Detection of pathogens associated with early-onset neonatal sepsis in cord blood at birth using quantitative PCR [version 2; peer review: 2 approved]
Background: Early onset neonatal sepsis (EONS) typically begins prior to, during or soon after birth and may be rapidly fatal. There is paucity of data on the aetiology of EONS in sub-Saharan Africa due to limited diagnostic capacity in this region, despite the associated significant mortality and l...
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| Format: | Article |
| Language: | English |
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Wellcome
2022-05-01
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| Series: | Wellcome Open Research |
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| Online Access: | https://wellcomeopenresearch.org/articles/7-3/v2 |
| _version_ | 1811246607302131712 |
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| author | Stella Mwakio Anna C. Seale Wilson Gumbi Christina W. Obiero Mami Taniuchi James A. Berkley Hope Mwangudzah Eric Houpt Jie Liu |
| author_facet | Stella Mwakio Anna C. Seale Wilson Gumbi Christina W. Obiero Mami Taniuchi James A. Berkley Hope Mwangudzah Eric Houpt Jie Liu |
| author_sort | Stella Mwakio |
| collection | DOAJ |
| description | Background: Early onset neonatal sepsis (EONS) typically begins prior to, during or soon after birth and may be rapidly fatal. There is paucity of data on the aetiology of EONS in sub-Saharan Africa due to limited diagnostic capacity in this region, despite the associated significant mortality and long-term neurological impairment. Methods: We compared pathogens detected in cord blood samples between neonates admitted to hospital with possible serious bacterial infection (pSBI) in the first 48 hours of life (cases) and neonates remaining well (controls). Cord blood was systematically collected at Kilifi County Hospital (KCH) from 2011-2016, and later tested for 21 bacterial, viral and protozoal targets using multiplex PCR via TaqMan Array Cards (TAC). Results: Among 603 cases (101 [17%] of whom died), 179 (30%) tested positive for ≥1 target and 37 (6.1%) tested positive for multiple targets. Klebsiella oxytoca, Escherichia coli/Shigella spp., Pseudomonas aeruginosa, and Streptococcus pyogenes were commonest. Among 300 controls, 79 (26%) tested positive for ≥1 target, 11 (3.7%) were positive for multiple targets, and K. oxytoca and P. aeruginosa were most common. Cumulative odds ratios across controls: cases (survived): cases (died) were E. coli/Shigella spp. 2.6 (95%CI 1.6-4.4); E. faecalis 4.0 (95%CI 1.1-15); S. agalactiae 4.5 (95%CI 1.6-13); Ureaplasma spp. 2.9 (95%CI 1.3-6.4); Enterovirus 9.1 (95%CI 2.3-37); and Plasmodium spp. 2.9 (95%CI 1.4-6.2). Excluding K. oxytoca and P. aeruginosa as likely contaminants, aetiology was attributed in 9.4% (95%CI 5.1-13) cases using TAC. Leading pathogen attributions by TAC were E. coli/Shigella spp. (3.5% (95%CI 1.7-5.3)) and Ureaplasma spp. (1.7% (95%CI 0.5-3.0)). Conclusions: Cord blood sample may be useful in describing EONS pathogens at birth, but more specific tests are needed for individual diagnosis. Careful sampling of cord blood using aseptic techniques is crucial to minimize contamination. In addition to culturable bacteria, Ureaplasma and Enterovirus were causes of EONS. |
| first_indexed | 2024-04-12T14:55:51Z |
| format | Article |
| id | doaj.art-0f69c3dee3fc4c09936d518388a9c87f |
| institution | Directory Open Access Journal |
| issn | 2398-502X |
| language | English |
| last_indexed | 2024-04-12T14:55:51Z |
| publishDate | 2022-05-01 |
| publisher | Wellcome |
| record_format | Article |
| series | Wellcome Open Research |
| spelling | doaj.art-0f69c3dee3fc4c09936d518388a9c87f2022-12-22T03:28:14ZengWellcomeWellcome Open Research2398-502X2022-05-01719812Detection of pathogens associated with early-onset neonatal sepsis in cord blood at birth using quantitative PCR [version 2; peer review: 2 approved]Stella Mwakio0https://orcid.org/0000-0001-9803-0264Anna C. Seale1https://orcid.org/0000-0002-0129-3146Wilson Gumbi2Christina W. Obiero3https://orcid.org/0000-0002-9321-0183Mami Taniuchi4James A. Berkley5https://orcid.org/0000-0002-1236-849XHope Mwangudzah6https://orcid.org/0000-0003-1166-8965Eric Houpt7Jie Liu8Clinical research, KEMRI-Wellcome Trust Research Programme, Kilifi, KenyaClinical research, KEMRI-Wellcome Trust Research Programme, Kilifi, KenyaBioscience department, KEMRI-Wellcome Trust Research Programme, Kilifi, KenyaClinical research, KEMRI-Wellcome Trust Research Programme, Kilifi, KenyaDivision of Infectious Diseases and International Health, University of Virginia, Virginia, USAClinical research, KEMRI-Wellcome Trust Research Programme, Kilifi, KenyaClinical research, KEMRI-Wellcome Trust Research Programme, Kilifi, KenyaDivision of Infectious Diseases and International Health, University of Virginia, Virginia, USADivision of Infectious Diseases and International Health, University of Virginia, Virginia, USABackground: Early onset neonatal sepsis (EONS) typically begins prior to, during or soon after birth and may be rapidly fatal. There is paucity of data on the aetiology of EONS in sub-Saharan Africa due to limited diagnostic capacity in this region, despite the associated significant mortality and long-term neurological impairment. Methods: We compared pathogens detected in cord blood samples between neonates admitted to hospital with possible serious bacterial infection (pSBI) in the first 48 hours of life (cases) and neonates remaining well (controls). Cord blood was systematically collected at Kilifi County Hospital (KCH) from 2011-2016, and later tested for 21 bacterial, viral and protozoal targets using multiplex PCR via TaqMan Array Cards (TAC). Results: Among 603 cases (101 [17%] of whom died), 179 (30%) tested positive for ≥1 target and 37 (6.1%) tested positive for multiple targets. Klebsiella oxytoca, Escherichia coli/Shigella spp., Pseudomonas aeruginosa, and Streptococcus pyogenes were commonest. Among 300 controls, 79 (26%) tested positive for ≥1 target, 11 (3.7%) were positive for multiple targets, and K. oxytoca and P. aeruginosa were most common. Cumulative odds ratios across controls: cases (survived): cases (died) were E. coli/Shigella spp. 2.6 (95%CI 1.6-4.4); E. faecalis 4.0 (95%CI 1.1-15); S. agalactiae 4.5 (95%CI 1.6-13); Ureaplasma spp. 2.9 (95%CI 1.3-6.4); Enterovirus 9.1 (95%CI 2.3-37); and Plasmodium spp. 2.9 (95%CI 1.4-6.2). Excluding K. oxytoca and P. aeruginosa as likely contaminants, aetiology was attributed in 9.4% (95%CI 5.1-13) cases using TAC. Leading pathogen attributions by TAC were E. coli/Shigella spp. (3.5% (95%CI 1.7-5.3)) and Ureaplasma spp. (1.7% (95%CI 0.5-3.0)). Conclusions: Cord blood sample may be useful in describing EONS pathogens at birth, but more specific tests are needed for individual diagnosis. Careful sampling of cord blood using aseptic techniques is crucial to minimize contamination. In addition to culturable bacteria, Ureaplasma and Enterovirus were causes of EONS.https://wellcomeopenresearch.org/articles/7-3/v2Neonate sepsis molecular aetiology PCReng |
| spellingShingle | Stella Mwakio Anna C. Seale Wilson Gumbi Christina W. Obiero Mami Taniuchi James A. Berkley Hope Mwangudzah Eric Houpt Jie Liu Detection of pathogens associated with early-onset neonatal sepsis in cord blood at birth using quantitative PCR [version 2; peer review: 2 approved] Wellcome Open Research Neonate sepsis molecular aetiology PCR eng |
| title | Detection of pathogens associated with early-onset neonatal sepsis in cord blood at birth using quantitative PCR [version 2; peer review: 2 approved] |
| title_full | Detection of pathogens associated with early-onset neonatal sepsis in cord blood at birth using quantitative PCR [version 2; peer review: 2 approved] |
| title_fullStr | Detection of pathogens associated with early-onset neonatal sepsis in cord blood at birth using quantitative PCR [version 2; peer review: 2 approved] |
| title_full_unstemmed | Detection of pathogens associated with early-onset neonatal sepsis in cord blood at birth using quantitative PCR [version 2; peer review: 2 approved] |
| title_short | Detection of pathogens associated with early-onset neonatal sepsis in cord blood at birth using quantitative PCR [version 2; peer review: 2 approved] |
| title_sort | detection of pathogens associated with early onset neonatal sepsis in cord blood at birth using quantitative pcr version 2 peer review 2 approved |
| topic | Neonate sepsis molecular aetiology PCR eng |
| url | https://wellcomeopenresearch.org/articles/7-3/v2 |
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