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HIV Exposure and Neonatal Sepsis: A Descriptive Etiological Study
Patience Atuhaire1, Mary Kyohere1,2, Valerie Tusubira1
1Makerere University-Johns Hopkins University (MUJHU) Research Collaboration, Kampala, Uganda.
Open Forum Infectious Diseases
|March 12, 2025
Summary
Culture-confirmed sepsis is a concern in HIV-exposed infants in Uganda. Common bacteria show antibiotic resistance, and these infants have higher mortality rates, highlighting an urgent public health issue.
Area of Science:
- Pediatrics
- Infectious Diseases
- Global Health
Background:
- Limited data exists on culture-confirmed sepsis in HIV-exposed infants in low- and middle-income countries.
- HIV-exposed infants face a heightened risk of infectious diseases and associated morbidity.
- This study addresses the data gap by examining sepsis and antibiotic resistance in Ugandan infants.
Purpose of the Study:
- To describe the incidence of culture-confirmed sepsis among HIV-exposed infants.
- To identify common causative organisms and their antibiotic resistance patterns.
- To compare mortality rates between HIV-exposed and HIV-unexposed infants.
Main Methods:
- Prospective birth cohort study conducted at two Ugandan sites.
- Blood cultures and nasopharyngeal swabs were collected from infants under 3 months presenting with signs of infection.
- Part of the Progressing Group B Streptococcal Vaccines (PROGRESS) study.
Main Results:
- Of 460 blood cultures from HIV-exposed infants, 1.9% were positive for sepsis.
- Key pathogens included Escherichia coli, group B Streptococcus, and Streptococcus viridans.
- These organisms exhibited resistance to common antibiotics; mortality was higher in HIV-exposed infants (15.8% vs. 11.2%).
Conclusions:
- Antimicrobial resistance is a growing concern in this population.
- Further research is needed to understand persistent mortality in HIV-exposed infants.
- Interventions are crucial to reduce sepsis-related morbidity and mortality.
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