Gram-negative neonatal sepsis in low- and lower-middle-income countries and WHO empirical antibiotic recommendations: A systematic review and meta-analysis

Sophie C H Wen, Yukiko Ezure, Lauren Rolley, Geoff Spurling, Colleen L Lau, Saba Riaz, David L Paterson and Adam D Irwin

PLOS Medicine, 2021, vol. 18, issue 9, 1-20

Abstract: Background: Neonatal sepsis is a significant global health issue associated with marked regional disparities in mortality. Antimicrobial resistance (AMR) is a growing concern in Gram-negative organisms, which increasingly predominate in neonatal sepsis, and existing WHO empirical antibiotic recommendations may no longer be appropriate. Previous systematic reviews have been limited to specific low- and middle-income countries. We therefore completed a systematic review and meta-analysis of available data from all low- and lower-middle-income countries (LLMICs) since 2010, with a focus on regional differences in Gram-negative infections and AMR. Methods and findings: All studies published from 1 January 2010 to 21 April 2021 about microbiologically confirmed bloodstream infections or meningitis in neonates and AMR in LLMICs were assessed for eligibility. Small case series, studies with a small number of Gram-negative isolates (

Date: 2021
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pmed00:1003787

DOI: 10.1371/journal.pmed.1003787

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