#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Neonatal sepsis in Iran: A systematic review and meta-analysis on national prevalence and causative pathogens


Autoři: Zahra Akbarian-Rad aff001;  Seyed Mohammad Riahi aff002;  Ali Abdollahi aff003;  Parisa Sabbagh aff004;  Soheil Ebrahimpour aff004;  Mostafa Javanian aff004;  VeneelaKrishnaRekha Vasigala aff005;  Ali Rostami aff004
Působiště autorů: Department of Pediatrics, Non-Communicable Pediatric Disease Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran aff001;  Cardiovascular Diseases Research Center, Department of Epidemiology and Biostatistics, Faculty of Health, Birjand University of Medical Sciences, Birjand, Iran aff002;  Department of Surgery, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran aff003;  Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran aff004;  Department of General medicine, Rangaraya Medical College, Kakinada, India aff005;  Immunoregulation Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran aff006
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0227570

Souhrn

Background

Neonatal sepsis is accounted for 30–50% of annual neonatal deaths in developing countries. We performed a systematic review and meta-analysis study to evaluate the national prevalence and identification of the etiological pathogens of neonatal sepsis in Iran.

Methods

A comprehensive literature search was done on the national and international databases for studies published between 2000 and 2019. The DerSimonian and Laird random-effects model was used to calculate pooled prevalence estimates, with 95% confidence intervals (CIs). Subgroup analyses and meta-regressions regarding the gender, type of sepsis and time during were also performed. Data were extracted, analyzed, and presented according to PRISMA guideline.

Results

Of 944 publications identified, 22 studies containing 14,683 neonates met the eligibility criteria. The pooled national prevalence of sepsis in Iran was 15.98% (95%CI, 11.96–20.46%; 1,367/14,683). Prevalence rate in boys (20.42%; 95%CI, 9.03–34.8%) was slightly higher than girls (18.5%; 95%CI, 7.4–32.8). A decreasing trend in prevalence of neonatal sepsis was found in recent years, although not statistically significant (c = -0.005; P value = 0.4). The most prevalent causative bacterial pathogens were Enterobacter spp. (23.04%), followed by Klebsiella pneumoniae (17.54%), coagulase-negative Staphylococci (14.06%), Escherichia coli (13.92%), Pseudomonas aeruginosa (12.67%), and Staphylococcus aureus (11.48%).

Conclusion

Our findings showed a high prevalence of neonatal sepsis in suspected neonates, suggesting the need to implement preventive measures, routine assessment, and close monitoring of neonates. Also, Enterobacter spp. and Klebsiella pneumoniae were identified as the principal bacterial pathogens responsible for neonatal septicemia in Iran.

Klíčová slova:

Bacterial pathogens – Database searching – Iran – Klebsiella pneumoniae – Metaanalysis – Neonatal sepsis – Neonates – Sepsis


Zdroje

1. Mersha A, Worku T, Shibiru S, Bante A, Molla A, Seifu G, et al. Neonatal sepsis and associated factors among newborns in hospitals of Wolaita Sodo Town, Southern Ethiopia. Res Rep Neonatol. 2019;9:1. https://doi.org/10.2147/RRN.S193074.

2. Fleischmann-Struzek C, Goldfarb DM, Schlattmann P, Schlapbach LJ, Reinhart K, Kissoon N. The global burden of paediatric and neonatal sepsis: a systematic review. The Lancet Respir Med. 2018;6(3):223–30. Epub 2018/03/07. doi: 10.1016/S2213-2600(18)30063-8 29508706.

3. Shah BA, Padbury JF. Neonatal sepsis: an old problem with new insights. Virulence. 2014;5(1):170–8. Epub 2013/11/01. doi: 10.4161/viru.26906 24185532.

4. Vergnano S, Sharland M, Kazembe P, Mwansambo C, Heath P. Neonatal sepsis: an international perspective. Arch Dis Child Fetal Neonatal Ed. 2005;90(3):220–4. doi: 10.1136/adc.2002.022863 15846011; PMCID: PMC1721871.

5. Giannoni E, Agyeman PKA, Stocker M, Posfay-Barbe KM, Heininger U, Spycher BD, et al. Neonatal Sepsis of Early Onset, and Hospital-Acquired and Community-Acquired Late Onset: A Prospective Population-Based Cohort Study. J Pediatr. 2018;201:106–14.e4. doi: 10.1016/j.jpeds.2018.05.048 30054165

6. Koenig JM, Keenan WJ. Group B streptococcus and early-onset sepsis in the era of maternal prophylaxis. Pediatr Clin North Am. 2009;56(3):689–708. doi: 10.1016/j.pcl.2009.04.003 19501699.

7. Simonsen KA, Anderson-Berry AL, Delair SF, Davies HD. Early-onset neonatal sepsis. Clin Microbiol Rev. 2014;27(1):21–47. doi: 10.1128/CMR.00031-13 24396135.

8. Chacko B, Sohi I. Early onset neonatal sepsis. Indian J Pediatr. 2005;72(1):23–6. doi: 10.1007/bf02760574 15684443.

9. Dong Y, Speer CP. Late-onset neonatal sepsis: recent developments. Arch Dis Child Fetal Neonatal Ed. 2015;100(3):257–63. doi: 10.1136/archdischild-2014-306213 25425653; PubMed Central PMCID: PMC4413803.

10. Yadav NS, Sharma S, Chaudhary DK, Panthi P, Pokhrel P, Shrestha A, et al. Bacteriological profile of neonatal sepsis and antibiotic susceptibility pattern of isolates admitted at Kanti Children's Hospital, Kathmandu, Nepal. BMC Res Notes. 2018;11(1):301. doi: 10.1186/s13104-018-3394-6 29764503; PubMed Central PMCID: PMC5952417.

11. Freitas FTM, Araujo AFOL, Melo MIS, Romero GAS. Late-onset sepsis and mortality among neonates in a Brazilian Intensive Care Unit: a cohort study and survival analysis. Epidemiol Infect. 2019;147:e208. doi: 10.1017/S095026881900092X 31364533.

12. Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4(1):1. doi: 10.1186/2046-4053-4-1 25554246; PubMed Central PMCID: PMC4320440.

13. Hunter JP, Saratzis A, Sutton AJ, Boucher RH, Sayers RD, Bown MJ. In meta-analyses of proportion studies, funnel plots were found to be an inaccurate method of assessing publication bias. J Clin Epidemiol. 2014;67(8):897–903. doi: 10.1016/j.jclinepi.2014.03.003 24794697.

14. Rad EM, Momtazmanesh N. Neonatal sepsis due to klebsiella: frequency, outcome and antibiotic sensitivity. Iranian J Public Health. 2004:43–8.

15. Fesharaki Nia, Miri M. The investigation of newborn septicemia in Valiy-e-Aser Hospital of Birjand. J Birjand Univ Med Sci. 2004; 11(4):9–15

16. Khosravi A, Najafabadi Farahani M. Neonatal septicemia caused by aerobic bacteria in newborn infants. J Qazvin Univ Med Sci. 2004;8(2):35–40.

17. Movahedian A, Moniri R, Mosayebi Z. Bacterial culture of neonatal sepsis. Iranian J Public Health. 2006:84–9.

18. Salamati P, Rahbarimanesh AA, Yunesian M, Naseri M. Neonatal nosocomial infections in Bahrami children hospital. Indian J Pediatr. 2006;73(3):197–200. doi: 10.1007/bf02825479 16567910.

19. Milani S. Clinical Manifestations and mortality in neonatal septicemia Children Medical Center. Tehran Univ Med J. 2008;65(2):46–51.

20. Nickavar A, Nateghian A, Setarehshenas R, Sajadi A. Bacteriologic study of blood culture in children and neonates with bacterimia and septicemia. Iran J Nursing. 2007;20(52):87–94.

21. Ghorbani MG, Karam bin MM, Sobhani AR, Fasihi M, Parandakh Joshari S, Shahrami H. Comparison of Neonatal Bacterial Septicemia in 2007 and 1998–2000 Years. J Guilan Univ Med Sci. 2009;18(69):25–32.

22. Torkaman M, Afsharpaiman S, Hoseini M, Moradi M, Mazraati A, Amirsalari S, et al. Platelet count and neonatal sepsis: a high prevalence of Enterobacter spp. Singapore Med J. 2009;50(5):482–5. 19495516

23. Hashemizadeh Z, Bazargani A, Davarpanah MA. Blood culture contamination in a neonatal intensive care unit in Shiraz, Southwest-Central Iran. Med Princ Pract. 2011;20(2):133–6. doi: 10.1159/000321237 21252567.

24. Shahian M, Pishva N, Kalani M. Bacterial etiology and antibiotic sensitivity patterns of early-late onset neonatal sepsis among newborns in Shiraz, Iran 2004–2007. Iranian J Med Sci. 2010;35(4):293–8.

25. Monsef A, Eghbalian F. Antibiotic sensitivity pattern of common bacterial pathogens in NICU and neonatal ward in Hamedan province of Iran. Health. 2010;2(06):625.

26. Dezfoulimanesh Z, Tohidnia MR, Darabi F, Almasi A. Prevalence of bacterial and antibiotic sensitivity in septicemia of neonates admitted to Kermanshah Imam Reza Hospital (2007–2008). J Kermanshah Univ Med Sci. 2011;15(2):e79381.

27. Aletayeb SMH, Khosravi AD, Dehdashtian M, Kompani F, Aramesh MR. Identification of bacterial agents and antimicrobial susceptibility of neonatal sepsis: A 54-month study in a tertiary hospital. Afr J Microbiol Res. 2011;5(5):528–31.

28. Adib M, Bakhshiani Z, Navaei F, Fosoul FS, Fouladi S, Kazemzadeh H. Procalcitonin: a reliable marker for the diagnosis of neonatal sepsis. Iranian J Basic Med Sci. 2012;15(2):777–82. 23493845; PMCID: PMC3586883

29. Karambin M, Zarkesh M. Enterobacter, the most common pathogen of neonatal septicemia in Rasht, Iran. Iranian J Pediatr. 2011;21(1):83–7. 23056769; PMCID: PMC3446115

30. Besharati R, Sadeghian A, Mamori G. Abundance of colonized bacteria as causative agent of septicemia in neonates hospitalized in the N.I.C.U Ward at Ghaem hospital in Mashhad. J North Khorasan Univ Med Sci. 2011;3(1):35–8. https://doi.org/10.29252/jnkums.3.1.5.

31. Mosayebi Z, Movahedian AH, Soori T. Clinical and bacteriological characteristics of neonatal sepsis in an inten-sive care unit in Kashan, Iran: a 2 year descriptive study. Arch Pediatr Infect Dis. 2013;1(2):62.

32. Ahmadi K, Farajzadeh Sheikh A, Mardaneh J, Modarresi F, Shoja S. Detection of Enterobacter sakazakii in neonatal sepsis by PCR on 16S ribosomal RNA. Iran South Med J. 2014;17(3):272–9.

33. Sharifi Yazdi MK, Haghi Ashtiani MT, Nikmanesh B, Soltan Dallal MM. Comparison of antibiotic resistance of bacterial agents associated in septicaemia in children and infants. Iran South Med J. 2014;17(2):223–32.

34. Khosravi N, Noorbakhsh S, Javadinia S, Ashouri S. Determination the bacterial etiologies for sepsis in premature newborns admitted in neonatal intensive care unit. Tehran Univ Med J. 2017;74(11):791–7.

35. Afsharpaiman S, Torkaman M, Saburi A, Farzaampur A, Amirsalari S, Kavehmanesh Z. Trends in incidence of neonatal sepsis and antibiotic susceptibility of causative agents in two neonatal intensive care units in Tehran, IR Iran. J Clin Neonatol. 2012;1(3):124–30. doi: 10.4103/2249-4847.101692 24027707; PMCID: PMC3762027.

36. Fleischmann-Struzek C, Goldfarb DM, Schlattmann P, Schlapbach LJ, Reinhart K, Kissoon N. The global burden of paediatric and neonatal sepsis: a systematic review. Lancet Respir Med. 2018;6(3):223–30. doi: 10.1016/S2213-2600(18)30063-8 29508706.

37. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016;315(8):801–10. doi: 10.1001/jama.2016.0287 26903338; PMCID: PMC4968574.

38. El-Din S, Rabie EM, El-Sokkary MMA, Bassiouny MR, Hassan R. Epidemiology of neonatal sepsis and implicated pathogens: a study from Egypt. BioMed Res Int. 2015;2015. 509484. doi: 10.1155/2015/509484 26146621; PMCID: PMC4471255.

39. Kayange N, Kamugisha E, Mwizamholya DL, Jeremiah S, Mshana SE. Predictors of positive blood culture and deaths among neonates with suspected neonatal sepsis in a tertiary hospital, Mwanza-Tanzania. BMC Pediatr. 2010;10(1):39. doi: 10.1186/1471-2431-10-39 20525358; PMCID: PMC2889942.

40. Chiabi A, Djoupomb M, Mah E, Nguefack S, Mbuagbaw L, Zafack J, et al. The clinical and bacteriogical spectrum of neonatal sepsis in a tertiary hospital in Yaounde, Cameroon. Iranian J Pediatr. 2011;21(4):441–8. 23056829; PMCID: PMC3446127.

41. Abdellatif M, Al-Khabori M, Rahman AU, Khan AA, Al-Farsi A, Ali K. Outcome of Late-onset Neonatal Sepsis at a Tertiary Hospital in Oman. Oman Med J. 2019;34(4):302. doi: 10.5001/omj.2019.60 31360318; PMCID: PMC6642716

42. Watson RS, Carcillo JA, Linde-Zwirble WT, Clermont G, Lidicker J, Angus DC. The epidemiology of severe sepsis in children in the United States. Am J Respir Crit Care Med. 2003;167(5):695–701. doi: 10.1164/rccm.200207-682OC 12433670.

43. Braye K, Foureur M, de Waal K, Jones M, Putt E, Ferguson J. Epidemiology of neonatal early-onset sepsis in a geographically diverse Australian health district 2006–2016. PloS One. 2019;14(4):e0214298. doi: 10.1371/journal.pone.0214298 30958832; PMCID: PMC6453454.

44. Gurung B, Shrestha L. Bacterial profile of Early versus Late onset neonatal sepsis and its antimicrobial susceptibility: A 1-year retrospective study in a tertiary level teaching hospital of Nepal. J Inst Med. 2017;39(3):40–46.

45. Anegundi R, Kulkarni RD, Chitharagi VB, Ajantha G, Shubhada C, Varaiya A. Bacteriological Profile and Clinical Outcome in Cases of Neonatal Sepsis. Int J Curr Microbiol App Sci. 2017;6(4):2206–14.

46. Yancey MK, Duff P, Kubilis P, Clark P, Frentzen BH. Risk factors for neonatal sepsis. Obstetr Gynecol. 1996;87(2):188–94. https://doi.org/10.1016/0029-7844(95)00402-5

47. Schuchat A, Zywicki SS, Dinsmoor MJ, Mercer B, Romaguera J, O'Sullivan MJ, et al. Risk factors and opportunities for prevention of early-onset neonatal sepsis: a multicenter case-control study. Pediatrics. 2000;105(1):21–6. doi: 10.1542/peds.105.1.21 10617699

48. Tsai M-H, Chu S-M, Hsu J-F, Lien R, Huang H-R, Chiang M-C, et al. Risk factors and outcomes for multidrug-resistant Gram-negative bacteremia in the NICU. Pediatrics. 2014;133(2):322–9. doi: 10.1542/peds.2013-1248 24420803.

49. Fanaroff AA, Martin RJ. Neonatal-perinatal medicine: diseases of the fetus and infant. 7th ed. St. Louis: Mosby; 2002.

50. Asadi-Lari M, Sayyari A, Akbari M, Gray D. Public health improvement in Iran—lessons from the last 20 years. Public health. 2004;118(6):395–402. doi: 10.1016/j.puhe.2004.05.011 15313592.

51. Danaei G, Farzadfar F, Kelishadi R, Rashidian A, Rouhani OM, Ahmadnia S, et al. Iran in transition. Lancet. 2019; 393(10184):1984–2005. doi: 10.1016/S0140-6736(18)33197-0 31043324.

52. Waters D, Jawad I, Ahmad A, Lukšić I, Nair H, Zgaga L, et al. Aetiology of community-acquired neonatal sepsis in low and middle income countries. J Glob Health. 2011;1(2):154–70. 23198116 PMCID: PMC3484773.

53. Li J-y, Chen S-q, Yan Y-y, Hu Y-y, Wei J, Wu Q-p, et al. Identification and antimicrobial resistance of pathogens in neonatal septicemia in China—A meta-analysis. Int J Infect Dis. 2018;71:89–93. doi: 10.1016/j.ijid.2018.04.794 29689386.


Článek vyšel v časopise

PLOS One


2020 Číslo 1
Nejčtenější tento týden
Nejčtenější v tomto čísle
Kurzy

Zvyšte si kvalifikaci online z pohodlí domova

Svět praktické medicíny 3/2024 (znalostní test z časopisu)
nový kurz

Kardiologické projevy hypereozinofilií
Autoři: prof. MUDr. Petr Němec, Ph.D.

Střevní příprava před kolonoskopií
Autoři: MUDr. Klára Kmochová, Ph.D.

Aktuální možnosti diagnostiky a léčby litiáz
Autoři: MUDr. Tomáš Ürge, PhD.

Závislosti moderní doby – digitální závislosti a hypnotika
Autoři: MUDr. Vladimír Kmoch

Všechny kurzy
Kurzy Podcasty Doporučená témata Časopisy
Přihlášení
Zapomenuté heslo

Zadejte e-mailovou adresu, se kterou jste vytvářel(a) účet, budou Vám na ni zaslány informace k nastavení nového hesla.

Přihlášení

Nemáte účet?  Registrujte se

#ADS_BOTTOM_SCRIPTS#