途上国における病院内新生児感染症
Anita K M Zaidi1, W Charles Huskins, Durrane Thaver
1Department of Paediatrics and Child Health, Aga Khan University, Stadium Road, PO Box 3500, Karachi 74800, Pakistan. ianita.zaidi@aku.edu
Lancet (London, England)
|March 30, 2005
まとめ
新生児感染は,感染制御の不良のため,開発途上国において著しく高くなっています. 多くの一般的な病原菌は標準的な治療に耐性を持ち,改善された戦略の緊急の必要性を強調しています.
科学分野:
- グローバル・ヘルス グローバル・ヘルス
- 感染症 感染症は感染症です.
- 新生児のケアについて
背景:
- 発展途上国の病院で生まれた新生児は,感染症のリスクが高まります.
- 標準の低い産前および産後の感染制御の慣行が,この高リスクに寄与しています.
研究 の 目的:
- 新生児感染率,病原体,抗菌剤耐性,開発途上国における介入の見直しを行う.
- これらの感染症が新生児のアウトカムや医療システムに与える影響を評価する.
主な方法:
- 新生児感染に関する開発途上国からのデータの体系的なレビュー.
- 病原体の有病率,抗菌剤の感受性,および報告された感染制御介入の分析.
主要な成果:
- 新生児の感染率は,工業国よりも3~20倍高かった.
- 主要な病原体には,クレブシエラ肺炎,グラム陰性棒 (エシェリキア大腸菌,プセドモナス,アシネトバクテリア),および黄金球菌が含まれる.
- アンピシリンやジェンタミシンのような実証的な抗生物質療法は,限られた範囲 (約. 感染の70%),多くの症例は資源が限られた環境では治療できない可能性がある.
結論:
- 新生児感染症と抗菌剤耐性の高い割合は,開発途上国における新生児のアウトカムに重大な課題をもたらしています.
- 品質改善のアプローチを用いた低コストでバンドル化された介入は有望ですが,文脈特有の証拠が必要です.
- これらの地域における新生児の生存率と長期的な健康を改善するために,感染制御に取り組むことは極めて重要です.
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