Significant improvements in child survival rates have contributed to the overall worldly gains in life expectancy during the past two decades. In 1990-2012 , the neonatal mortality decreased from 36 to 19 deaths per 1000 livebirths but it lagged behind the postneonatal under—5 years mortality.

In the August online issue of “The Lancet Global Health”, the editor discusses the reasons why almost half of the newborn mortality occurs around the time of birth, for which interventions must focus in this period. Neonatal sepsis or meningitis accounts for 421, 000 or 16% of the total tally.

In the Republic of India—where there has been a remarkable improvement of the equity and quality of primary health care facilities for the population at large in the past two decades—there are still 56,524 neonatal deaths per year due to resistance of the gram negative bacteria to first line antibiotics.

The Delhi Neonatal Infection Study (DeNIS) followed a cohort of 88,636 newborn infants treated in three large New Delhi hospitals for three years. The rate of improvement in the treatment of culture positive—neonatal sepsis was 9.5 per 1000 livebirths compared to 15.6 for the rest of India. Two thirds of he sepsis cases occurred within 72 hours of birth and the most common agents were Klebsiella spp, Acinetobacter spp and Escherichia coli.

The significant neonatal mortality in South Asia could also be related to the severity of the initial presentation and the treatment delay in rural areas. Paradoxically the increased availability of antibiotics in primary care centers and their indiscriminate use by medical practitioners to treat ailments could have sparked the surge of resistant organisms in closed-knit communities.

As there has been a concerted effort by international health organisations to move the birth process away from the inadequate home settings to the better equipped hospitals and clinics in low and middle income countries like India, the infection control services must get more economic and human resources.

What do you think? Please tell us.

Don’t leave me alone.

 

4 thoughts on “Antibiotic resistance in neonatal sepsis

  1. Bon jour, Mario. C’est vraiment choquant de savoir que tellement d’enfants meurent a cause du problemecde la resistance aux antibiotiques. Ici au Senegal nous avons une situation pareille a celle de l’Inde.”
    Merci!

    Liked by 1 person

    1. Bon soir mon cher ami. Oui, c’est vraiment une situation sanitaire catastrophique car les nourissons doivent payer avec leur vie les graves fautes des professionels de la sante et de leur parents. Merci beaucoup pour lire mon blog et a bientot mon cher correspondent a Dakar, la ville de Leopold Senghor.

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  2. For developing countries like India AMR is both a public health as well as a development challenge and there is a great need for international support for public financing, investment and policy space for implementation. A Lancet study published by Ramanan et al in early 2016 found that more than a million children worldwide die each year because of untreated infections like pneumonia and sepsis which was also highlighted in UNICEF 2012 report that less than one third of children with suspected pneumonia received antibiotics in developing countries.

    Coming to the practical aspects, poor patients may not have resources to pay for full prescription and just consume partial amounts that are cheaper and most of the times they buy the medicines over the counter as they cant afford doctor’s consultation fee and investigations. On the other hand you also have irrational prescriptions of antibiotics by many doctors and quacks in the rural communities adding to the burden of AMR impacting on the lives of newborns…
    There is a great need to improve awareness of AMR, strengthen surveillance, reduce incidence of infection by effective sanitation and optimize the use of antibiotics and increase investment for vaccines and other interventions

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    1. Dear Vijay: good evening, dear friend, and thank you very much for your comprehensive comment on the blog. Indeed there are many factors and actors preying on poor families’ needs for proper Primary Care services all over the globe. Sadly it is more burdensome for families andvindividuals of the Third World and I do believe that international organisations should be more active and vigilant. Thanks again for reading the blog and offering your impeccable opinion. Ciao!

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