Healthcare Associated Neonatal Infections and Antimicrobial Resistance in Developing Countries

Anita K. M. Zaidi, of the Department of Pediatrics and Child Health, Aga Khan Univeristy, Karachi, Pakistan introduced the problem of hospital-acquired infections in developing countries (Figure 2.1).

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In developing countries more and more deliveries occur in hospitals. Unfortunately this is associated with a high, and increasing, incidence of neonatal infections (Figure 2.1). Hospital-acquired infections are frequent because of failures in the health care system (Figure 2.2).

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In order to obtain information on the nature of hospital-acquired infections in the developing world an extensive review of the world literature was performed (Figure 2.3).

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The incidence of neonatal infections in various countries is shown in Figure 2.4, while  an interpretation of those figures is shown in Figure 2.5.

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The types of bacteria responsible for neonatal infections are shown in Figure 2.6, emphasizing the wide variation that occurs and therefore the need for studies to determine the nature of bacterial infections in each community. Detailed data on the incidence of various types of infections is shown in Figure 2.7 and is summarized in Figure 2.8.

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Antimicrobial resistance is a major and alarming problem in developing countries. It appears to result from poor infection control, indiscriminate use of antibiotics and lack of microbiological laboratory facilities. The rate of antimicrobial resistance in developing countries is shown in Figure 2.9 and is briefly summarized in Figure 2.10.

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The causes of nosocomial neonatal infections in developing countries are many. They include failures in both peri-partum and post-natal care (Figure 2.11).

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The conclusions from this extensive literature review are summarized in Figures 2.12 and 2.13.

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