Neonatal septicemia at intensive care unit, Ayder Comprehensive Specialized Hospital, Tigray, North Ethiopia: Bacteriological profile, drug susceptibility pattern, and associated factors

Weldu, Yemane; Naizgi, Mulugeta; Hadgu, Amanuel; Desta, Abraham Aregay; Kahsay, Amlsha; Negash, Letemichael; Hailu, Genet Gebrehiwet; Wasihun, Araya Gebreyesus

doi:10.1371/journal.pone.0235391

Cited by 15 publications

(11 citation statements)

References 20 publications

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“…The prevalence of neonatal sepsis in the present study is 36.5% of which 53.1% were early-onset and 46.9% were late-onset sepsis. The finding is in agreement with studies conducted in different parts of Ethiopia and other countries (30–36%) 4 , 11 – 17 . In contrast to our study, lower than 30% prevalence of neonatal sepsis was reported in Southeast Ethiopia 3 , India 18 ; and less than 20% prevalence was reported in Pakistan 13 , Ghana 19 , Uganda 20 , Kenya 21 , and Nepal 22 .…”

Section: Discussionsupporting

confidence: 93%

“…The etiology of neonatal sepsis is heterogeneous; it varies from country to country; for instance, S. agalactiae was among the leading cause of neonatal sepsis in the United States until Intrapartum Antibiotic Prophylaxis, a prevention strategy, was implemented 12 . However, this bacterium is rarely isolated from newborns suspected of sepsis in Ethiopia 4 , 11 . The prevalence of neonatal sepsis in the present study is 36.5% of which 53.1% were early-onset and 46.9% were late-onset sepsis.…”

Section: Discussionmentioning

confidence: 99%

“…The sample size was determined using a single population proportion formula by taking the prevalence of neonatal sepsis (36.6%) reported from Tigray, Northern Ethiopia 11 , the margin of error (5%), and 95% Confidence level (z = 1.96). After considering 10% for the non-response rate the sample size was 392.…”

Section: Methodsmentioning

confidence: 99%

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Bacterial etiology and risk factors among newborns suspected of sepsis at Hawassa, Ethiopia

Worku

Fenta

Ali

2022

Sci Rep

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Neonatal sepsis is a systemic infection that occurs at an early age. Its etiology varies from one region to the other. The contribution of sepsis to neonatal mortality and morbidity is significant in resource-limited countries; however, there is limited information about the etiology of sepsis in Sidama Regional State, Ethiopia. The aim of this study was to determine the prevalence of bacterial caused newborn sepsis, associated factors, and the antimicrobial susceptibility profile of bacteria. A hospital-based prospective cross-sectional study was conducted among 392 sepsis suspected newborns admitted to the neonatal intensive care unit of Hawassa University Comprehensive Specialized Hospital from March 2021 to November 2021. Blood specimens were collected and bacteria were isolated using the standard culture method. The drug resistance profile of bacteria was evaluated using the disk diffusion method. The socio-demographic and clinical parameters of participants were gathered using a questionnaire. Binary logistic regression was used to determine the determinants of sepsis. A variable with a p < 0.05 was considered a significant determinant of neonatal sepsis with a 95% confidence level. The prevalence of sepsis caused by bacteria among newborns was 143 (36.5%); 95% CI (31.3–41.4). The predominant bacteria was Klebsiella species (n = 61; 42.65%), followed by non-lactose fermenting Gram-negative bacteria (n = 27; 18.88%) and Enterococcus species (n = 26; 18.18%). The overall proportions of antimicrobial resistance of Gram-negative bacteria range from 10.2 to 99.1%. All Klebsiella species were resistant to ceftriaxone. Ppremature rupture of membrane [AOR = 12.7 (95% CI 6.430–25.106)], absence of respiratory support [AOR = 3.53 (95% CI 1.840–6.759)], sex of newborns [AOR = 2.10 (1.214–3.560)] and reason for admission [AOR = 3.17 (95% CI 1.278–7.859)] were significantly associated with culture-confirmed neonatal sepsis. This study indicated the contribution of bacteria in causing sepsis among newborns; the majority of them were Gram-negative bacteria. Most recovered bacteria were resistant to commonly used antibiotics. Pre-term, mode of delivery and types of respiratory support were significantly associated with the occurrence of sepsis caused by bacteria.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

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Bacterial etiology and risk factors among newborns suspected of sepsis at Hawassa, Ethiopia

Worku

Fenta

Ali

2022

Sci Rep

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“… 7 The standard method to determine whether a neonatal septicemia is in progress is a positive blood culture. 8 There were considerable variations in septic microorganisms in the neonatal intensive care unit (NICU). In earlier studies in China, it was found that Klebsiella Pneumoniae was the most common bacteria causing neonatal septicemia, followed by Staphylococcus Aureus .…”

Section: Introductionmentioning

confidence: 99%

Bacteriological Profile and Antibiotic Susceptibility Pattern of Neonatal Septicemia and Associated Factors of ICU Hospitalization Days

Li¹,

Xia²,

Y³

et al. 2022

IDR

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Purpose To evaluate the microorganisms involved in neonatal septicemia and its antibiotic susceptibility pattern and to further investigate the factors associated with the length of intensive care unit (ICU) stay in neonatal septicemia. Patients and Methods A total of 297 infants with septicemia at neonatal ICU (NICU), Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology from 2016 to 2020 were enrolled. Identification of bacterial species was done using the standard positive blood culture. Data included demographics, signs at time of septicemia, laboratory values, patient sources, complications, microbiologic characteristics, and the duration of ICU stay. Univariate and multivariate gamma regression analyses were applied to determine the variables associated with ICU stay. Results The result demonstrated that the main causative pathogens of neonatal septicemia in our hospital were Gram-positive bacteria, among which Staphylococcus epidermidis (100 isolates, 47.17%) was the main conditional pathogens; Escherichia coli (27 isolates, 49.09%) was most frequently isolated among Gram-negative pathogens. Gram-positive bacteria had higher susceptibility to vancomycin, tigecycline and linezolid. Escherichia coli was susceptive to piperacillin (27/27, 100.00%), cefotetan (27/27, 100.00%), meropenem and imipenem (27/27, 100.00%). Streptococcus agalactiae (95% CI: 0.140–0.539), for patients who were transferred from other hospital (95% CI: 0.016 to 0.354), septicemia during hospitalization (95% CI: 0.411 to 0.825), the use of antibacterial drug during pregnancy (95% CI: 0.362 to 2.136), feeding intolerance (95% CI: 0.127 to 0.437), bradycardia (95% CI: 0.196 to 0.838), septicemia newborns have complications (95% CI: 0.063 to 0.291), the onset age (95% CI: 0.006 to 0.023), TRIPS score (95% CI: 0.005 to 0.016), and CRP level (95% CI: 0.002 to 0.005) were related to prolonged ICU stay days. Conclusion This study summarized common pathogens and associated drug sensitivity, and factors influencing ICU stay length. Prevention and control policy in the NICU should be strengthened.

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“…The review was conducted among 20 109 live births delivered after 28 weeks of gestation to estimate the pooled effect of preterm birth on adverse outcomes. Of those, 8 studies reported perinatal mortality, 24 , 25 , 49 – 52 3 studies 53 – 55 reported stillbirth, 9 studies 27 , 56 – 63 reported neonatal sepsis, 4 studies 26 , 64 – 66 were on neonatal hypothermia and 8 studies 28 , 67 – 74 reported neonatal mortality. Regarding the design of the included studies, sixteen (48.5%) were cross-sectional studies, 26 , 49 , 51 , 53 , 56 , 58 , 60 , 64 , 66 , 68 , 72 – 74 8 (24.2%) studies were case-control 24 , 25 , 50 , 52 , 54 , 59 , 60 ,…”

Section: Resultsmentioning

confidence: 99%

Effect of Preterm Birth on the Risk of Adverse Perinatal and Neonatal Outcomes in Ethiopia: A Systematic Review and Meta-Analysis

Admas

Yeshitila

Meselu

et al. 2021

INQUIRY

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Despite remarkable progress in the reduction of under-five mortality, the rate of perinatal and neonatal mortality is still high especially in developing countries. The adverse outcome associated with preterm birth is one of the major public health challenges in Africa. However, there are limited and inconsistent studies conducted on the effect of preterm birth on adverse perinatal and neonatal outcomes in Ethiopia. Therefore, this systematic review and meta-analysis aimed to investigate the association between preterm birth and its adverse perinatal and neonatal outcomes in Ethiopia. We systematically searched several electronic databases like PubMed, Web of Science, SCOPUS, CINAHL, Google Scholar, African Journals Online databases and Science Direct. All identified observational studies were included. The I 1 statistics were used to assess the heterogeneity among the studies. A random-effects model was computed to estimate the pooled effect of preterm birth on adverse perinatal and neonatal outcomes. Thirty-three studies with a total of 20 109 live births were included in the final meta-analysis. Our meta-analysis showed that preterm birth increased the odds of perinatal mortality by 10-folds [POR = 9.56 (95% CI: 5.47, 19.69)] and there was a 5.44-folds risk of stillbirth [Odds Ratio = 5.44 (95% CI: 3.57, 8.28)] among women who gave birth before 37 weeks of gestation. In addition, preterm birth was significantly associated with neonatal hypothermia [OR=3.54 (95% CI: 2.41, 5.21)], neonatal mortality [OR= 3.16 (95% CI: 1.57, 6.34). The sub-group analysis of this meta-analysis showed that there was an increased risk of neonatal sepsis [OR=2.33 (95% CI: 1.15, 4.71)] among preterm babies. Preterm births significantly increased the risk of adverse perinatal and neonatal outcomes in Ethiopia. Therefore, scale-up strategies and improving the quality of maternal and child health care providers should be an area of intervention to reduce adverse outcomes associated with preterm birth. The Federal Ministry of Health and concerned bodies should work towards the prevention of preterm birth and its adverse outcomes.

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Neonatal septicemia at intensive care unit, Ayder Comprehensive Specialized Hospital, Tigray, North Ethiopia: Bacteriological profile, drug susceptibility pattern, and associated factors

Cited by 15 publications

References 20 publications

Bacterial etiology and risk factors among newborns suspected of sepsis at Hawassa, Ethiopia

Bacterial etiology and risk factors among newborns suspected of sepsis at Hawassa, Ethiopia

Bacteriological Profile and Antibiotic Susceptibility Pattern of Neonatal Septicemia and Associated Factors of ICU Hospitalization Days

Effect of Preterm Birth on the Risk of Adverse Perinatal and Neonatal Outcomes in Ethiopia: A Systematic Review and Meta-Analysis

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