title: The microbial spectrum of neonatal sepsis in Uganda: recovery of culturable bacteria in mother-infant pairs.
abstract: Neonatal sepsis in the developing world is incompletely characterized. We seek to characterize the microbial spectrum involved in sepsis and determine the role of maternal transmission by comparing organisms that can be cultured from septic newborn infants and their mothers. From 80 consecutive mother-infant pairs meeting clinical criteria for neonatal sepsis, we collected infant blood and spinal fluid, and maternal blood and vaginal specimens. Identifiable bacteria were recovered from the blood in 32.5% of infants, and from 2.5% of cerebrospinal fluid cultures, for a total of 35% recoverable putative causative agents. Bacteria recovered from vaginal specimens were not concordant with those recovered from infants. Similarly there was no concordance of bacteria recovered from blood and cerebrospinal fluid. We conclude that relying on traditional bacterial culture techniques does not adequately delineate the role of maternal versus environmental sources of neonatal sepsis in this setting. More sensitive molecular approaches will be needed to properly characterize the maternal and environmental microbial community involved in neonatal sepsis in such developing countries.
authors.affiliation: Department of Pediatrics, Mbarara University of Science and Technology, Mbarara, Uganda.
authors.forename: Julius
authors.initials: J
authors.lastname: Kiwanuka
authors.forename: Joel
authors.initials: J
authors.lastname: Bazira
authors.forename: Juliet
authors.initials: J
authors.lastname: Mwanga
authors.forename: Dickson
authors.initials: D
authors.lastname: Tumusiime
authors.forename: Eunice
authors.initials: E
authors.lastname: Nyesigire
authors.forename: Nkangi
authors.initials: N
authors.lastname: Lwanga
authors.forename: Benjamin C
authors.initials: BC
authors.lastname: Warf
authors.forename: Vivek
authors.initials: V
authors.lastname: Kapur
authors.forename: Mary
authors.initials: M
authors.lastname: Poss
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Schiff
mesh_terms: D000328:Adult; D001419:Bacteria / Q000302:isolation & purification*; D015169:Colony Count, Microbial / Q000379:methods; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000097:blood / Q000134:cerebrospinal fluid / Q000453:epidemiology / Q000382:microbiology; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D018805:Sepsis / Q000097:blood / Q000134:cerebrospinal fluid / Q000453:epidemiology / Q000382:microbiology; D014454:Uganda