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SCIENTIFIC CHALLENGE

In contrast with "rich" countries where morbidity and economic cost are the most sensitive measures for evaluating the consequences of antibiotic resistanceAntibiotic resistance
Infections caused by antibiotic-resistant bacteria are increasing steadily worldwide in hospitals as well as in the community. These infections often have more severe outcomes than those caused by so called "sensitive" bacteria. As a consequence, they also require more expensive second-line treatments as well as a more careful and costly follow-up care for patients.
, it seems that in developing countriesDeveloping country
This term is generally used to describe a nation with a low level of material well-being. Since no single definition of the term developing country is recognized internationally, the levels of development may vary widely within so-called developing countries. Some developing countries have high average standards of living.

The World Bank classifies all low- and middle-income countries as developing but notes, "The use of the term is convenient; it is not intended to imply that all economies in the group are experiencing similar development or that other economies have reached a preferred or final stage of development. Classification by income does not necessarily reflect development status".
resistance may substantially increase mortality (Okeke IN et al, 2005, Lancet Infect Dis). Poor sanitary conditions, the absence of a water supply, and the significant number of immunosuppressed patients probably also contribute to the negative consequences of resistant infections (Bax RP, 1997, Clin Infect Dis).

Although infections associated with bacteria resistant to antibioticsAntibiotic resistance
Infections caused by antibiotic-resistant bacteria are increasing steadily worldwide in hospitals as well as in the community. These infections often have more severe outcomes than those caused by so called "sensitive" bacteria. As a consequence, they also require more expensive second-line treatments as well as a more careful and costly follow-up care for patients.
are an important factor in the health status of populations living in developing countriesDeveloping country
This term is generally used to describe a nation with a low level of material well-being. Since no single definition of the term developing country is recognized internationally, the levels of development may vary widely within so-called developing countries. Some developing countries have high average standards of living.

The World Bank classifies all low- and middle-income countries as developing but notes, "The use of the term is convenient; it is not intended to imply that all economies in the group are experiencing similar development or that other economies have reached a preferred or final stage of development. Classification by income does not necessarily reflect development status".
, no data allows a precise estimate of the contribution of resistance to morbidity and mortality in these countries, particularly among young children.



Without any data allowing a clear evaluation of the medical consequences of this threat, this public health issue will remain neglected.

In this project, we aim to measure the incidence of bacterial infections resistant to antibioticsAntibiotic resistance
Infections caused by antibiotic-resistant bacteria are increasing steadily worldwide in hospitals as well as in the community. These infections often have more severe outcomes than those caused by so called "sensitive" bacteria. As a consequence, they also require more expensive second-line treatments as well as a more careful and costly follow-up care for patients.
in children
living in low-income countriesLow-income countries
The World Bank is a vital source of financial and technical assistance to developing countriesDeveloping country
This term is generally used to describe a nation with a low level of material well-being. Since no single definition of the term developing country is recognized internationally, the levels of development may vary widely within so-called developing countries. Some developing countries have high average standards of living.

The World Bank classifies all low- and middle-income countries as developing but notes, "The use of the term is convenient; it is not intended to imply that all economies in the group are experiencing similar development or that other economies have reached a preferred or final stage of development. Classification by income does not necessarily reflect development status".
around the world. It is not a bank in the common sense. It is made up of two unique development institutions owned by 187 member countries: the International Bank for Reconstruction and Development (IBRD) and the International Development Association (IDA). Each institution plays a different but collaborative role in advancing the vision of inclusive and sustainable globalization. The IBRD aims to reduce poverty in middle-income and creditworthy poorer countries, while the IDA focuses on the world's poorest countries.

For operational and analytical purposes, the World Bank's main criterion for classifying economies is gross national income (GNI) per capita. Based on its annual GNI per capita, every economy is classified as low-income, middle income (lower and upper middle income) or high income.
during both the neonatal (< 30 days of life) and childhood periods (30 days to < 2 years).



This programme will also allow us to:

  • Determine the incidence of neonatal
    bacterial infections (sensitive or resistant
    to antibiotics);

  • Better characterize bacterial aetiology and
    severity of neonatal infections;

  • Study the transmission of multi-resistant
    bacteria either by vertical transmission
    (mother to child) or by horizontal transmission
    (from the environment/other people to child).

A detailed analysis of the clinical consequences of the observed resistant bacterial infections will also be performed in order to get a better appreciation of the extent of this phenomenon. This step is essential in order to inform health care decision makers and to determine the objectives of a policy to control bacterial resistance.