Status: Funded - Open
ESBL colonization in pregnant women in Gwagwalada, Federal Capital Territory, Nigeria
Kari Neemann, M.D.
BACKGROUND: The major cause of neonatal deaths in Nigeria are infections which amount to 34% of a neonatal mortality rate of 48/1000 live births. A 2013 pilot study from central Nigeria found that extended spectrum beta lactamases (ESBL) Enterobacteriaceae accounted for 50% of the etiological agents of neonatal sepsis, whereas group B streptococcus (GBS) sepsis was absent.
GAP: The rate of ESBL colonization among pregnant Nigerian women is unknown as is the significance of such colonization on subsequent infection in the newborn. When available, routine GBS screening has resulted in decreased early-onset GBS sepsis in developed countries. However, routine antenatal screening programs do not exist in many developing countries.
HYPOTHESIS: We hypothesize that maternal ano-vaginal carriage of ESBL Enterobacteriaceae promotes early onset neonatal sepsis in this population.
METHODS: We will perform a prospective, cross-sectional study on pregnant Nigerian women presenting to a community hospital in Gwagwalada, Nigeria, obtaining lower vaginal and rectal swabs of the mothers and surface cultures of the neonate at the time of delivery to determine the maternal ESBL Enterobacteriaceae colonization rate and subsequent vertical transmission rates to the infants. One month follow-up will allow us to determine the impact of ESBL carriage on early neonatal morbidity and mortality.
IMPACT: Documentation of maternal and neonatal ESBL carriage rates and impact on early-onset neonatal sepsis will enable the formulation of an antenatal screening program targeting appropriate intrapartum antimicrobial prophylaxis.
University of Nebraska Medical Center
United States, Nigeria