ArticlePloS one2018
Acquisition of extended spectrum beta-lactamase-producing enterobacteriaceae in neonates: A community based cohort in Madagascar.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.
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Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it, 54 citations in OpenAlex.
- Neonatal Colonization With Antibiotic-Resistant Pathogens in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis.JAMA network open · 2024Pooled it
- Gut mucosal colonisation with extended-spectrum beta-lactamase producing Enterobacteriaceae in sub-Saharan Africa: a systematic review and meta-analysis.Wellcome open research · 2019Pooled it
- Colonization of selected antibiotic-resistant bacteria among pregnant women: a cross-sectional study at a tertiary care hospital in the Eastern Province of Sri Lanka.BMC microbiology · 2026Article
- Contribution of maternal gut carriage to neonatal acquisition of extended-spectrum beta-lactamase-producing Enterobacterales in Madagascar and Cambodia.Nature communications · 2025Article
- Pathogen aetiology and risk factors for death among neonates with bloodstream infections at lower-tier South African hospitals: a cross-sectional study.The Lancet. Microbe · 2025Article
- Clinical and Antibiotic Resistance Features for Extended-Spectrum Betalactamase-ProducingInfection and drug resistance · 2025Article
- Carriage of third-generation cephalosporin-resistant and carbapenem-resistant Enterobacterales among children in sub-Saharan Africa: a systematic review and meta-analysis.EClinicalMedicine · 2024Article
- Antimicrobial Resistance Patterns in Patients with Vaginal Discharge: A 2019-2022 Analysis at the National Health Laboratory in Eritrea.BioMed research international · 2024Article
- Extended-spectrum beta-lactamase-producing Enterobacterales in human health: Experience from the tricycle project, Ghana.PloS one · 2024Article
- Multidrug-Resistant Bacterial Infections Among Very Low Birthweight Infants With Late-Onset Sepsis in Johannesburg, South Africa.Open forum infectious diseases · 2023Article
- Acquisition and carriage of genetically diverse multi-drug resistant gram-negative bacilli in hospitalised newborns in The Gambia.Communications medicine · 2023Article
- Article
- Prevalence and factors associated with faecal carriage of extended-spectrum β-lactamase-producing Enterobacterales among peripartum women in the community in Cambodia.The Journal of antimicrobial chemotherapy · 2022Article
- Article
- Comparison of the global prevalence and trend of human intestinal carriage of ESBL-producingJAC-antimicrobial resistance · 2022Review
- Neonatal sepsis and mortality in low-income and middle-income countries from a facility-based birth cohort: an international multisite prospective observational study.The Lancet. Global health · 2022Observational
- Vertical Transmission of Extended-Spectrum, Beta-Lactamase-ProducingMicroorganisms · 2021Article
- Vaginal colonization with antimicrobial-resistant bacteria among women in labor in central Uganda: prevalence and associated factors.Antimicrobial resistance and infection control · 2021Article
- Neonatal Sepsis: The Impact of Carbapenem-Resistant and HypervirulentFrontiers in medicine · 2021Review
- Prevalence, Risk Factors, and Genetic Characterization of Extended-Spectrum Beta-LactamaseFrontiers in microbiology · 2021Article
Corrections and comments
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Authors and funding
15 authors at 5 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
In low and middle income countries (LMICs), where the burden of neonatal sepsis is the highest, the spread of extended spectrum beta-lactamase-producing enterobacteriaceae (ESBL-PE) in the community, potentially contributing to the neonatal mortality, is a public health concern. Data regarding the acquisition of ESBL-PE during the neonatal period are scarce. The routes of transmission are not well defined and particularly the possible key role played by pregnant women. This study aimed to understand the neonatal acquisition of ESBL-PE in the community in Madagascar. The study was conducted in urban and semi-rural areas. Newborns were included at birth and followed-up during their first month of life. Maternal stool samples at delivery and six stool samples in each infant were collected to screen for ESBL-PE. A Cox proportional hazards model was performed to identify factors associated with the first ESBL-PE acquisition. The incidence rate of ESBL-PE acquisition was 10.4 cases/1000 newborn-days [95% CI: 8.0-13.4 cases per 1000 newborn-days]. Of the 83 ESBL-PE isolates identified, Escherichia coli was the most frequent species (n = 28, 34.1%), followed by Klebsiella pneumoniae (n = 20, 24.4%). Cox multivariate analysis showed that independent risk factors for ESBL-PE acquisition were low birth weight (adjusted Hazard-ratio (aHR) = 2.7, 95% CI [1.2; 5.9]), cesarean-section, (aHR = 3.4, 95% CI [1.7; 7.1]) and maternal use of antibiotics at delivery (aHR = 2.2, 95% CI [1.1; 4.5]). Our results confirm that mothers play a significant role in the neonatal acquisition of ESBL-PE. In LMICs, public health interventions during pregnancy should be reinforced to avoid unnecessary caesarean section, unnecessary antibiotic use at delivery and low birth weight newborns.
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