Epidemiology of clinically suspected and laboratory-confirmed bloodstream infections at a South African neonatal unit

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dc.contributor.authorDramowski, Angelaen_ZA
dc.contributor.authorBekker, Adrieen_Za
dc.contributor.authorCotton, Mark Fredericen_ZA
dc.contributor.authorWhitelaw, Andrew Christopheren_ZA
dc.contributor.authorCoffin, Susanen_ZA
dc.date.accessioned2023-03-20T07:46:21Zen_ZA
dc.date.available2023-03-20T07:46:21Zen_ZA
dc.date.issued2021-07en_ZA
dc.descriptionCITATION: Dramowski A, Bekker A, Cotton MF, Whitelaw AC, Coffin S (2021) Epidemiology of clinically suspected and laboratory-confirmed bloodstream infections at a South African neonatal unit. J Infect Dev Ctries 15:943–952. doi. 10.3855/jidc.13971en_ZA
dc.descriptionThe original publication is available at:jidc.orgen_ZA
dc.description.abstractIntroduction: Data from Africa reporting the epidemiology of infection in hospitalised neonates are limited. Methodology: A prospective study with convenience sampling was conducted to characterise neonates investigated with blood culture/s for suspected infection at a 132-bed neonatal unit in Cape Town, South Africa (1 February-31 October 2018). Enrolled neonates were classified as having proven bloodstream infection (BSI) (blood culture-positive with a pathogen) or presumed infection (clinically suspected but blood culture-negative) or as potentially at risk of infection (maternal risk factors at birth). Results: Of 1299 hospitalised neonates with >1 blood culture sampling episode, 712 (55%) were enrolled: 126 (17.7%) had proven BSI; 299 (42%) had presumed infection and 287 (40.3%) were potentially at risk of infection. Neonates with proven BSI had lower birth weight and higher rates of co-existing surgical conditions versus the presumed/potential infection groups (p < 0.001). Median onset of proven BSI versus presumed infection was at 8 (IQR = 5-13) and 1 (IQR = 0-5) days respectively (p < 0.001). Most proven BSI were healthcare-associated (114/126; 90.5%), with Klebsiella pneumoniae (80.6% extended-spectrum β-lactamase producers) and Staphylococcus aureus (66.7% methicillin-resistant) predominating. Mortality from proven BSI (34/126; 27%) was substantially higher than that observed in presumed (8/299; 2.7%) and potential infections (3/287; 1.0%) (p < 0.001). The odds of death from proven BSI was 3-fold higher for Gram-negatives than for Gram-positive/fungal pathogens (OR = 3.23; 95% CI = 1.17-8.92). Conclusions: Proven BSI episodes were predominantly healthcare-associated and associated with a high case fatality rate. Most neonates with presumed infection or at potential risk of infection had favourable 30-day outcomes.en_ZA
dc.description.versionPublisher’s versionen_ZA
dc.format.extent10 pagesen_ZA
dc.identifier.citationCITATION: Dramowski A, Bekker A, Cotton MF, Whitelaw AC, Coffin S (2021) Epidemiology of clinically suspected and laboratory-confirmed bloodstream infections at a South African neonatal unit. J Infect Dev Ctries 15:943–952. doi. 10.3855/jidc.13971en_ZA
dc.identifier.issn1972-2680 (online)en_ZA
dc.identifier.urihttp://hdl.handle.net/10019.1/126670en_ZA
dc.language.isoen_ZAen_ZA
dc.publisherJIDCen_ZA
dc.rights.holderAuthors retain copyrighten_ZA
dc.subjectNeonatal infections -- South Africaen_ZA
dc.subjectCommunicable diseases -- South Africaen_ZA
dc.subjectBacteraemia -- South Africaen_ZA
dc.subjectSepticemia -- South Africaen_ZA
dc.subjectAnti-infective agents -- South Africaen_ZA
dc.titleEpidemiology of clinically suspected and laboratory-confirmed bloodstream infections at a South African neonatal uniten_ZA
dc.typeArticleen_ZA
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