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Bloodstream Infections at Two Neonatal Intensive Care Units in Ghana
Bloodstream Infections at Two Neonatal Intensive Care Units in Ghana
- Source :
- Pediatric Infectious Disease Journal. 40:1115-1121
- Publication Year :
- 2021
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2021.
-
Abstract
- Background Bloodstream infections (BSIs) are a major cause of morbidity and mortality in hospitalized neonates. Data on antibiotic resistance in neonatal BSIs and their impact on clinical outcomes in Africa are limited. Methods We conducted a prospective cohort study at 2 tertiary level neonatal intensive care units (NICUs) in Ghana. All neonates admitted to the NICUs were included from October 2017 to September 2019. We monitored BSI rates and analyzed the effect of BSI and antibiotic resistance on mortality and duration of hospitalization. Results Out of 5433 neonates included, 3514 had at least one blood culture performed and 355 had growth of a total of 368 pathogenic microorganisms. Overall incidence of BSI was 1.0 (0.9-1.1) per 100 person days. The predominant organisms were Klebsiella pneumoniae 49.7% (183/368) and Streptococcus spp. 10.6% (39/368). In addition, 512 coagulase negative Staphylococci were isolated but considered probable contaminants. Among K. pneumoniae, resistance to gentamicin and amikacin was 91.8% and 16.4%, respectively, while carbapenem resistance was 4.4%. All-cause mortality among enrolled neonates was 19.7% (1066/5416). The mortality rate was significantly higher in neonates with BSI compared with culture-negative neonates in univariate analysis (27.9%, n = 99/355 vs. 16.5%, n = 520/3148; hazard ratio 1.4, 95% confidence interval 1.07-1.70) but not in multivariate analysis. Conclusion The diversity of etiological agents and the high risk of antibiotic resistance suggest that standard empirical treatment is unlikely to improve the outcome of BSIs in low and middle income. Such improvements will depend on access to reliable clinical microbiologic services.
- Subjects :
- Male
Microbiology (medical)
medicine.medical_specialty
Ghana
Antibiotic resistance
Enterobacteriaceae
Drug Resistance, Multiple, Bacterial
Intensive Care Units, Neonatal
Sepsis
Internal medicine
Intensive care
medicine
Humans
Blood culture
Prospective Studies
Cross Infection
medicine.diagnostic_test
business.industry
Incidence
Incidence (epidemiology)
Mortality rate
Hazard ratio
Enterobacteriaceae Infections
Infant, Newborn
Anti-Bacterial Agents
Infectious Diseases
Amikacin
Pediatrics, Perinatology and Child Health
Female
Gentamicin
business
medicine.drug
Subjects
Details
- ISSN :
- 08913668
- Volume :
- 40
- Database :
- OpenAIRE
- Journal :
- Pediatric Infectious Disease Journal
- Accession number :
- edsair.doi.dedup.....98ef4abd682eb1f3f8428eb416ffa1f5
- Full Text :
- https://doi.org/10.1097/inf.0000000000003284