Related Experiment Video
Updated: Aug 23, 2025
A Murine Model of Group B Streptococcus Vaginal Colonization
Published on: November 16, 2016
Risk factors for community-acquired bacterial infection among young infants in South Asia: a longitudinal cohort
Nicholas E Connor1,2, Mohammad Shahidul Islam3, Luke C Mullany4
1Department of Microbiology, Child Health Research Foundation, Dhaka, Bangladesh connorne@tcd.ie.
Insights
Low birth weight, male sex, breathing problems at birth, and premature rupture of membranes are key risk factors for serious bacterial infections in South Asian infants. Identifying these factors aids in prevention and antibiotic stewardship.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Community-acquired bacterial infections pose a significant threat to infants in South Asia.
- Risk factors predisposing young infants to these infections are not well understood in the region.
- Identifying these factors is crucial for developing effective preventive strategies and improving antibiotic stewardship.
Purpose of the Study:
- To identify and analyze risk factors associated with community-acquired bacterial infections in infants during the first two months of life in South Asia.
- To inform the development of targeted preventive measures and antimicrobial use guidelines.
Main Methods:
- A population-based study was conducted across five sites in Bangladesh, India, and Pakistan.
- Mother-child pairs were enrolled, and data on medical, sociodemographic, and epidemiological risk factors were collected.
- Infants with signs of possible serious bacterial infection (pSBI) and controls provided specimens for blood culture and real-time PCR analysis.
- A Bayesian partial latent class model (PLCM) was used to attribute probable causes of infection, and logistic regression analyzed risk factors.
Main Results:
- Among 14,655 assessed infants, 6022 had signs of pSBI.
- Significant risk factors for bacterial-attributed infections included low and very low birth weight, male sex, breathing problems at birth, premature rupture of membranes (PROM), and lower socioeconomic status.
- Relative risks (RR) were notably high for very low birth weight (RR 5.77) and breathing problems at birth (RR 2.50).
Conclusions:
- Birth weight, male sex, breathing difficulties at birth, and PROM are significant risk factors for bacterial sepsis in South Asian infants.
- These findings support the need for refined clinical assessment and targeted antimicrobial interventions in the region.
- Understanding these distinct risk factors can enhance the management of infant infections.
Objective:
Risk factors predisposing infants to community-acquired bacterial infections during the first 2 months of life are poorly understood in South Asia. Identifying risk factors for infection could lead to improved preventive measures and antibiotic stewardship.
Methods:
Five sites in Bangladesh, India and Pakistan enrolled mother-child pairs via population-based pregnancy surveillance by community health workers. Medical, sociodemographic and epidemiological risk factor data were collected. Young infants aged 0-59 days with signs of possible serious bacterial infection (pSBI) and age-matched controls provided blood and respiratory specimens that were analysed by blood culture and real-time PCR. These tests were used to build a Bayesian partial latent class model (PLCM) capable of attributing the probable cause of each infant's infection in the ANISA study. The collected risk factors from all mother-child pairs were classified and analysed against the PLCM using bivariate and stepwise logistic multivariable regression modelling to determine risk factors of probable bacterial infection.
Results:
Among 63 114 infants born, 14 655 were assessed and 6022 had signs of pSBI; of these, 81% (4859) provided blood samples for culture, 71% (4216) provided blood samples for quantitative PCR (qPCR) and 86% (5209) provided respiratory qPCR samples. Risk factors associated with bacterial-attributed infections included: low (relative risk (RR) 1.73, 95% credible interval (CrI) 1.42 to 2.11) and very low birth weight (RR 5.77, 95% CrI 3.73 to 8.94), male sex (RR 1.27, 95% CrI 1.07 to 1.52), breathing problems at birth (RR 2.50, 95% CrI 1.96 to 3.18), premature rupture of membranes (PROMs) (RR 1.27, 95% CrI 1.03 to 1.58) and being in the lowest three socioeconomic status quintiles (first RR 1.52, 95% CrI 1.07 to 2.16; second RR 1.41, 95% CrI 1.00 to 1.97; third RR 1.42, 95% CrI 1.01 to 1.99).
Conclusion:
Distinct risk factors: birth weight, male sex, breathing problems at birth and PROM were significantly associated with the development of bacterial sepsis across South Asian community settings, supporting refined clinical discernment and targeted use of antimicrobials.
Related Concept Videos
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:20Infection
The chain begins with pathogens: bacteria, viruses, fungi, prions, or parasites such as protozoa helminths. These can be present on the skin as transient or resident flora, or they can be acquired from the environment. Identifying and treating the type of infection and...
01:22Development of Immunocompetence
The initial cells that migrate from the fetal thymus settle within the skin and epithelial tissues lining the mouth, digestive tract, and in females, the uterus and vagina. These cells, including skin-based dendritic cells, serve as antigen-presenting cells, playing a key role in T cell activation.
Subsequent T...
01:26Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...