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. 2025 Mar 10;11(Suppl 3):S187-S192.
doi: 10.1093/ofid/ofae642. eCollection 2024 Dec.

HIV Exposure and Neonatal Sepsis: A Descriptive Etiological Study

Patience Atuhaire  1 , Mary Kyohere  1   2 , Valerie Tusubira  1 , Hannah G Davies  2   3 , Philippa Musoke  1 , Musa Sekikubo  4 , Amusa Wamawobe  5 , Joseph Peacock  2 , Kirsty Le Doare  1   2   4 ; PROGRESS Study Author Group
Collaborators, Affiliations

HIV Exposure and Neonatal Sepsis: A Descriptive Etiological Study

Patience Atuhaire et al. Open Forum Infect Dis. .

Abstract

Background: Low- and middle-income countries lack data on culture-confirmed sepsis in HIV-exposed infants, despite the reported heightened risk of infectious morbidity. This study describes culture-confirmed sepsis and antibiotic resistance patterns among HIV-exposed children in a large etiological cohort study in Kampala, Uganda.

Methods: This was a prospective birth cohort study based at 2 Ugandan sites, as part of the Progressing Group B Streptococcal Vaccines (PROGRESS) study. Any infant with risk factors, signs, or symptoms of infection presenting before 3 months of age had a blood culture and nasopharyngeal swab taken to determine the etiology of neonatal and young infant sepsis.

Results: Among 4492 blood cultures, 460 were obtained from HIV-exposed infants. Nine infants (1.9%) had positive blood cultures. The most frequently isolated organisms were Escherichia coli, group B Streptococcus, and Streptococcus viridans, and these organisms demonstrated resistance to the common antibiotics (aminoglycosides, penicillins, and cephalosporins) used for management of suspected sepsis. A higher proportion of the exposed babies died vs HIV-unexposed (15.8 vs 11.2; P = .005). Nasopharyngeal swabs were collected from 114 infants, with 7.9% positive for at least one virus or bacterium.

Conclusions: Future work is needed to investigate why mortality among HIV-exposed infants persists despite maternal antiretroviral treatment. Antimicrobial resistance is an increasing concern in this setting.

Keywords: HIV exposure; antimicrobial resistance; neonatal infection; neonates; sepsis.

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Conflict of interest statement

Potential conflicts of interest. K.L.D. received research grants from Pfizer and MinervaX for research undertaken at the Institute for Infection and Immunity, St George's, University of London, for work that is unrelated to this manuscript. She has received no personal funds. All other authors report no potential conflicts.

Figures

Figure 1.
Figure 1.
Flowchart showing culture results for HIV-exposed and -unexposed infants.
See this image and copyright information in PMC

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