The clinical features, microbiology, and genomics of neonatal sepsis in a children’s hospital in Vietnam
<p>Sepsis is a common and deadly condition affecting the neonatal population. I aimed to understand the causes and outcomes of neonatal sepsis at Children’s Hospital 1 in Ho Chi Minh City, Vietnam. A retrospective study from 2013 to 2016 found that Acinetobacter spp., Escherichia coli, Klebsie...
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| Format: | Thesis |
| Language: | English |
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2020
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| _version_ | 1797073374787141632 |
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| author | Nguyen, TD |
| author2 | Boinett, C |
| author_facet | Boinett, C Nguyen, TD |
| author_sort | Nguyen, TD |
| collection | OXFORD |
| description | <p>Sepsis is a common and deadly condition affecting the neonatal population. I aimed to understand the causes and outcomes of neonatal sepsis at Children’s Hospital 1 in Ho Chi Minh City, Vietnam. A retrospective study from 2013 to 2016 found that Acinetobacter spp., Escherichia coli, Klebsiella spp., Pseudomonas spp., coagulase-negative staphylococci (CoNS), Staphylococcus aureus, and Streptococcus pneumoniae were the most common organisms. These organisms were resistant to a wide variety of antimicrobials, which may impact on the efficacy of antimicrobial therapy. I next conducted a prospective study of sepsis in 524 neonates with 69 deaths from January 2017 to June 2018. This group had a mortality of 13.2%; sclerema, leukopenia <4,000/mm3, thrombocytopenia <100,000/mm3, base excess < –20 mEq/L, lactate >4 mmol/L, and hyperglycaemia >180 mg/dL, were associated with death. The major organisms (from 405 isolates) included Klebsiella spp. (6.9%), Escherichia coli (6.7%), Acinetobacter spp. (4.0%), Enterobacter spp. (3.5%), CoNS (57.3%), Staphylococcus aureus (4.4%), and Streptococcus spp. (2.5%). These organisms were highly resistant to all non-carbapenem antimicrobials. The genomics of 15 Acinetobacter baumannii identified sequence type ST570 within genomic complex 2 in 80% of isolates and found the blaOXA-23, blaMBL, blaADC, blaA2, mphE, msrE, and armA AMR genes. A common transposon, carrying blaOXA-23 was associated with widespread carbapenem resistance. In this location, neonatal sepsis was associated with high mortality, complicated clinical features and caused by caused by differing MDR bacteria.</p> |
| first_indexed | 2024-03-06T23:21:11Z |
| format | Thesis |
| id | oxford-uuid:68c746d1-afd1-438c-8e7a-157c2a466630 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T23:21:11Z |
| publishDate | 2020 |
| record_format | dspace |
| spelling | oxford-uuid:68c746d1-afd1-438c-8e7a-157c2a4666302022-03-26T18:47:15ZThe clinical features, microbiology, and genomics of neonatal sepsis in a children’s hospital in VietnamThesishttp://purl.org/coar/resource_type/c_db06uuid:68c746d1-afd1-438c-8e7a-157c2a466630genomicssepsisclinical featuresmicrobiologyneonatologyEnglishHyrax Deposit2020Nguyen, TDBoinett, CBaker, S<p>Sepsis is a common and deadly condition affecting the neonatal population. I aimed to understand the causes and outcomes of neonatal sepsis at Children’s Hospital 1 in Ho Chi Minh City, Vietnam. A retrospective study from 2013 to 2016 found that Acinetobacter spp., Escherichia coli, Klebsiella spp., Pseudomonas spp., coagulase-negative staphylococci (CoNS), Staphylococcus aureus, and Streptococcus pneumoniae were the most common organisms. These organisms were resistant to a wide variety of antimicrobials, which may impact on the efficacy of antimicrobial therapy. I next conducted a prospective study of sepsis in 524 neonates with 69 deaths from January 2017 to June 2018. This group had a mortality of 13.2%; sclerema, leukopenia <4,000/mm3, thrombocytopenia <100,000/mm3, base excess < –20 mEq/L, lactate >4 mmol/L, and hyperglycaemia >180 mg/dL, were associated with death. The major organisms (from 405 isolates) included Klebsiella spp. (6.9%), Escherichia coli (6.7%), Acinetobacter spp. (4.0%), Enterobacter spp. (3.5%), CoNS (57.3%), Staphylococcus aureus (4.4%), and Streptococcus spp. (2.5%). These organisms were highly resistant to all non-carbapenem antimicrobials. The genomics of 15 Acinetobacter baumannii identified sequence type ST570 within genomic complex 2 in 80% of isolates and found the blaOXA-23, blaMBL, blaADC, blaA2, mphE, msrE, and armA AMR genes. A common transposon, carrying blaOXA-23 was associated with widespread carbapenem resistance. In this location, neonatal sepsis was associated with high mortality, complicated clinical features and caused by caused by differing MDR bacteria.</p> |
| spellingShingle | genomics sepsis clinical features microbiology neonatology Nguyen, TD The clinical features, microbiology, and genomics of neonatal sepsis in a children’s hospital in Vietnam |
| title | The clinical features, microbiology, and genomics of neonatal sepsis in a children’s hospital in Vietnam |
| title_full | The clinical features, microbiology, and genomics of neonatal sepsis in a children’s hospital in Vietnam |
| title_fullStr | The clinical features, microbiology, and genomics of neonatal sepsis in a children’s hospital in Vietnam |
| title_full_unstemmed | The clinical features, microbiology, and genomics of neonatal sepsis in a children’s hospital in Vietnam |
| title_short | The clinical features, microbiology, and genomics of neonatal sepsis in a children’s hospital in Vietnam |
| title_sort | clinical features microbiology and genomics of neonatal sepsis in a children s hospital in vietnam |
| topic | genomics sepsis clinical features microbiology neonatology |
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