Original Research

Bacteraemia and antibiotic sensitivity in a tertiary neonatal intensive care unit

Hamida van Staaden, Candice Hendricks, Kevin Spicer
Southern African Journal of Infectious Diseases | Vol 36, No 1 | a195 | DOI: https://doi.org/10.4102/sajid.v36i1.195 | © 2021 Hamida van Staaden, Candice Hendricks, Kevin Spicer | This work is licensed under CC Attribution 4.0
Submitted: 05 March 2020 | Published: 05 January 2021

About the author(s)

Hamida van Staaden, Department of Paediatrics and Child Health, Nelson R. Mandela School of Medicine, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
Candice Hendricks, Department of Paediatrics and Child Health, Nelson R. Mandela School of Medicine, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
Kevin Spicer, Department of Paediatrics, Pietermaritzburg Metropolitan Hospitals Complex, KwaZulu-Natal Department of Health, Pietermaritzburg, South Africa


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Abstract

Background: Neonatal sepsis is an important cause of mortality and morbidity in neonatal intensive care populations worldwide. Data on rates of bacteraemia and antibiotic resistance patterns are limited, particularly in the developing world.

Methods: We retrospectively reviewed positive blood cultures obtained in the neonatal intensive care unit between 01 January 2015 and 31 December 2015. All neonates, either born at the tertiary hospital or transferred from referral units, regardless of diagnosis, who had a positive blood culture were included.

Results: There were 702 admissions during the study period and 437 positive cultures. Male patients made up 55.1% (65/118), and the gender was unknown for 11.0% (13/118). Late onset sepsis accounted for 85.7% (102/119) and early onset sepsis, 14.3% (17/119). Of the 119 organisms cultured, 76 (63.8%) were Gram-negative, 35 (29.4%) were Gram-positive and 8 (6.7%) were Candida species. Klebsiella was the most common genus at 42% (50/119). Of the clinically relevant organisms recovered, 37.0% (44/119) were susceptible to the empiric first-line regimen of penicillin and gentamycin. Furthermore, 69.7% (53/76) of the Gram-negative organisms produced extended-spectrum beta-lactamases.

Conclusion: The majority of organisms cultured were considered contaminants and were not clinically relevant. Improvements in culture collection processes are needed. The majority of organisms considered clinically relevant were resistant to the first-line antibiotic regimen. To improve the likelihood of clinical success, empiric antibiotic regimens should be based on local data, if possible.


Keywords

neonatal sepsis; positive blood cultures; antimicrobial resistance; antibiotic resistance; culture collection processes.

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