Neonatal infection in Sub-Saharan Africa: a cross-sectional pilot study on bacterial pathogens and maternal risk factors
IntroductionAlthough child morbidity and mortality could be reduced in Sub-Saharan Africa during the last years both remain high. Since neonatal infections play a major role, we conducted a cross-sectional pilot study in the lake region of Western Tanzania in order to analyze not only the prevalence...
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Frontiers Media S.A.
2023-04-01
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| Series: | Frontiers in Microbiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmicb.2023.1171651/full |
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| author | Simone Blumenröder Damas Wilson Edgard Ndaboine Mariam M. Mirambo Martha F. Mushi Oliver Bader Ortrud Zimmermann Stephen E. Mshana Uwe Groß |
| author_facet | Simone Blumenröder Damas Wilson Edgard Ndaboine Mariam M. Mirambo Martha F. Mushi Oliver Bader Ortrud Zimmermann Stephen E. Mshana Uwe Groß |
| author_sort | Simone Blumenröder |
| collection | DOAJ |
| description | IntroductionAlthough child morbidity and mortality could be reduced in Sub-Saharan Africa during the last years both remain high. Since neonatal infections play a major role, we conducted a cross-sectional pilot study in the lake region of Western Tanzania in order to analyze not only the prevalence of neonatal infection with its bacterial etiology including antimicrobial resistance pattern but also to detect potential maternal risk factors.MethodsWe screened 156 women for potential risk factors and examined their neonates for clinical signs of an infection including microbiological verification. All women were interviewed for medical history and their socio-economic background. High-vaginal swabs (HVS) of pregnant women and blood cultures of sick infants were investigated for bacterial pathogens using culture followed by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) or polymerase-chain-reaction (PCR)-based assays. Antimicrobial resistances were determined using a disk diffusion test and verified by VITEK 2. Maternal malaria, blood glucose, and hemoglobin levels were determined by rapid tests and helminth infections by stool microscopy.Results and discussionOur results showed a prevalence of 22% for neonatal infections. In total, 57% of them had culture-positive bloodstream infections with Gram-negative bacteria being the most prevalent. All these expressed resistance against ampicillin. The prevalence of maternal infection with helminths or Plasmodium was low, indicating that anti-worming strategies and intermittent preventive treatment of malaria for pregnant women (IPTp) are effective. The study identified maternal urinary tract infection (UTI) and an elevated blood glucose level as potential maternal risk factors for early neonatal infection, an elevated blood glucose level, and maternal anemia for a late-onset infection.ConclusionOur study, therefore, indicates that monitoring maternal UTI in the last trimester as well as levels of maternal hemoglobin and blood glucose might be important to predict and eventually manage neonatal infections. As Gram-negative bacteria with resistance to ampicillin were most prevalent in culture-proven neonatal sepsis, WHO recommendations for calculated antibiosis in the sick young infant should be discussed. |
| first_indexed | 2024-04-09T16:06:06Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 1664-302X |
| language | English |
| last_indexed | 2024-04-09T16:06:06Z |
| publishDate | 2023-04-01 |
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| spelling | doaj.art-36eaeef5ee96427ab1d18adaa78ca5062023-04-25T05:53:29ZengFrontiers Media S.A.Frontiers in Microbiology1664-302X2023-04-011410.3389/fmicb.2023.11716511171651Neonatal infection in Sub-Saharan Africa: a cross-sectional pilot study on bacterial pathogens and maternal risk factorsSimone Blumenröder0Damas Wilson1Edgard Ndaboine2Mariam M. Mirambo3Martha F. Mushi4Oliver Bader5Ortrud Zimmermann6Stephen E. Mshana7Uwe Groß8Institute of Medical Microbiology and Virology, University Medical Centre Göttingen, Göttingen, GermanyDepartment of Obstetrics and Gynaecology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, TanzaniaDepartment of Obstetrics and Gynaecology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, TanzaniaDepartment of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, TanzaniaDepartment of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, TanzaniaInstitute of Medical Microbiology and Virology, University Medical Centre Göttingen, Göttingen, GermanyInstitute of Medical Microbiology and Virology, University Medical Centre Göttingen, Göttingen, GermanyDepartment of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, TanzaniaInstitute of Medical Microbiology and Virology, University Medical Centre Göttingen, Göttingen, GermanyIntroductionAlthough child morbidity and mortality could be reduced in Sub-Saharan Africa during the last years both remain high. Since neonatal infections play a major role, we conducted a cross-sectional pilot study in the lake region of Western Tanzania in order to analyze not only the prevalence of neonatal infection with its bacterial etiology including antimicrobial resistance pattern but also to detect potential maternal risk factors.MethodsWe screened 156 women for potential risk factors and examined their neonates for clinical signs of an infection including microbiological verification. All women were interviewed for medical history and their socio-economic background. High-vaginal swabs (HVS) of pregnant women and blood cultures of sick infants were investigated for bacterial pathogens using culture followed by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) or polymerase-chain-reaction (PCR)-based assays. Antimicrobial resistances were determined using a disk diffusion test and verified by VITEK 2. Maternal malaria, blood glucose, and hemoglobin levels were determined by rapid tests and helminth infections by stool microscopy.Results and discussionOur results showed a prevalence of 22% for neonatal infections. In total, 57% of them had culture-positive bloodstream infections with Gram-negative bacteria being the most prevalent. All these expressed resistance against ampicillin. The prevalence of maternal infection with helminths or Plasmodium was low, indicating that anti-worming strategies and intermittent preventive treatment of malaria for pregnant women (IPTp) are effective. The study identified maternal urinary tract infection (UTI) and an elevated blood glucose level as potential maternal risk factors for early neonatal infection, an elevated blood glucose level, and maternal anemia for a late-onset infection.ConclusionOur study, therefore, indicates that monitoring maternal UTI in the last trimester as well as levels of maternal hemoglobin and blood glucose might be important to predict and eventually manage neonatal infections. As Gram-negative bacteria with resistance to ampicillin were most prevalent in culture-proven neonatal sepsis, WHO recommendations for calculated antibiosis in the sick young infant should be discussed.https://www.frontiersin.org/articles/10.3389/fmicb.2023.1171651/fullneonatal infectiongram-negative bacteriaampicillinmaternal risk factors Sub-Saharan AfricaTanzania |
| spellingShingle | Simone Blumenröder Damas Wilson Edgard Ndaboine Mariam M. Mirambo Martha F. Mushi Oliver Bader Ortrud Zimmermann Stephen E. Mshana Uwe Groß Neonatal infection in Sub-Saharan Africa: a cross-sectional pilot study on bacterial pathogens and maternal risk factors Frontiers in Microbiology neonatal infection gram-negative bacteria ampicillin maternal risk factors Sub-Saharan Africa Tanzania |
| title | Neonatal infection in Sub-Saharan Africa: a cross-sectional pilot study on bacterial pathogens and maternal risk factors |
| title_full | Neonatal infection in Sub-Saharan Africa: a cross-sectional pilot study on bacterial pathogens and maternal risk factors |
| title_fullStr | Neonatal infection in Sub-Saharan Africa: a cross-sectional pilot study on bacterial pathogens and maternal risk factors |
| title_full_unstemmed | Neonatal infection in Sub-Saharan Africa: a cross-sectional pilot study on bacterial pathogens and maternal risk factors |
| title_short | Neonatal infection in Sub-Saharan Africa: a cross-sectional pilot study on bacterial pathogens and maternal risk factors |
| title_sort | neonatal infection in sub saharan africa a cross sectional pilot study on bacterial pathogens and maternal risk factors |
| topic | neonatal infection gram-negative bacteria ampicillin maternal risk factors Sub-Saharan Africa Tanzania |
| url | https://www.frontiersin.org/articles/10.3389/fmicb.2023.1171651/full |
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