Identification and antimicrobial resistance of pathogens in neonatal septicemia in China—A meta-analysis

Li, Jingyang; Chen, Shangqin; Yan, Yanyan; Hu, Yingying; Jia, Wei; Wu, Qiuping; Lin, Zhenlang; Lin, Jing

doi:10.1016/j.ijid.2018.04.794

Cited by 46 publications

(49 citation statements)

References 37 publications

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“…Moreover in consistent with our findings, results from another large systematic review indicated that Enterobacter species, Klebsiella, Escherichia coli, Pseudomonas species, and Streptococcus pneumonia were recognized as the most common bacterial pathogens of neonatal sepsis in the Middle East region [52]. In a country-level meta-analysis in China, Li et al reported that Staphylococcus, Enterococcus, Escherichia, and Klebsiella were found to be the most common organisms responsible for neonatal septicaemia in China [53]. This variation could also be explained by differences in geographical and climatic parameters in different regions.…”

Section: Discussionsupporting

confidence: 91%

Neonatal sepsis in Iran: A systematic review and meta-analysis on national prevalence and causative pathogens

et al. 2020

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Background Neonatal sepsis is accounted for 30-50% of annual neonatal deaths in developing countries. We performed a systematic review and meta-analysis study to evaluate the national prevalence and identification of the etiological pathogens of neonatal sepsis in Iran. Methods A comprehensive literature search was done on the national and international databases for studies published between 2000 and 2019. The DerSimonian and Laird random-effects model was used to calculate pooled prevalence estimates, with 95% confidence intervals (CIs). Subgroup analyses and meta-regressions regarding the gender, type of sepsis and time during were also performed. Data were extracted, analyzed, and presented according to PRISMA guideline. Results Of 944 publications identified, 22 studies containing 14,683 neonates met the eligibility criteria. The pooled national prevalence of sepsis in Iran was 15.98% (95%CI, 11.96-20.46%; 1,367/14,683). Prevalence rate in boys (20.42%; 95%CI, 9.03-34.8%) was slightly higher than girls (18.5%; 95%CI, 7.4-32.8). A decreasing trend in prevalence of neonatal sepsis was found in recent years, although not statistically significant (c =-0.005; P value = 0.4). The most prevalent causative bacterial pathogens were Enterobacter spp. (23.04%), followed by Klebsiella pneumoniae (17.54%), coagulase-negative Staphylococci (14.

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Section: Discussionsupporting

confidence: 91%

Neonatal sepsis in Iran: A systematic review and meta-analysis on national prevalence and causative pathogens

et al. 2020

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“…The MDR patterns in both Gram-negative and Gram-positive bacteria in our study (84.4%) is by far higher than national and global reports: Ethiopia (65%) [26], Jordan (69%) [23], and China (50%) [40].…”

Section: Discussioncontrasting

confidence: 69%

“…Concerning to drug resistance, the isolates in the present study were resistant against commonly used antibiotics in the area and high frequency of MDR bacterial pathogens were observed predominantly among the Gram-negative bacteria. Recent studies in Ethiopia, India, Nepal, and China also showed high levels of resistance in Gram-negative organisms against ampicillin (85%, 78%, 100%, 80%), respectively, and ceftriaxone (57%, 100%, 100%, 50%), respectively [26,29,30,40].…”

Section: Discussionmentioning

confidence: 99%

Bacterial profile and drug resistance patterns in neonates admitted with sepsis to a tertiary teaching hospital in Ethiopia

Gashaw¹,

Ali²,

Tesfaw³

et al. 2019

Preprint

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Background : Tackling neonatal infections and antibiotic resistance remains a challenge in low-income countries where neonatal mortality is high and antibiotic resistance is growing. The aim of this study was to identify bacterial etiologies and their drug resistance patterns in neonates admitted with diagnosis of sepsis to neonatal intensive care unit at Jimma Medical Center in Ethiopia. Methods : A prospective longitudinal study was conducted from April to October 2018. A total of 313 clinical specimens (211 blood and 102 cerebrospinal fluid) were processed for 238 neonates suspected to have sepsis. Blood culture was done using BD BACTEC FX40 automated system. Bacterial identification and antibiotic susceptibility testing were done according to standard microbiological techniques. Results : Bacterial etiologies were isolated from 62.1% (131/211) and 3.9% (4/102) of blood and cerebrospinal fluid cultures respectively. The predominant bacteria isolated from blood were Coagulase negative Staphylococcus 27.5% (36/131), followed by S. aureus 20.6% (27/131), Klebsiella species 14.5% (19/131), and Acinetobacter species 10.7% (14/131). Nearly 85% of the isolates were multidrug resistant, predominantly observed in Gram-negative bacteria. Among locally available antibiotics, only meropenem for Gram-negatives and vancomycin for Gram-positives were found to be largely effective. Conclusion : Bacterial pathogens identified in the study were highly resistant to available antibiotics. Thus, an effort to reduce neonatal mortality in the setting should focus on improving diagnostics for neonatal infection and containment of antimicrobial resistance.

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“…Of these, one-third were caused by gram negative bacilli and 70 (18.6%) were multidrug resistant [17]. A meta-analysis of 71 studies reported from China showed that 50% of gram negative organisms were resistant to thirdgeneration cephalosporins [18].…”

Section: Multidrug Resistance: Global Picturementioning

confidence: 99%

Neonatal Sepsis: Mortality and Morbidity in Neonatal Sepsis due to Multidrug-Resistant (MDR) Organisms: Part 1

et al. 2019

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The major causes of emergence of multidrug-resistant organisms (MDRO) in neonatal sepsis include empiric antibiotic prescriptions, unregulated use of over-the-counter drugs, high incidence of healthcare associated infections (HAI), lack of awareness about antibiotic stewardship program and under staffing of neonatal intensive care units. In general, mortality due to MDRO sepsis is significantly higher as compared to non MDRO sepsis. Reported morbidities include prolonged use of total parenteral nutrition, need for central venous catheter, invasive ventilation, increased duration of hospital stay and neurologic sequelae.

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Identification and antimicrobial resistance of pathogens in neonatal septicemia in China—A meta-analysis

Cited by 46 publications

References 37 publications

Neonatal sepsis in Iran: A systematic review and meta-analysis on national prevalence and causative pathogens

Neonatal sepsis in Iran: A systematic review and meta-analysis on national prevalence and causative pathogens

Bacterial profile and drug resistance patterns in neonates admitted with sepsis to a tertiary teaching hospital in Ethiopia

Neonatal Sepsis: Mortality and Morbidity in Neonatal Sepsis due to Multidrug-Resistant (MDR) Organisms: Part 1

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