Table 2.
Neonatal infections in developing countries (2000-May 2014)
| Author, country, and study year | Disease type and age | Setting | Neonatal Isolation rate and aetiology* | |
|---|---|---|---|---|
| Sub-Saharan Africa | ||||
| Blomberg et al. [10] | Bacteremia | urban, hospital recruitment | 54 early onset (EOS) isolates † : 31 late onset (LOS) isolates: | |
| Tanzania 2001-2002 | <7 yrs | Klebsiella spp. | EOS 14 (26%), LOS 7 (23%) | |
| S. aureus | EOS 6 (11%), LOS 5 (16%) | |||
| E. coli | EOS 6 (11%), LOS 3 (10%) | |||
| Group B Streptococcus | EOS 2 (4%), LOS 1 (3%) | |||
| Sigaúque et al. [21] | Bacteremia | rural, hospital recruitment | 154 isolates: 16% blood cultures positive | |
| Mozambique 2001-2006 | <15 yrs | S. aureus | 60 (39%) | |
| Group B Streptococcus | 31 (20%) | |||
| E. coli | 9 (6%) | |||
| S. pneumoniae | 7 (5%) | |||
| Nielsen et al. [17] | Bacteremia | rural, hospital recruitment | 23 isolates: | |
| Ghana 2007-2009 | <5 yrs | S. aureus | 6 (26%) | |
| Klebsiella spp. | 6 (26%) | |||
| Streptococcus spp. | 3 (13%) | |||
| E. coli | 3 (13%) | |||
| Non-tyhoid Salmonella | 2 (9%) | |||
| Gray et al. [29] | Group B streptococcus | urban, hospital recruitment | 290 isolates: 12% blood cultures positive | |
| Malawi 2004-2005 | <90 days | Group B Streptococcus | 48 (17%) | |
| Talbert et al. [24] | Neonatal sepsis | rural, hospital recruitment | 474 isolates: 9% blood cultures positive (25 infants had 2 bacterial species isolated) | |
| Kenya 2001-2009 | <60 days | Klebsiella spp. | 57 (13%) | |
| S. aureus | 55 (12%) | |||
| Acinetobacter spp. | 48 (11%) | |||
| E. coli | 41 (9%) | |||
| Group B Streptococcus | 32 (7%) | |||
| 86 isolates from CSF samples : 4% CSF cultures positive | ||||
| S. pneumoniae | 17 (20%) | |||
| Group B Streptococcus | 16 (19%) | |||
| Salmonella spp. | 10 (12%) | |||
| Ojukwu et al. [18] | Neonatal sepsis | urban, hospital recruitment | 33 isolates: 24% blood cultures positive | |
| Nigeria 2002-2003 | 0-28 days | S. aureus | 15 (45%) | |
| E. coli | 6 (18%) | |||
| Klebsiella spp. | 3 (9%) | |||
| Group B Streptococcus | 1 (3%) | |||
| Mugalu et al. [15] | Neonatal sepsis | urban, hospital recruitment | 110 isolates: 37% blood or CSF cultures positive | |
| Uganda 2002 | used WHO guidelines | S. aureus | 69 (63%) | |
| E. coli | 17 (15%) | |||
| Group B Streptococcus | 7 (6%) | |||
| Shitaye et al. [19] | Neonatal sepsis | urban, hospital recruitment | 135 isolates: 45% blood cultures positive | |
| Ethiopia 2006-2007 | 0-28 days | Klebsiella spp. | 53 (39%) | |
| S. aureus | 30 (22%) | |||
| Coagulase-negative Staphylococcus | 10 (7%) | |||
| Mhada et al. | Neonatal sepsis | urban, hospital recruitment | 52 early onset (EOS) isolates † : 22 late onset (LOS) isolates: 22.4% blood cultures positive | |
| Tanzania 2009-2010 | 0-28 days | S. aureus | EOS 15 (29%), LOS 12 (55%) | |
| Klebsiella spp. | EOS 17 (33%), LOS 5 (23%) | |||
| E. coli | EOS 10 (19%), LOS 4 (18%) | |||
| Staphylococcus epidermidis | EOS 6 (12%), LOS 0 (0%) | |||
| Group B Streptococcus | EOS 1 (2%), LOS 0 (0%) | |||
| Kiwanuka et al. [13] | Neonatal sepsis | urban, hospital recruitment | 19 early onset (EOS) isolates † : 7 late onset (LOS) isolates: 33% blood cultures | |
| Uganda 2010 | <1 month | S. aureus | EOS 13 (68%), LOS 3 (43%) | |
| E. coli | EOS 3 (16%), LOS 1 (14%) | |||
| Klebsiella spp. | EOS 1 (5%), LOS 1 (14%) | |||
| Group B Streptococcus | EOS 1 (5%), LOS 0 (0%) | |||
| SE Asia | ||||
| Stoesser et al. [22] | Bacteremia | urban, hospital recruitment | 65 isolates: | |
| Cambodia 2007-2011 | <16 yrs | Klebsiella spp. | 14 (22%) | |
| S. aureus | 9 (14%) | |||
| Enterobacter spp. | 4 (6%) | |||
| E. coli | 3 (5%) | |||
| Streptococcus pyogenes | 3 (5%) | |||
| Kruse et al. [30] | Neonatal sepsis | urban, hospital recruitment | 399 isolates: 17% blood cultures positive | |
| Vietnam 2009-2010 | <28 days | Klebsiella spp. | 78 (20%) | |
| Acinetobacter spp. | 58 (15%) | |||
| E. coli | 21 (5%) | |||
| Enterobacter spp. | 16 (4%) | |||
| S. aureus | 11 (3%) | |||
| Morganella spp. | 8 (2%) | |||
| Pseudomonas spp. | 6 (2%) | |||
| Coagulase-negative Staphylococcus | 175 (44%) | |||
| India subcontinent | ||||
| Mir et al. [28] | Omphalitis with sepsis | urban, community recruitment | 432 isolates: 64% umbilical cord cultures positive | |
| Pakistan 2004-2007 | neonates (<1 month) | S. aureus | 225 (52%)‡ | |
| Streptococcus pyogenes | 78 (18%)‡ | |||
| Group B Streptococcus | 43 (10%)‡ | |||
| Jain et al. [26] | Neonatal sepsis | urban, hospital recruitment | 350 isolates: 48% blood cultures positive for bacteria | |
| India 2001-2002 | Not defined | Klebsiella spp. | 86 (25%)‡ | |
| Enterobacter spp. | 80 (23%)‡ | |||
| E. coli | 49 (14%)‡ | |||
| Sundaram et al. [23] | Neonatal sepsis | urban, hospital recruitment | 527 early onset (EOS) isolates § : 364 late onset (LOS) isolates: | |
| India 1995–1998, 2001-2006 | Not defined | S. aureus | EOS 108 (20%), LOS 112 (31%) | |
| K. pneumoniae | EOS 62 (12%), LOS 49 (14%) | |||
| Non-fermenting gram negative bacilli | EOS 161 (30%), LOS 60 (17%) | |||
| E. coli | EOS 48 (9%), LOS 40 (11%) | |||
| Zakariya et al. [25] | Neonatal sepsis | urban, hospital recruitment | 50 isolates: 42% blood cultures positive | |
| India 2004-2006 | <= 30 days | K. pneumoniae | 33 (66%) | |
| Coagulase-negative Staphylococcus | 6 (12%) | |||
| Group B Streptococcus | 1 (2%) | |||
| Muhammad et al. [16] | Neonatal sepsis | urban, hospital recruitment | 130 isolates: | |
| Pakistan 2009-2010 | <28 days | S. aureus | 35 (27%) | |
| E. coli | 30 (23%) | |||
| Staphylococcus epidermidis | 17 (13%) | |||
| Acinetobacter spp. | 17 (13%) | |||
| Klebsiella spp. | 13 (10%) | |||
| Streptococcus species only found in early onset sepsis (first week) | ||||
| Klebseilla species only found in late onset sepsis (after first week to 28 days) | ||||
| Darmstadt et al. [27] | Neonatal sepsis | rural, community recruitment | 29 isolates: 6% blood cultures positive | |
| Bangladesh 2004-2006 | <28 days | S. aureus | 10 (34%) | |
| S. pneumoniae | 3 (10%) | |||
| Group B Streptococcus | 1 (3%) | |||
| Gyawali et al. [12] | Neonatal sepsis | urban, hospital recruitment | 238 isolates: 15% blood cultures positive | |
| Nepal 2009-2010 | first 4 weeks of life | S. aureus | 94 (40%) | |
| Klebsiella spp. | 32 (14%) | |||
| Acinetobacter spp. | 30 (13%) | |||
| Enterobacter spp. | 27 (11%) | |||
| Pseudomonas spp. | 21 (9%) | |||
| E. coli | 16 (7%) | |||
| Shresta et al. [20] | Neonatal sepsis | urban, hospital recruitment | 37 isolates: 32% blood cultures positive | |
| Nepal, 2011-2012 | not defined | S. aureus | 21 (57%) | |
| K. pneumoniae | 8 (22%) | |||
| P. aeruginosa | 5 (13%) | |||
| Europe | ||||
| Macharashvili et al. [14] | Neonatal sepsis | urban, hospital recruitment | 126 isolates: 67% blood cultures positive | |
| Georgia 2003-2004 | 8 weeks or younger | K. pneumoniae | 36 (29%) | |
| Enterobacter cloacae | 19 (15%) | |||
| S. aureus | 15 (12%) | |||
| Group B Streptococcus | 6 (5%) | |||
*Percentages calculated when not reported in the article. Pathogens listed in order of relative percentages.
†Early onset sepsis (EOS) defined as 0–6 days.
‡Number of isolates calculated from percentages presented in article.
§Early onset sepsis (EOS) defined as <72 hours, late onset (LOS) defined as >72 hours.