Bacterial Infections in Neonates, Madagascar, 2012–2014

• Main Authors: Bich-Tram Huynh, Elsa Kermorvant-Duchemin, Perlinot Herindrainy, Michael Padget, Feno Manitra Jacob Rakotoarimanana, Herisoa Feno, Elisoa Hariniaina-Ratsima, Tanjona Raheliarivao, Awa Ndir, Sophie Goyet, Patrice Piola, Frederique Randrianirina, Benoit Garin, Jean-Marc Collard, Didier Guillemot, Elisabeth Delarocque-Astagneau
• Format: Article
• Language: English
• Published: Centers for Disease Control and Prevention 2018-04-01
• Series: Emerging Infectious Diseases
• Subjects: bacterial infection; drug resistance; antimicrobial resistance; developing countries; low-income countries; infant
• Online Access: https://wwwnc.cdc.gov/eid/article/24/4/16-1977_article
• ISSN: 1080-6040; 1080-6059

Severe bacterial infections are a leading cause of death among neonates in low-income countries, which harbor several factors leading to emergence and spread of multidrug-resistant bacteria. Low-income countries should prioritize interventions to decrease neonatal infections; however, data are scarce, specifically from the community. To assess incidence, etiologies, and antimicrobial drug–resistance patterns of neonatal infections, during 2012–2014, we conducted a community-based prospective investigation of 981 newborns in rural and urban areas of Madagascar. The incidence of culture-confirmed severe neonatal infections was high: 17.7 cases/1,000 live births. Most (75%) occurred during the first week of life. The most common (81%) bacteria isolated were gram-negative. The incidence rate for multidrug-resistant neonatal infection was 7.7 cases/1,000 live births. In Madagascar, interventions to improve prevention, early diagnosis, and management of bacterial infections in neonates should be prioritized.