title: Neonatal bloodstream infections in a pediatric hospital in Vietnam: a cohort study.
abstract: Septicemia and bloodstream infections (BSIs) are major causes of neonatal morbidity and mortality in developing countries. We prospectively recorded all positive blood cultures (BSI) among neonates admitted consecutively to a tertiary pediatric hospital in Vietnam during a 12-month period. Among 5763 neonates, 2202 blood cultures were performed, of which 399 were positive in 385 neonates. Among these, 64 died, 62 in relation to septicemia. Of the BSI isolates, 56% was known pathogenic and 48% was gram-negative bacteria, most frequently Klebsiella spp. (n = 78), Acinetobacter spp. (n = 58) and Escherichia coli (n = 21). Only three Streptococcus spp. were identified, none group B. Resistance against antibiotics applied was common. The mortality was highest in neonates with gram-negative BSI compared with no confirmed BSI and gram-positive BSI (P < 0.01). In this setting, the majority of BSI were likely to have been transmitted from the environment. Improvement of hygienic precautions and systematic BSI surveillance are recommended.
authors.affiliation: International Child Health Research Unit, JMC, Rigshospitalet - Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Alexandra Yasmin
authors.initials: AY
authors.lastname: Kruse
authors.forename: Do Huu
authors.initials: do H
authors.lastname: Thieu Chuong
authors.forename: Cam Ngoc
authors.initials: CN
authors.lastname: Phuong
authors.forename: Than
authors.initials: T
authors.lastname: Duc
authors.forename: Lone
authors.initials: L
authors.lastname: Graff Stensballe
authors.forename: Jorgen
authors.initials: J
authors.lastname: Prag
authors.forename: Jorgen
authors.initials: J
authors.lastname: Kurtzhals
authors.forename: Gorm
authors.initials: G
authors.lastname: Greisen
authors.forename: Freddy Karup
authors.initials: FK
authors.lastname: Pedersen
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000209:etiology / Q000382:microbiology* / Q000401:mortality; D002648:Child; D024881:Drug Resistance, Bacterial; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification*; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology; D006094:Gram-Positive Bacteria / Q000302:isolation & purification*; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology; D006776:Hospitals, Pediatric; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D008826:Microbial Sensitivity Tests; D011446:Prospective Studies; D018805:Sepsis / Q000188:drug therapy / Q000382:microbiology* / Q000401:mortality; D012720:Severity of Illness Index; D017678:Sex Distribution; D016019:Survival Analysis; D014744:Vietnam / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents
keywords: Vietnam; bloodstream infections; developing country; mortality; neonate; septicemia