Related Experiment Video
Updated: May 14, 2025
23:56
Comprehensive & Cost Effective Laboratory Monitoring of HIV/AIDS: an African Role Model
Published on: October 31, 2010
16.7K
Development of a Bloodstream Infection Surveillance Programme at a Resource-Limited South African Neonatal Unit.
Frances Ashton1, Adrie Bekker1, Magdalena Aucamp2
1Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 7500, South Africa.
Antibiotics (Basel, Switzerland)
|April 29, 2025
Summary
Limited data exists on African neonatal bloodstream infections (BSIs). This study found declining antibiotic coverage for early-onset BSIs and high mortality, emphasizing the need for updated treatment guidelines.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Public Health Surveillance
Background:
- Limited data on bloodstream infections (BSIs) in African neonatal units.
- Tygerberg Hospital, Cape Town, South Africa, serves a 132-bed neonatal service.
Purpose of the Study:
- To conduct prospective surveillance of neonatal BSIs.
- To describe patient demographics, BSI rates, pathogen profiles, and antibiotic concordance.
- To identify factors influencing BSI-related mortality.
Main Methods:
- Prospective clinical and laboratory surveillance of BSIs from 2017-2021.
- Analysis of patient demographics, BSI incidence, causative pathogens, and empiric antibiotic use.
- Retrospective review of mortality and its attribution to BSIs.
Main Results:
- 842 BSI episodes in 740 neonates, predominantly preterm and low birth weight.
- Early-onset BSI rate: 2.9/1000 live births; predominant pathogens: S. agalactiae, K. pneumoniae, E. coli.
- Healthcare-associated BSI rate: 3.4/1000 in-patient days; predominant pathogens: K. pneumoniae, S. aureus, S. marcescens.
- Declining empiric antibiotic coverage for early-onset BSIs (ampicillin/gentamicin).
- Improving antibiotic coverage for healthcare-associated BSIs.
- Nearly one-third of BSIs were fatal (29.0%), with Gram-negative BSIs and discordant therapy increasing mortality risk.
Conclusions:
- Gram-negative pathogens are significant causes of neonatal BSIs in this resource-limited setting.
- Declining antibiotic coverage for early-onset BSIs necessitates guideline revision.
- Minimizing discordant empiric antibiotic therapy is crucial to reduce neonatal BSI mortality.
