Global, regional, and national burden of neonatal sepsis and other neonatal infections, 1990–2019: findings from the Global Burden of Disease Study 2019

Li, Jing; Xiang, Lingling; Chen, Xinsi; Li, Siyu; Sun, Qian; Cheng, Xiuyong; Hua, Ziyu

doi:10.1007/s00431-023-04911-7

Cited by 7 publications

(9 citation statements)

References 24 publications

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“…A plausible explanation is that premature newborns are more susceptible to infections due to the immaturity of vital organs and their immune systems ( 18 ). Furthermore, premature infants often require specialized continuous care, including surfactant drug administration, cooling therapy, and advanced support such as extracorporeal membrane oxygenation ( 4 ). However, critical services like these are often limited in developing countries ( 24 , 25 ), leading to an increased risk of hazards and resulting in a shorter time to death among neonates affected by sepsis.…”

Section: Discussionmentioning

confidence: 99%

“…The health of newborns is seriously affected by neonatal sepsis, and consequently, neonatal sepsis caused 0.23 million deaths worldwide and 6.31 million incidence cases of the condition in 2019. From 1990 to 2019, there were global trends of rising incidence and falling mortality from newborn sepsis, with sub-Saharan Africa and Asia bearing the greatest absolute burden ( 4 ). Western Sub-Saharan Africa posed the greatest threat to neonatal sepsis mortality (8.18 per 100,000), while Eastern Sub-Saharan Africa came in second (6.88 per 100,000), including Ethiopia in 2019 ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

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Time to death and its predictors among neonates admitted with sepsis in neonatal intensive care unit at comprehensive specialized hospitals in Northeast Ethiopia

Wudu,

Bekalu,

Wondifraw

et al. 2024

Front. Pediatr.

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BackgroundIn impoverished nations like Ethiopia, neonatal sepsis contributes significantly to neonatal mortality. Despite variations in the specific timing of death and predictors of neonatal mortality associated with sepsis across different settings, there's limited documented information in the Neonatal Intensive Care Units of northeastern Ethiopia. Consequently, the aim of this study was to determine time to death and its predictors among neonates with sepsis admitted to Neonatal Intensive Care Units in comprehensive specialized hospitals in northeastern EthiopiaMethodsA prospective cohort study conducted at the institution level involved 306 neonates diagnosed with sepsis. Data collection utilized face-to-face interviews and chart reviews. Subsequently, the data were inputted into Epi-data version 4.6 and later analyzed using STATA version 17. The median time to death was determined, and both the Kaplan-Meier curve and log-rank test were applied. Furthermore, a Cox proportional hazard regression model was utilized to identify predictors of neonatal mortality associated with sepsis.ResultThe cumulative incidence of mortality among neonates admitted with sepsis was 34% (95% CI: 28.9%–39.5%). The neonatal mortality rate stood at 51 (95% CI: 42.1, 62) per 1,000 neonates admitted to the intensive care units with sepsis over a total of 1,854 person-days of observation. Additionally, the median time to death was 13 days (IQR = 5–23 days). Tachypnea [AHR 6.2 (95% CI: 1.5–9.7)], respiratory distress syndrome [AHR 2.1 (95% CI: 1.3–3.5)], lethargy [AHR 1.8 (95% CI: 1.2–2.6)], preterm birth [AHR 1.8 (95% CI: 1.2–2.7)], continuous positive airway pressure use [AHR 2.1 (95% CI: 1.3–3.4)], home delivery [AHR 2.63 (95% CI: 1.1–6.4)], Subgalea hemorrhage [AHR 1.8 (95% CI: 1.1–3.9)], and low platelet count [AHR 5.9 (95% CI: 2.3–8.6)] were found to be predictors of time to death in neonates with sepsis.ConclusionThe study revealed an alarmingly high neonatal mortality rate among septic neonates, underscoring the urgency for intervention. Enhancing the quality of care in neonatal intensive care units, bolstering infection prevention during procedures such as continuous positive airway pressure, exercising caution with locally made accessories, and reinforcing a culture of institutional delivery are critical in curbing neonatal sepsis-related mortalities.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Time to death and its predictors among neonates admitted with sepsis in neonatal intensive care unit at comprehensive specialized hospitals in Northeast Ethiopia

Wudu,

Bekalu,

Wondifraw

et al. 2024

Front. Pediatr.

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“…The Asian region has the highest global population, accounts for 40% of global cases of neonatal sepsis, and is anticipated to have the greatest number of deaths attributable to AMR by 2050[5,12,13]. Despite this, there remains a paucity of data on both the causes neonatal sepsis and the burden of AMR in this region [14].…”

Section: Introductionmentioning

confidence: 99%

High burden of anti-microbial resistance among neonatal blood stream infections in Southeast Asia: results of the NeoSEAP study

R Dickson,

Putri,

Adrizain

et al. 2023

Preprint

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BackgroundProgress on neonatal sepsis has remained modest in recent decades and is threatened by the global rise of antimicrobial resistance. The Southeast Asian region has a high burden of both neonatal sepsis and antimicrobial resistance. Despite this, their remains a lack of robust epidemiological data on the causes of neonatal sepsis and the prevalence of AMR in the region.MethodsWe evaluated the causes of neonatal sepsis and AMR burden in 10 sites across five countries in South and Southeast Asia (Sri Lanka, Indonesia, The Philippines, Malaysia and Vietnam). Retrospective data on all blood cultures collected from neonates between 1stJanuary 2019 – 31stDecember 2020 were extracted from laboratory records. Data were also collected on the availability of clinical resources, the implementation of infection prevention and control strategies, and antimicrobial prescribing practices.FindingsA total of 1,528 blood cultures were positive for significant isolates over the study period. Gram-negative pathogens predominated (1,163/1,528, 76.1%) with the most frequently isolated pathogensKlebsiellaspp. (408/1,528, 26.7%) andAcinetobacterspp. (261/1,528, 17.08%) Among Gram-negative Enterobacteriaceae pooled resistance to ampicillin, gentamicin, third-generation cephalosporins (ceftriaxone and/or cefotaxime) and carbapenems was 75% (193/257), 59% (393/665), 67% (441/655) and 18.6% (125/672). For Gram negative non-Enterobacteriaceae resistance to gentamicin and carbapenems was 76.6% (326/282) and 69.7% (207/297).InterpretationNeonatal sepsis among study sites was caused predominantly by Gram-negative pathogens and associated with high levels of non-susceptibility to common empirical treatment regimes.

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“…Increasing trends in the incidence of neonatal sepsis have been observed in recent years, with total cases increasing from 5.59 million in 1990 to 6.31 million in 2019, with the highest burden in sub-Saharan Africa and Asia. 1 Neonatal sepsis is associated with preterm birth, low birth weight (BW), premature membrane rupture, sex and intrapartum-related complications (eg, perinatal asphyxia, low socioeconomic status, poor sanitation, malnutrition and hospital overcrowding). 2 The increase in neonatal sepsis incidence may result from a high maternal colonization rate, increasing antimicrobial resistance, poverty and limited medical resources.…”

mentioning

confidence: 99%

“…2 The increase in neonatal sepsis incidence may result from a high maternal colonization rate, increasing antimicrobial resistance, poverty and limited medical resources. 1 The prevention of neonatal sepsis is important to reduce mortality and morbidity in very-low-BW (VLBW) infants.…”

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confidence: 99%

Differential Abundances of Bdellovibrio and Rheinheimera in the Oral Microbiota of Neonates With and Without Clinical Sepsis

Thatrimontrichai,

Surachat,

Singkhamanan

et al. 2024

Pediatric Infectious Disease Journal

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Background: Neonatal sepsis is associated with high rates of morbidity and mortality, long hospital stays and high cost of care, thereby inflicting a burden on health care systems. Oral care with breast milk has been shown to modify the intestinal tract microbiota and immune system. Herein, we attempted to identify probiotics that may be beneficial to prevent or treat neonatal sepsis. Methods: This was a secondary analysis comparing the microbiota during oropharyngeal care in very-low-birth-weight infants with and without clinical sepsis. Oral samples were collected before oral feeding was initiated. The primary outcome was oral microbiota composition including diversity, relative abundance and linear discriminant analysis effect size. Results: Sixty-three neonates, including 39 and 24 with and without clinical sepsis, respectively, were enrolled. The medians gestational age and birth weight were 29 (27–30) weeks and 1010 (808–1263) g. Neonates with clinical sepsis had lower gestational age, birth weight (both P < 0.001) and lower rate of oral care with breast milk (P = 0.03), but higher doses and days of antibiotic exposure (both P < 0.001) compared to neonates without clinical sepsis. No differences in alpha and beta diversities were found between groups and Streptococcus agalactiae was the most common bacteria in both groups. Linear discriminant analysis effect size analysis revealed that neonates without clinical sepsis had significantly higher abundances of order Bdellovibrionales, family Bdellovibrionaceae, genus Bdellovibrio and genus Rheinheimera. Conclusions: Neonates without clinical sepsis had a significantly greater abundance of the Bdellovibrio and Rheinheimera genera.

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Global, regional, and national burden of neonatal sepsis and other neonatal infections, 1990–2019: findings from the Global Burden of Disease Study 2019

Cited by 7 publications

References 24 publications

Time to death and its predictors among neonates admitted with sepsis in neonatal intensive care unit at comprehensive specialized hospitals in Northeast Ethiopia

Time to death and its predictors among neonates admitted with sepsis in neonatal intensive care unit at comprehensive specialized hospitals in Northeast Ethiopia

High burden of anti-microbial resistance among neonatal blood stream infections in Southeast Asia: results of the NeoSEAP study

Differential Abundances of Bdellovibrio and Rheinheimera in the Oral Microbiota of Neonates With and Without Clinical Sepsis

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