibiotic-resistant clinical pathogens in Uganda

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