ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2019
Carriage and Acquisition of Extended-spectrum β-Lactamase-producing Enterobacterales Among Neonates Admitted to Hospital in Kilifi, Kenya.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06590675 (Development and Evaluation of a ChlorHexidine Gluconate bAthing pRotocol for Healthcare Settings in Low- and Middle-income Countries), which is not on this map. Cited by 32 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Development and Evaluation of a ChlorHexidine Gluconate bAthing pRotocol for Healthcare Settings in Low- and Middle-income Countries
Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Neonatal Colonization With Antibiotic-Resistant Pathogens in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis.JAMA network open · 2024Pooled it
- Review and analysis of the overlapping threats of carbapenem and polymyxin resistant E. coli and Klebsiella in Africa.Antimicrobial resistance and infection control · 2023Pooled it
- Neonatal Unit Colonization Pressure and Acquisition of Extended-Spectrum β-Lactamase Gut Colonization.JAMA network open · 2026Article
- Delineating the risk factors, sources of acquisition and clinical outcomes in neonates colonised with multidrug-resistant bacteria: the NeoCol study.Nature communications · 2026Article
- High gastrointestinal carriage rates of extended-spectrum-β-lactamase-producing enterobacterales and associated factors among hospitalized and nonhospitalized children in Kenya.Scientific reports · 2026Article
- Molecular characterization of multidrug-resistantMicrobiology spectrum · 2025Article
- Perinatal colonization with extended-spectrum beta-lactamase-producing and carbapenem-resistant Gram-negative bacteria among home births in Bangladesh.medRxiv : the preprint server for health sciences · 2025Article
- Genomic relatedness of colonizing and invasive disease Klebsiella pneumoniae isolates in South African infants.Scientific reports · 2025Article
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- β-Lactamase and Macrolide Resistance Gene Carriage inOpen forum infectious diseases · 2024Article
- Phenotypic and molecular characterization of β-lactamase-producing Klebsiella species among children discharged from hospital in Western Kenya.BMC microbiology · 2024Article
- Carriage of third-generation cephalosporin-resistant and carbapenem-resistant Enterobacterales among children in sub-Saharan Africa: a systematic review and meta-analysis.EClinicalMedicine · 2024Article
- Faecal Carriage of Multidrug ResistantThe East African health research journal · 2024Article
- Whole strains vs MGEs in short and longterm transmission of ESBL genes between healthcare and community settings in Uganda.Scientific reports · 2023Article
- Molecular surveillance reveals widespread colonisation by carbapenemase and extended spectrum beta-lactamase producing organisms in neonatal units in Kenya and Nigeria.Antimicrobial resistance and infection control · 2023Article
- Antibiotic resistance genes in the gut microbiota of mothers and linked neonates with or without sepsis from low- and middle-income countries.Nature microbiology · 2022Article
- Antimicrobial resistance including Extended Spectrum Beta Lactamases (ESBL) among E. coli isolated from kenyan children at hospital discharge.PLoS neglected tropical diseases · 2022Article
- Keeping It Real: Antibiotic Use Problems and Stewardship Solutions in Low- and Middle-income Countries.The Pediatric infectious disease journal · 2022Article
- Genomic transmission analysis of multidrug-resistant Gram-negative bacteria within a newborn unit of a Kenyan tertiary hospital: A four-month prospective colonization study.Frontiers in cellular and infection microbiology · 2022Article
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
backgroundInfections caused by extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) among hospitalized neonates in sub-Saharan Africa pose significant clinical challenges. Data on prevalence and acquisition of ESBL-E carriage among hospitalized neonates in the region are few, and risk factors for transmission are not clearly defined.
methodsIn a cohort study of consecutive neonatal admissions to Kilifi County Hospital from July 2013 through August 2014, we estimated ESBL-E carriage prevalence on admission using rectal swab cultures and identified risk factors using logistic regression. Using twice-weekly follow-up swabs, we estimated the incidence and identified risk factors for ESBL-E acquisition in hospital using Poisson regression.
resultsThe prevalence of ESBL-E carriage at admission was 10% (59/569). Cesarean delivery, older neonatal age, and smaller household size were significant risk factors. Of the 510 infants admitted without ESBL-E carriage, 238 (55%) acquired carriage during their hospital stay. The incidence of acquisition was 21.4% (95% confidence interval, 19.0%-24.0%) per day. The rate was positively associated with the number of known neonatal ESBL-E carriers and with the total number of neonates on the same ward.
conclusionsCarriage of ESBL-E was common among neonates on admission, and in-hospital acquisition was rapid. The dissemination and selection of ESBL-E appears to be driven by hospital exposures, operative delivery, and neonatal ward patient density. Further attention to infection control, patient crowding, and carriage surveillance is warranted.
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