Improving the Treatment of Neonatal Sepsis in Resource-Limited Settings: Gaps and Recommendations
Sarah Sturrock,1 Samantha Sadoo,2 Carol Nanyunja,3 Kirsty Le Doare1,4,5 1Centre for Neonatal and Paediatric Infection, St George’s, University of London, London, UK; 2Department of Infectious Disease Epidemiology and International Health, London School of Hygiene & Tropical Medicine, London, UK;...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2023-12-01
|
| Series: | Research and Reports in Tropical Medicine |
| Subjects: | |
| Online Access: | https://www.dovepress.com/improving-the-treatment-of-neonatal-sepsis-in-resource-limited-setting-peer-reviewed-fulltext-article-RRTM |
| _version_ | 1797391140415078400 |
|---|---|
| author | Sturrock S Sadoo S Nanyunja C Le Doare K |
| author_facet | Sturrock S Sadoo S Nanyunja C Le Doare K |
| author_sort | Sturrock S |
| collection | DOAJ |
| description | Sarah Sturrock,1 Samantha Sadoo,2 Carol Nanyunja,3 Kirsty Le Doare1,4,5 1Centre for Neonatal and Paediatric Infection, St George’s, University of London, London, UK; 2Department of Infectious Disease Epidemiology and International Health, London School of Hygiene & Tropical Medicine, London, UK; 3MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda; 4UK Health Security Agency, Salisbury, UK; 5Makerere University, Johns Hopkins University, Kampala, UgandaCorrespondence: Sarah Sturrock, Centre for Neonatal and Paediatric Infection, Maternal and Neonatal Vaccine Immunology Research Group, St George’s, University of London, Cranmer Terrace, London, SW17 0RE, United Kingdom, Tel +44 7855 478 360, Email ssturroc@sgul.ac.ukAbstract: Neonatal sepsis causes significant global morbidity and mortality, with the highest burden in resource-limited settings where 99% of neonatal deaths occur. There are multiple challenges to achieving successful treatment of neonates in this setting. Firstly, reliable and low-cost strategies for risk identification are urgently needed to facilitate treatment as early as possible. Improved laboratory capacity to allow identification of causative organisms would support antimicrobial stewardship. Antibiotic treatment is still hampered by availability, but also increasingly by antimicrobial resistance – making surveillance of organisms and judicious antibiotic use a priority. Finally, supportive care is key in the management of the neonate with sepsis and has been underrecognized as a priority in resource-limited settings. This includes fluid balance and nutritional support in the acute phase, and follow-up care in order to mitigate complications and optimise long-term outcomes. There is much more work to be done in identifying the holistic needs of neonates and their families to provide effective family-integrated interventions and complete the package of neonatal sepsis management in resource-limited settings.Keywords: neonate, low- and middle-income countries, antimicrobial resistance, outcomes, sepsis |
| first_indexed | 2024-03-08T23:28:34Z |
| format | Article |
| id | doaj.art-3faf22ad8726417487a73c1c0da8fb28 |
| institution | Directory Open Access Journal |
| issn | 1179-7282 |
| language | English |
| last_indexed | 2024-03-08T23:28:34Z |
| publishDate | 2023-12-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Research and Reports in Tropical Medicine |
| spelling | doaj.art-3faf22ad8726417487a73c1c0da8fb282023-12-14T17:01:45ZengDove Medical PressResearch and Reports in Tropical Medicine1179-72822023-12-01Volume 1412113489019Improving the Treatment of Neonatal Sepsis in Resource-Limited Settings: Gaps and RecommendationsSturrock SSadoo SNanyunja CLe Doare KSarah Sturrock,1 Samantha Sadoo,2 Carol Nanyunja,3 Kirsty Le Doare1,4,5 1Centre for Neonatal and Paediatric Infection, St George’s, University of London, London, UK; 2Department of Infectious Disease Epidemiology and International Health, London School of Hygiene & Tropical Medicine, London, UK; 3MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda; 4UK Health Security Agency, Salisbury, UK; 5Makerere University, Johns Hopkins University, Kampala, UgandaCorrespondence: Sarah Sturrock, Centre for Neonatal and Paediatric Infection, Maternal and Neonatal Vaccine Immunology Research Group, St George’s, University of London, Cranmer Terrace, London, SW17 0RE, United Kingdom, Tel +44 7855 478 360, Email ssturroc@sgul.ac.ukAbstract: Neonatal sepsis causes significant global morbidity and mortality, with the highest burden in resource-limited settings where 99% of neonatal deaths occur. There are multiple challenges to achieving successful treatment of neonates in this setting. Firstly, reliable and low-cost strategies for risk identification are urgently needed to facilitate treatment as early as possible. Improved laboratory capacity to allow identification of causative organisms would support antimicrobial stewardship. Antibiotic treatment is still hampered by availability, but also increasingly by antimicrobial resistance – making surveillance of organisms and judicious antibiotic use a priority. Finally, supportive care is key in the management of the neonate with sepsis and has been underrecognized as a priority in resource-limited settings. This includes fluid balance and nutritional support in the acute phase, and follow-up care in order to mitigate complications and optimise long-term outcomes. There is much more work to be done in identifying the holistic needs of neonates and their families to provide effective family-integrated interventions and complete the package of neonatal sepsis management in resource-limited settings.Keywords: neonate, low- and middle-income countries, antimicrobial resistance, outcomes, sepsishttps://www.dovepress.com/improving-the-treatment-of-neonatal-sepsis-in-resource-limited-setting-peer-reviewed-fulltext-article-RRTMneonatelow- and middle- income countriesantimicrobial resistanceoutcomessepsis |
| spellingShingle | Sturrock S Sadoo S Nanyunja C Le Doare K Improving the Treatment of Neonatal Sepsis in Resource-Limited Settings: Gaps and Recommendations Research and Reports in Tropical Medicine neonate low- and middle- income countries antimicrobial resistance outcomes sepsis |
| title | Improving the Treatment of Neonatal Sepsis in Resource-Limited Settings: Gaps and Recommendations |
| title_full | Improving the Treatment of Neonatal Sepsis in Resource-Limited Settings: Gaps and Recommendations |
| title_fullStr | Improving the Treatment of Neonatal Sepsis in Resource-Limited Settings: Gaps and Recommendations |
| title_full_unstemmed | Improving the Treatment of Neonatal Sepsis in Resource-Limited Settings: Gaps and Recommendations |
| title_short | Improving the Treatment of Neonatal Sepsis in Resource-Limited Settings: Gaps and Recommendations |
| title_sort | improving the treatment of neonatal sepsis in resource limited settings gaps and recommendations |
| topic | neonate low- and middle- income countries antimicrobial resistance outcomes sepsis |
| url | https://www.dovepress.com/improving-the-treatment-of-neonatal-sepsis-in-resource-limited-setting-peer-reviewed-fulltext-article-RRTM |
| work_keys_str_mv | AT sturrocks improvingthetreatmentofneonatalsepsisinresourcelimitedsettingsgapsandrecommendations AT sadoos improvingthetreatmentofneonatalsepsisinresourcelimitedsettingsgapsandrecommendations AT nanyunjac improvingthetreatmentofneonatalsepsisinresourcelimitedsettingsgapsandrecommendations AT ledoarek improvingthetreatmentofneonatalsepsisinresourcelimitedsettingsgapsandrecommendations |