title: Population-based incidence and etiology of community-acquired neonatal bacteremia in Mirzapur, Bangladesh: an observational study.
abstract: BACKGROUND
  To devise treatment strategies for neonatal infections, the population-level incidence and antibiotic susceptibility of pathogens must be defined.
  
  
  METHODS
  Surveillance for suspected neonatal sepsis was conducted in Mirzapur, Bangladesh, from February 2004 through November 2006. Community health workers assessed neonates on postnatal days 0, 2, 5, and 8 and referred sick neonates to a hospital, where blood was collected for culture from neonates with suspected sepsis. We estimated the incidence and pattern of community-acquired neonatal bacteremia and determined the antibiotic susceptibility profile of pathogens.
  
  
  RESULTS
  The incidence rate of community-acquired neonatal bacteremia was 3.0 per 1000 person-neonatal periods. Among the 30 pathogens identified, the most common was Staphylococcus aureus (n = 10); half of all isolates were gram positive. Nine were resistant to ampicillin and gentamicin or to ceftiaxone, and 13 were resistant to cotrimoxazole.
  
  
  CONCLUSIONS
  S. aureus was the most common pathogen to cause community-acquired neonatal bacteremia. Nearly 40% of infections were identified on days 0-3, emphasizing the need to address maternal and environmental sources of infection. The combination of parenteral procaine benzyl penicillin and an aminoglycoside is recommended for the first-line treatment of serious community-acquired neonatal infections in rural Bangladesh, which has a moderate level of neonatal mortality. Additional population-based data are needed to further guide national and global strategies.
authors: Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
authors: Gary L
authors: GL
authors: Darmstadt
authors: Samir K
authors: SK
authors: Saha
authors: Yoonjoung
authors: Y
authors: Choi
authors: Shams
authors: S
authors: El Arifeen
authors: Nawshad Uddin
authors: NU
authors: Ahmed
authors: Sanwarul
authors: S
authors: Bari
authors: Syed M
authors: SM
authors: Rahman
authors: Ishtiaq
authors: I
authors: Mannan
authors: Derrick
authors: D
authors: Crook
authors: Kaniz
authors: K
authors: Fatima
authors: Peter J
authors: PJ
authors: Winch
authors: Habibur Rahman
authors: HR
authors: Seraji
authors: Nazma
authors: N
authors: Begum
authors: Radwanur
authors: R
authors: Rahman
authors: Maksuda
authors: M
authors: Islam
authors: Anisur
authors: A
authors: Rahman
authors: Robert E
authors: RE
authors: Black
authors: Mathuram
authors: M
authors: Santosham
authors: Emma
authors: E
authors: Sacks
authors: Abdullah H
authors: AH
authors: Baqui
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D001419:Bacteria / Q000145:classification / Q000187:drug effects; D001459:Bangladesh / Q000453:epidemiology; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D024881:Drug Resistance, Bacterial; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents