Identifying Clinical, Obstetric, Parent, and Sociocultural Factors that Predict Antimicrobial Resistance of Neonatal Sepsis among Infants at a Specialty and General Hospital in Ethiopia’s Amhara Region Open Access
Mengesha, Melkam (Spring 2022)
Abstract
Approximately 200,000 cases of neonatal mortality due to sepsis per year are a result of antimicrobial resistance. Antimicrobial resistance (AMR) is a microorganism’s ability to survive despite the use of antimicrobial therapies. Antimicrobial resistance is worsening in sub-Saharan Africa as an escalation of resistance to second, third, and fourth-line therapies is being observed due to the widespread availability of antimicrobials in the region. Some scientists believe antimicrobial resistance could cause illnesses that were once easily treatable, such as strep throat, to become deadly. This issue is of public health importance because a lack of effective and affordable antimicrobial therapies for infections will increase morbidity and mortality that are preventable. The goal of this analysis is to identify the clinical, obstetric, parent, and sociocultural factors that could predict antimicrobial resistance among infants with neonatal sepsis. A dataset from a cohort study that took place at a Felege Hiwot Referral Hospital and Debre Tabor General Hospital in Ethiopia’s Amhara region was analyzed using a univariate and multivariable logistic regression. The AUC and Hoshmer-Lemsow test were used to measure the strength of the aforementioned factors in predicting antimicrobial resistance in a neonate at one of the two hospitals. The findings of this study suggest that among neonates with neonatal sepsis and for whom blood cultures were collected at the referral and the general hospital, parent factors and clinical factors listed in the tables, were most predictive of antimicrobial resistance. The age gap between parents, maternal literacy, and the number of antenatal care visits were significantly associated with antimicrobial resistance among neonates with neonatal sepsis. Given resource constraints in Ethiopia, physicians need mechanisms to identify the neonates who are at the highest risk of developing antimicrobial resistance. These findings are important in that, if replicated in larger datasets, they can inform clinical decision-making to provide those who develop neonatal sepsis with the safest and most effective treatment options.
Table of Contents
Table of Contents
Chapter 1: Introduction
Defining Neonatal Sepsis
Neonatal Sepsis Burden in Ethiopia
Relevant Pathogens
What is Antimicrobial Resistance?
What are the Implications of AMR?
Chapter 2: Methodology
Description of Study Hospitals
Study Subjects and Recruitment Strategy
Variables
Data Analysis
Chapter 3: Results and Discussion
Table 1: Descriptive Statistics by Presence and Absence of Antimicrobial Resistance
Table 2: Antimicrobial Resistance Prediction with Univariate Logistic Regression
Table 3: Antimicrobial Model Performance—All Variables by Category vs. Integrated Model and Optimized Models
Table 4: Predictors included in the Golden Model
Discussion
Strengths and Limitations of the Study
Conclusion
References
About this Master's Thesis
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Identifying Clinical, Obstetric, Parent, and Sociocultural Factors that Predict Antimicrobial Resistance of Neonatal Sepsis among Infants at a Specialty and General Hospital in Ethiopia’s Amhara Region () | 2022-04-20 16:19:29 -0400 |
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