Hospital-acquired neonatal infections in developing countries

Anita K.M. Zaidi, W. Charles Huskins, Durrane Thaver, Zulfiqar A. Bhutta, Zohair Abbas, Donald A. Goldmann

Research output: Contribution to journalReview articlepeer-review

537 Citations (Scopus)

Abstract

Hospital-born babies in developing countries are at increased risk of neonatal infections because of poor intrapartum and postnatal infection-control practices. We reviewed data from developing countries on rates of neonatal infections among hospital-born babies, range of pathogens, antimicrobial resistance, and infection-control interventions. Reported rates of neonatal infections were 3-20 times higher than those reported for hospital-born babies in industrialised countries. Klebsiella pneumoniae, other gram-negative rods (Escherichia coli, Pseudomonas spp, Acinetobacter spp), and Staphylococcus aureus were the major pathogens among 11 471 bloodstream isolates reported. These infections can often present soon after birth. About 70% would not be covered by an empiric regimen of ampicillin and gentamicin, and many might be untreatable in resource-constrained environments. The associated morbidity, mortality, costs, and adverse effect on future health-seeking behaviour by communities pose barriers to improvement of neonatal outcomes in developing countries. Low-cost, "bundled" interventions using systems quality improvement approaches for improved infection control are possible, but should be supported by evidence in developing country settings.

Original languageEnglish
Pages (from-to)1175-1188
Number of pages14
JournalThe Lancet
Volume365
Issue number9465
DOIs
Publication statusPublished - 26 Mar 2005

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