Okomo, U; Akpalu, ENK; Le Doare, K; Roca, A; Cousens, S; Jarde, A; Sharland, M; Kampmann, B; Lawn, JE
(2019)
Aetiology of invasive bacterial infection and antimicrobial resistance in neonates in sub-Saharan Africa: a systematic review and meta-analysis in line with the STROBE-NI reporting guidelines.
The Lancet Infectious Diseases, 19 (11).
pp. 1219-1234.
ISSN 1473-3099
https://doi.org/10.1016/S1473-3099(19)30414-1
SGUL Authors: Le Doare, Kirsty
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Abstract
Background: Aetiological data for neonatal infections are essential to inform policies and programme strategies at various levels, but such data are scarce from sub-Saharan Africa. We therefore conducted a systematic review and meta-analysis of available data from the African continent since 1980, with a focus on regional differences in aetiology and antimicrobial resistance (AMR) in the last decade (2008 – 2018). Methods: We included data for microbiologically confirmed invasive bacterial infection including meningitis and AMR among neonates in sub-Saharan Africa and assessed the quality of scientific reporting according to Strengthening the Reporting of Observational Studies in Epidemiology for Newborn Infection (STROBE-NI) checklist. We calculated pooled proportions for reported bacterial isolates and AMR. Findings: We included 151 studies comprising data from 84534 neonates from 26 countries, almost all of which were hospital-based. Of the 82 studies published between 2008 and 2018, insufficient details were reported regarding most STROBE-NI items. Regarding culture positive bacteraemia/sepsis, S aureus, Klebsiella spp and E coli accounted for 25% (95% CI 21 – 29%) 21%, (16 – 27%) and 10% (8 – 10%) respectively. For meningitis, the predominant identified causes were Group B streptococcus 25% (16 – 33%), S pneumoniae 17% (9 – 26%), and S aureus 12% (3 – 25%). Resistance to WHO recommended β-lactams was reported in >68% of 904 cases and to aminoglycosides in 27% of 1176 cases. Interpretation: Hospital-acquired neonatal infections and AMR are a major burden in Africa, and improved surveillance is required. More population-based neonatal infection studies are also needed, and all studies should be reported according to standardised reporting guidelines, such as STROBE-NI to aid comparability and reduce research wastage.
Item Type: | Article | ||||||||||||||||||
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Additional Information: | © 2019. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ | ||||||||||||||||||
Keywords: | 1103 Clinical Sciences, 1108 Medical Microbiology, Microbiology | ||||||||||||||||||
SGUL Research Institute / Research Centre: | Academic Structure > Infection and Immunity Research Institute (INII) | ||||||||||||||||||
Journal or Publication Title: | The Lancet Infectious Diseases | ||||||||||||||||||
ISSN: | 1473-3099 | ||||||||||||||||||
Publisher License: | Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0 | ||||||||||||||||||
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URI: | https://openaccess.sgul.ac.uk/id/eprint/111029 | ||||||||||||||||||
Publisher's version: | https://doi.org/10.1016/S1473-3099(19)30414-1 |
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