Neonatal sepsis in a tertiary unit in South Africa

• DOI: 10.1186/s12879-021-05869-3
• Publication Date: 2021-02-27T08:02:26Z
• Authors: Dharshni Pillay; Lerusha Naidoo; Khine Swe Swe-Han; Yesholata Mahabeer
• Keywords: Neonatal Sepsis; Medical microbiology; Blood Culture; Acinetobacter baumannii

Abstract Background Antimicrobial resistance (AMR) has emerged as a global threat to healthcare resulting in an increase morbidity and mortality. Neonatal sepsis is ranked the third highest cause of neonatal demise globally, which AMR accounted for 31.0% deaths. neonates been poorly characterised Durban, South Africa. Thus, resultant effect on empiric regimens uncertain this setting. Therefore, study analysed aetiology antimicrobial susceptibility patterns bloodstream infections within intensive care unit at tertiary hospital with aim establishing effective regimen unit. Methods A retrospective data review positive blood cultures from Inkosi Albert Luthuli Central Hospital was conducted. Three time periods were analysed: 2014, 2016 2018. Culture aged 0–30 days included repeat de-duplicated. The frequency common organisms their susceptibilities analysed. Fischer’s exact test used subgroup analysis. Poisson logistic regressions assess significant trends over time. Results Late-onset (86.8%) predominated early-onset (13.2%). preponderance gram-positive (68.7%) gram-negatives (26.8%) fungi (4.5%) detected. Common pathogens coagulase-negative staphylococci (53.5%), Klebsiella pneumoniae (11.6%) , enterococci (9.3%), Acinetobacter baumannii (7.7%). Despite small contribution microbial profile, fluconazole-resistant Candida parapsilosis that group. High rates first- second-line antibiotics also noted among gram-negative organisms. Multidrug resistant extended-spectrum beta-lactamase (ESBL) K. (7.6%) extensively-drug A. (7.0%). However, statistically decrease ESBL-producing documented during entire period ( p = 0.005). Conclusions It determined first-line antimicrobials, advocated by World Health Organization treatment sepsis, proved ineffective due high levels AMR. advises meropenem or without vancomycin provides optimal cover. Amphotericin B antifungal therapy. Ongoing surveillance necessary.