The golden hour of sepsis: An in-depth analysis of sepsis-related maternal mortality in middle-income country Suriname.
Lachmi R. Kodan,Lachmi R. Kodan,Kim J. C. Verschueren,H. H. H. Kanhai,H. H. H. Kanhai,Jos van Roosmalen,Jos van Roosmalen,Kitty W. M. Bloemenkamp,Marcus J. Rijken,Marcus J. Rijken +9 more
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TLDR
In Suriname, a middle-income country, maternal mortality could be reduced by improving early recognition and timely diagnosis of sepsis, vital signs monitoring and immediate antibiotic infusion (within the golden hour), according to the ‘golden hour’ principle of antibiotic therapy.Abstract:
Background Sepsis was the main cause of maternal mortality in Suriname, a middle-income country Objective of this study was to perform a qualitative analysis of the clinical and management aspects of sepsis-related maternal deaths with a focus on the ‘golden hour’ principle of antibiotic therapy Methods A nationwide reproductive age mortality survey was performed from 2010 to 2014 to identify and audit all maternal deaths in Suriname All sepsis-related deaths were reviewed by a local expert committee to assess socio-demographic characteristics, clinical aspects and substandard care Results Of all 65 maternal deaths in Suriname 29 (45%) were sepsis-related These women were mostly of low socio-economic class (n = 23, 82%), of Maroon ethnicity (n = 14, 48%) and most deaths occurred postpartum (n = 21, 72%) Underlying causes were pneumonia (n = 14, 48%), wound infections (n = 3, 10%) and endometritis (n = 3, 10%) Bacterial growth was detected in 10 (50%) of the 20 available blood cultures None of the women with sepsis as underlying cause of death received antibiotic treatment within the first hour, although most women fulfilled the diagnostic criteria of sepsis upon admission In 27 (93%) of the 29 women from which sufficient information was available, substandard care factors were identified: delay in monitoring in 16 (59%) women, in diagnosis in 17 (63%) and in treatment in 21 (78%) Conclusion In Suriname, a middle-income country, maternal mortality could be reduced by improving early recognition and timely diagnosis of sepsis, vital signs monitoring and immediate antibiotic infusion (within the golden hour)read more
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Frequency and management of maternal infection in health facilities in 52 countries (GLOSS): a 1-week inception cohort study
Mercedes Bonet,Vanessa Brizuela,Edgardo Abalos,Cristina Beatriz Cuesta,Adama Baguiya,Mónica Chamillard,Bukola Fawole,Marian Knight,Seni Kouanda,Pisake Lumbiganon,Ashraf Nabhan,Ruta Nadisauskiene,Abdulfetah Abdulkadir,Richard Mk Adanu,Mohammad Iqbal Aman,William Enrique Arriaga Romero,Bouchra Assarag,Kitty W. M. Bloemenkamp,Aigul Boobekova,Mihaela A. Budianu,Vicenç Cararach,Rigoberto Castro,Sylvia Cebekhulu,José Guilherme Cecatti,Lotte Berdiin Colmorn,Ala Curteanu,Serena Donati,Hla Mya Thway Einda,Yasser Salah El Deen,Faysal El Kak,Mohamed A. El-Sheikh,Maria F. Escobar-Vidarte,Marisa Mabel Espinoza,María Ester Estrada,Luis Gadama,Sourou Goufodji,Saima Hamid,Rosalinda Hernandez Munoz,Nazarea Herrera Maldonado,Kapila Jayaratne,Saule Kabylova,Alexandra Kristufkova,Vijay Kumar,David Lissauer,Wilson Mereci,Meile Minkauskiene,Philippe Marc Moreira,Stephen Peter Munjanja,Nafissa Bique Osman,Henri Gautier Ouedraogo,Aquilino M. Perez,Julia Pasquale,Lucian Puscasiu,Zahida Qureshi,Zenaida Dy Recidoro,Carolina C. Ribeiro-do-Valle,Dhammica Rowel,Hamadoun Sangho,Amir Babu Shrestha,Thitiporn Siriwachirachai,Pierre Marie Tebeu,Khaing Nwe Tin,Dinh Anh Tuan,Rathavy Tung,Griet Vandenberghe,Buyanjargal Yadamsuren,Dilrabo Yunusova,Nelly M. Zavaleta Pimentel,Bashir Noormal,Virginia Díaz,Charlotte Leroy,Kristien Roelens,M. Christian Urlyss Agossou,Christiane Tshabu Aguemon,Patricia Soledad Apaza Peralta,Víctor Conde Altamirano,Vincent Batiene,Kadari Cisse,Kannitha Cheang,Phirun Lam,Elie Simo,Emah Irene Yakana,Javier Carvajal,Paula Fernández,Jens Langhoff-Roos,Paola Vélez,Alaa Sultan,Alula M. Teklu,Dawit Worku,Philip Govule,Charles Noora Lwanga,María Guadalupe Flores Aceituno,Carolina Bustillo,Bredy Lara,Vanita Suri,Sonia Trikha,Irene Cetin,Carlo Personeni,Guldana Baimussanova,Balgyn Sagyndykova,George Gwako,Alfred Osoti,Raisa Asylbasheva,Damira Seksenbaeva,Saad Eddine Itani,Sabina Abou Malham,Diana Ramašauskaitė,Owen Chikhwaza,Eddie Malunga,Haoua Dembele,Fanta Eliane Zerbo,Filiberto Dávila Serapio,Juan I. Islas Castañeda,Tatiana Cauaus,Victor Petrov,Seded Khishgee,Bat Erdene Lkhagvasuren,Amina Essolbi,Rachid Moulki,Zara Jaze,Arlete Mariano,Thae Maung Maung,Tara Gurung,Sangeeta Shrestha,Marcus J. Rijken,Thomas van den Akker,María Esther Estrada,Néstor J. Pavón Gómez,Adesina Oa,Chris Aimakhu,Rizwana Chaudhri,M. Adnan Khan,María del Pilar Huatuco Hernández,Maria Lu Andal,Carolina Paula Martin,Léopold Diouf,Dembo Guirassy,Miroslav Borovsky,Ladislav Kovac,Laura Cornelissen,Priya Soma-Pillay,Marta López,María José Vidal Benedé,Hemali Jayakody,Wisal Nabag,Sara Omer,Victoria Tsoy,Urunbish Uzakova,Thumwadee Tangsiriwatthana,Catherine Dunlop,Jhon Roman,Gerardo Vitureira,Luong Ngoc Truong,Nghiem Thi Xuan Hanh,Mugove Gerald Madziyire,Thulani Magwali,Linda Bartlett,Fernando Bellissimo-Rodrigues,Shevin T. Jacob,Sadia Shakoor,Khalid Yunis,Liana Campodonico,Hugo Gamerro,Daniel Giordano,Fernando Althabe,A Metin Gülmezoglu,João Paulo Souza +166 more
TL;DR: The results suggest that contribution of direct and indirect infections to overall maternal deaths is greater than previously thought and improvement of early identification is urgently needed, as well as prompt management of women with infections in health facilities by implementing effective evidence-based practices.
Journal ArticleDOI
Clinical pharmacokinetics of 3-h extended infusion of meropenem in adult patients with severe sepsis and septic shock: implications for empirical therapy against Gram-negative bacteria
Amol T Kothekar,Jigeeshu V Divatia,Sheila Nainan Myatra,Anand Patil,Manjunath Nookala Krishnamurthy,Harish Mallapura Maheshwarappa,Suhail Sarwar Siddiqui,Murari Gurjar,Sanjay Biswas,Vikram Gota +9 more
TL;DR: This data indicates that in patients with severe sepsis or septic shock, EI of 1000 mg of meropenem over 3 h administered Q8H is inadequate to provide activity (fT’s 4 µg/mL > 40) against strains susceptible to increased exposure, which requires a bolus dose of 500 mg followed by 3-h E I of 1500 mgQ8H to achieve this target.
Journal ArticleDOI
Rapid Point-of-Care Genotyping to Avoid Aminoglycoside-Induced Ototoxicity in Neonatal Intensive Care
John H. McDermott,Ajit Mahaveer,R. J. A. James,Nicola Booth,Mark A. Turner,Karen Harvey,Gino Miele,Glenda M. Beaman,Duncan Stoddard,K. J. Tricker,Rachel J Corry,Julia Garlick,Shaun Ainsworth,Thomas Beevers,Iain A. Bruce,Richard Body,Fiona Ulph,Rhona MacLeod,Peter L Roberts,Paul M Wilson,William G. Newman +20 more
TL;DR: This pragmatic prospective implementation trial uses a rapid genotyping platform for the m.1555A>G variant to assess whether this technology could be implemented to avoid aminoglycoside-induced ototoxicity without disrupting normal clinical practice on neonatal intensive care units.
Journal ArticleDOI
Bottom-up development of national obstetric guidelines in middle-income country Suriname
Kim J. C. Verschueren,Lachmi R. Kodan,Lachmi R. Kodan,Tom K Brinkman,Raëz R. Paidin,Sheran S Henar,Humphrey H.H. Kanhai,Humphrey H.H. Kanhai,Joyce L. Browne,Marcus J. Rijken,Marcus J. Rijken,Kitty W. M. Bloemenkamp +11 more
TL;DR: Development of national context-tailored guidelines is achievable in a middle-income country when using a ‘bottom-up’ approach that involves all obstetric health care providers and stakeholders in the earliest phase.
Journal ArticleDOI
Childbirth outcomes and ethnic disparities in Suriname: a nationwide registry-based study in a middle-income country
Kim J. C. Verschueren,Zita D. Prüst,Raëz R. Paidin,Lachmi R. Kodan,Kitty W. M. Bloemenkamp,Marcus J. Rijken,Joyce L. Browne +6 more
TL;DR: Disaggregated perinatal health data in Suriname shows substantial inequities in outcomes by ethnicity which need to be targetted by health professionals, researchers and policy makers.
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Lale Say,Doris Chou,Alison Gemmill,Alison Gemmill,Özge Tunçalp,Ann Beth Moller,Jane P Daniels,A Metin Gülmezoglu,Marleen Temmerman,Leontine Alkema +9 more
TL;DR: Between 2003 and 2009, haemorrhage, hypertensive disorders, and sepsis were responsible for more than half of maternal deaths worldwide, and more than a quarter of deaths were attributable to indirect causes.
Journal ArticleDOI
Too far to walk : maternal mortality in context
Sereen Thaddeus,Deborah Maine +1 more
TL;DR: Findings from a broad body of research on the factors that delay the decision to seek care are presented and examples of efforts to reduce maternal deaths are presented, with an emphasis on strategies to mobilize and adapt existing resources.