Related Experiment Videos
Etiology of serious infections in young Gambian infants
E K Mulholland1, O O Ogunlesi, R A Adegbola
1Medical Research Council Laboratories, Banjul, The Gambia. mulhollande@who.int
Insights
Bacterial infections, particularly Staphylococcus aureus and Streptococcus pneumoniae, are leading causes of serious illness and death in young Gambian infants. Identifying these pathogens is crucial for improving neonatal mortality rates.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Neonatal mortality remains high in The Gambia despite overall improvements in infant survival.
- Infections are a primary cause of neonatal deaths in the region.
- This study aimed to identify the bacterial and viral causes of serious infections in infants.
Purpose of the Study:
- To determine the bacterial and viral etiology of serious infections in Gambian infants under 91 days old.
- To identify the most prevalent pathogens contributing to neonatal morbidity and mortality.
- To inform public health strategies for combating infant infections in The Gambia.
Main Methods:
- Infants presenting with symptoms suggestive of serious infection were enrolled at health facilities.
- Blood and cerebrospinal fluid cultures were performed to identify bacterial pathogens.
- Nasopharyngeal aspirates were analyzed for common respiratory viruses.
Main Results:
- Key bacterial pathogens identified include Staphylococcus aureus, Streptococcus pneumoniae, and Salmonella spp.
- Meningitis cases were primarily caused by Streptococcus pneumoniae.
- Respiratory syncytial virus and influenza A were the most common viral isolates, detected towards the end of the wet season.
Conclusions:
- Staphylococcus aureus, Streptococcus pneumoniae, and Salmonella spp. are the most significant causes of serious infections in young Gambian infants.
- Bacterial infections were associated with a higher mortality risk compared to viral infections.
- Findings highlight the need for targeted interventions against specific bacterial pathogens to reduce neonatal mortality.
Background:
Despite improvements in infant mortality rates in many developing countries including The Gambia, neonatal mortality remains high and many neonatal deaths are caused by infection. The study described in this paper was conducted to determine the bacterial and viral etiology of serious infections in Gambian infants younger than 91 days old.
Methods:
At a first level health facility 497 infants with symptoms that could indicate serious infection were enrolled, of whom 239 with 1 or more signs of serious infection and 55 with no signs were investigated, yielding 17 cases with positive bacterial cultures of blood and/or cerebrospinal fluid. At a nearby pediatric referral hospital 198 infants were seen and 182 were investigated, yielding 35 positive bacterial cultures.
Results:
There were 15 culture positive cases of meningitis caused by Streptococcus pneumoniae (7), Streptococcus pyogenes (2), Enterobacter cloacae (2), Escherichia coli (1), Haemophilus influenzae type b (1), Streptococcus agalactiae (1) and Salmonella spp. (1). Six of these children died. Thirty-three infants without meningitis had positive blood cultures for Staphylococcus aureus (17), S. pneumoniae (3), Salmonella spp. (5), E. coli (3), other enterobacteria (4) and S. agalactiae (1), of whom 14 died. Nasopharyngeal aspirates from 438 children were investigated for common respiratory viruses. Respiratory syncytial virus was found in 51, influenza A in 46, influenza B in 22, parainfluenza in 26 and adenovirus in 16. Respiratory syncytial virus and influenza A isolates were found most frequently toward the end of the wet season. Nasopharyngeal carriage of S. pneumoniae and H. influenzae was studied in 320 infants recruited during the first year. Of these 184 (58%) were positive for S. pneumoniae and 141 (44%) were positive for H. influenzae, 18 of which were type b. Infants with a bacterial isolate from blood or cerebrospinal fluid were more likely than the rest to die, whereas those with a viral isolate were less likely to die.
Conclusions:
The most important causes of serious infections in young Gambian infants are Staphylococcus aureus, S. pneumoniae and Salmonella spp.