Journal Article

HIV Exposure and Neonatal Sepsis: A Descriptive Etiological Study

Nanyunja, Carol, Beach, Simon, Bentley, Stephen, Davies, Hannah G, Karampatsas, Konstantinos, Hookham, Lauren, Spiller, Owen B, Ssali, Agnes, Komugisha, Cleophas, Cowie, Katie, Nyamaizi, Agnes, Shelley, Dan R, Kipyeko, Sam, Kyohere, Mary, Mutabazi, Tobius, Owor, Maxensia, O’Hara, Geraldine, Matovu, Godfrey, Sendagala, Juliet Nsimire, Katungye, Richard, Doare, Kirsty Le, Le Doare, Kirsty, Peacock, Joseph, Djennad, Abdelmajid, Ravji, Pooja, Heath, Paul T, Duckworth, Ellie, Chalker, Vicki, Wamawobe, Amusa, Tusubira, Valerie, Najuka, Christine, Voysey, Merryn, Sewegaba, Margaret, Atuhaire, Patience, Portal, Edward A R, Karafillakis, Emilie, Azuba, Rose, Farley, Caitlin, Musooko, Moses, Old, Tim, Seeley, Janet, Parks, Rosalin, Namugumya, Ritah, Musoke, Philippa, Etti, Melanie, Sekikubo, Musa, Nakimuli, Annettee, Nalubega, Phiona, Cochet, Madeleine, Amone, Alexander

2024

Overview

Low- and middle-income countries lack data on culture-confirmed sepsis in HIV-exposed infants, despite the reported heightened risk of infectious morbidity. This study describes culture-confirmed sepsis and antibiotic resistance patterns among HIV-exposed children in a large etiological cohort study in Kampala, Uganda. This was a prospective birth cohort study based at 2 Ugandan sites, as part of the Progressing Group B Streptococcal Vaccines (PROGRESS) study. Any infant with risk factors, signs, or symptoms of infection presenting before 3 months of age had a blood culture and nasopharyngeal swab taken to determine the etiology of neonatal and young infant sepsis. Among 4492 blood cultures, 460 were obtained from HIV-exposed infants. Nine infants (1.9%) had positive blood cultures. The most frequently isolated organisms were , group B , and , and these organisms demonstrated resistance to the common antibiotics (aminoglycosides, penicillins, and cephalosporins) used for management of suspected sepsis. A higher proportion of the exposed babies died vs HIV-unexposed (15.8 vs 11.2; = .005). Nasopharyngeal swabs were collected from 114 infants, with 7.9% positive for at least one virus or bacterium. Future work is needed to investigate why mortality among HIV-exposed infants persists despite maternal antiretroviral treatment. Antimicrobial resistance is an increasing concern in this setting.

• Publisher: Oxford University Press
• Subject: Antibiotics / Cohort analysis / Sepsis / Supplement