Dataset Information

Carriage and Acquisition of Extended-spectrum ?-Lactamase-producing Enterobacterales Among Neonates Admitted to Hospital in Kilifi, Kenya.

ABSTRACT:

Background

Infections caused by extended-spectrum ?-lactamase-producing Enterobacterales (ESBL-E) among hospitalized neonates in sub-Saharan Africa pose significant clinical challenges. Data on prevalence and acquisition of ESBL-E carriage among hospitalized neonates in the region are few, and risk factors for transmission are not clearly defined.

Methods

In a cohort study of consecutive neonatal admissions to Kilifi County Hospital from July 2013 through August 2014, we estimated ESBL-E carriage prevalence on admission using rectal swab cultures and identified risk factors using logistic regression. Using twice-weekly follow-up swabs, we estimated the incidence and identified risk factors for ESBL-E acquisition in hospital using Poisson regression.

Results

The prevalence of ESBL-E carriage at admission was 10% (59/569). Cesarean delivery, older neonatal age, and smaller household size were significant risk factors. Of the 510 infants admitted without ESBL-E carriage, 238 (55%) acquired carriage during their hospital stay. The incidence of acquisition was 21.4% (95% confidence interval, 19.0%-24.0%) per day. The rate was positively associated with the number of known neonatal ESBL-E carriers and with the total number of neonates on the same ward.

Conclusions

Carriage of ESBL-E was common among neonates on admission, and in-hospital acquisition was rapid. The dissemination and selection of ESBL-E appears to be driven by hospital exposures, operative delivery, and neonatal ward patient density. Further attention to infection control, patient crowding, and carriage surveillance is warranted.

SUBMITTER: Kagia N

PROVIDER: S-EPMC6695508 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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Publications

Carriage and Acquisition of Extended-spectrum β-Lactamase-producing Enterobacterales Among Neonates Admitted to Hospital in Kilifi, Kenya.

Kagia Ngure N Kosgei Patrick P Ooko Michael M Wafula Leonard L Mturi Neema N Anampiu Kirimi K Mwarumba Salim S Njuguna Patricia P Seale Anna C AC Berkley James A JA Bottomley Christian C Scott J Anthony G JAG Morpeth Susan C SC

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 20190801 5

<h4>Background</h4>Infections caused by extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) among hospitalized neonates in sub-Saharan Africa pose significant clinical challenges. Data on prevalence and acquisition of ESBL-E carriage among hospitalized neonates in the region are few, and risk factors for transmission are not clearly defined.<h4>Methods</h4>In a cohort study of consecutive neonatal admissions to Kilifi County Hospital from July 2013 through August 2014, we estimated ...[more]

PMID: 30830952

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