1. Gram-negative neonatal sepsis in low- and lower-middle-income countries and WHO empirical antibiotic recommendations: A systematic review and meta-analysis
- Author
-
Wen, Sophie C. H., Ezure, Yukiko, Rolley, Lauren, Spurling, Geoff, Lau, Colleen L., Riaz, Saba, Paterson, David L., and Irwin, Adam D.
- Subjects
Infants (Newborn) -- Diseases ,Practice guidelines (Medicine) -- International aspects ,Developing countries -- Health aspects ,Gram-negative bacterial infections -- Risk factors -- Demographic aspects -- Statistics -- Drug therapy ,Sepsis -- Risk factors -- Demographic aspects -- Statistics -- Drug therapy ,Pediatric research ,Biological sciences ,World Health Organization -- Standards - Abstract
Background Neonatal sepsis is a significant global health issue associated with marked regional disparities in mortality. Antimicrobial resistance (AMR) is a growing concern in Gram-negative organisms, which increasingly predominate in neonatal sepsis, and existing WHO empirical antibiotic recommendations may no longer be appropriate. Previous systematic reviews have been limited to specific low- and middle-income countries. We therefore completed a systematic review and meta-analysis of available data from all low- and lower-middle-income countries (LLMICs) since 2010, with a focus on regional differences in Gram-negative infections and AMR. Methods and findings All studies published from 1 January 2010 to 21 April 2021 about microbiologically confirmed bloodstream infections or meningitis in neonates and AMR in LLMICs were assessed for eligibility. Small case series, studies with a small number of Gram-negative isolates ( Conclusions Gram-negative bacteria are an important cause of neonatal sepsis in LLMICs and are associated with significant rates of resistance to WHO-recommended first- and second-line empirical antibiotics. AMR surveillance should underpin region-specific empirical treatment recommendations. Meanwhile, a significant global commitment to accessible and effective antimicrobials for neonates is required., Author(s): Sophie C. H. Wen 1,2,*, Yukiko Ezure 1,3, Lauren Rolley 2, Geoff Spurling 4, Colleen L. Lau 3,5, Saba Riaz 6, David L. Paterson 1,7, Adam D. Irwin 1,2 [...]
- Published
- 2021
- Full Text
- View/download PDF