In particular, neonates in LMICs have infection rates 3 to 20 times higher than those in high-income countries. More than half of neonatal deaths are associated with infections. In 2020, an estimated 2.4 million neonates died worldwide at an average global rate of 17 deaths per 1,000 live births ( ). However, neonatal mortality rates vary significantly across countries, with a substantial proportion of deaths occurring in LMICs. The Every Newborn Action Plan aims for countries to have ≤12 neonatal deaths per 1,000 livebirths by 2030 or ≤10 by 2035. Neonatal mortality is a major concern for public health, especially in low- and middle-income countries (LMICs) where optimized use of antimicrobial agents is problematic for many neonates. Matrix-assisted laser desorption ionization-time of flight mass spectrometry MBL, Low- and middle-income country MALDI-TOF MS, The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Ĭompeting interests: The authors have declared that no competing interests exist.Ĭarbapenem-resistant Enterobacterales CRKP,Ĭarbapenem-resistant K. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: All relevant data are within the manuscript and its Supporting Information files.įunding: The work was supported by a joint grant from the National Natural Science Foundation of China (81861138055 to ZZ) and the Medical Research Council (MR/S013660/1 to AM) and grants from West China Hospital of Sichuan University (ZYYC08006 and ZYGD22001 to ZZ). Received: JAccepted: ApPublished: June 20, 2023Ĭopyright: © 2023 Hu et al. (2023) Prevalence and clonal diversity of carbapenem-resistant Klebsiella pneumoniae causing neonatal infections: A systematic review of 128 articles across 30 countries. The main limitation of this study is the absence or scarcity of data from North America, South America, and Oceania.Ĭitation: Hu Y, Yang Y, Feng Y, Fang Q, Wang C, Zhao F, et al. ![]() The vast majority (75.3%) of the 1,592 neonatal CRKP strains available for analyzing carbapenemase have genes encoding metallo-β-lactamases and NDM (New Delhi metallo-β-lactamase) appeared to be the most common carbapenemase (64.3%). In particular, ST17 CRKP has been seen in neonates in 8 countries across 4 continents. We identified 146 sequence types (STs) for neonatal CRKP strains and found that ST17, ST11, and ST15 were the 3 most common lineages. We incorporated the 204 genomes with a literature review for understanding the species distribution, clonal diversity, and carbapenemase types. A total of 535 neonatal CRKP genomes were identified from GenBank including Sequence Read Archive, of which 204 were not linked to any publications. Based on 21 studies reporting patient outcomes, we found that the pooled mortality of neonatal CRKP infections was 22.9% (95% CI, 13.0% to 32.9%). We estimated that the pooled global prevalence of CRKP infections in hospitalized neonates was 0.3% (95% confidence interval, 0.2% to 0.3%). We found that bloodstream infection is the most common infection type in reported data. We included 128 studies, none of which were preprints, comprising 127,583 neonates in 30 countries including 21 low- and middle-income countries (LMICs) for analysis. We identified 8,558 articles and excluding those that did not meet inclusion criteria. ![]() We used narrative synthesis for pooling data with JMP statistical software. ![]() We included studies addressing the prevalence of CRKP infections and colonization in neonates but excluded studies lacking the numbers of neonates, the geographical location, or independent data on Klebsiella or CRKP isolates. We searched multiple databases (PubMed, Web of Science, Embase, Ovid MEDLINE, Cochrane, bioRxiv, and medRxiv) to identify studies that have reported data of neonatal CRKP infections up to June 30, 2022. We performed a systematic review of studies reporting population-based neonatal infections caused by CRKP in combination with a genome-based analysis of all publicly available CRKP genomes with neonatal origins.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |