Speaker
Description
Background: Antimicrobial resistance and bacterial neonatal sepsis are major threats causing high morbidity and mortality among neonates in developing countries, especially Ethiopia. Due to limited data, this meta-analysis aims to assess the prevalence, antimicrobial resistance patterns, and risk factors of neonatal sepsis in Ethiopian neonates.
Methods: PRISMA was used to screen the identified studies. We searched various data bases including PubMed/MEDLINE, Cochrane Library, African Journals Online, Web of Science, and Google Scholar. The data were extracted in Microsoft Excel using a standardized data extraction format, and the analysis was carried out with STATA version 17. To detect heterogeneity across studies, the I2 and the Cochrane Q test statistics were computed. To determine the overall pooled prevalence, a random effect meta-analysis model was used and registered in PROSPERO CRD1133703.
Results: Of 8,688 retrieved articles, 20 studies containing 11,754 neonates with a total of 3,168 bacterial isolates (837 Gram-positive, 2,328 Gram-negative). The predominant bacteria identified were; K. pneumoniae (1,343), E. coli (854), S. aureus (356), other Klebsiella spp (234), CoNS (192), Acinetobacter species (172), GBS (164). The overall pooled prevalence of bacterial neonatal sepsis and MDR were 29.92% (25.79- 34,05) and 66.20 (55.43-76.97). The isolated bacteria were more resistance to penicillin groups, cephalosporin’s and aminoglycosides. The most important risk factors identified with their AoR and 95%CI; preterm birth 8.2(1.12-15.77), PROM 4.8 (3.17-12.77), history of UTIs at ANC 33.21(3.2-63.21) and low birth weight 13.73(4.4.8-3195) significantly associated with bacterial neonatal sepsis.
Conclusion: Bacterial neonatal sepsis has frighteningly increased by both gram-positive and Gram-negative bacteria. Death rates have escalated largely driven by MDR and AMR bacteria in Ethiopia. Premature rupture of membranes, history of urinary tract infection at antenatal care, low birth weight and preterm birth were significantly associated. Consolidation of AMR surveillance and reporting is essential to guide region-specific empirical antimicrobial use in neonates to decrease the burden of mortality.
