Microbial profile and antimicrobial susceptibility patterns of neonatal blood stream infections in Durban, South Africa.
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Date
2020
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Abstract
Objectives
Antimicrobial resistance (AMR) has emerged as a global threat to healthcare resulting in an
increase in morbidity and mortality. Neonatal sepsis is ranked as the third highest cause of
neonatal demise globally, in which AMR accounted for 31.0% of deaths. This study analysed
the aetiology and antimicrobial resistance patterns of bloodstream infections within the
neonatal intensive care unit (NICU) at a tertiary hospital in Durban, South Africa.
Methods
A retrospective data review was conducted on all positive blood cultures at three time periods:
2014, 2016 and 2018. The organisms and antimicrobial susceptibilities were analysed for
significant trends using Poisson and logistic regression.
Results
A preponderance of gram-positive organisms (68.7%) over gram-negatives (26.8%) and fungi
(4.5%) was detected. Common pathogens included coagulase-negative staphylococci (53.5%),
Klebsiella pneumoniae (11.6%), enterococci (9.3%), and Acinetobacter baumannii (7.7%).
Late-onset sepsis (86.8%) predominated over early-onset sepsis (13.2%). High rates of
resistance to first- and second-line antibiotics were noted among gram-positive and gramnegative
organisms. Multidrug resistant organisms included extended-spectrum betalactamase
(ESBL) K. pneumoniae (7.6%) and multi-drug resistant A. baumannii (7.0%). A
statistically significant decrease in ESBL-producing organisms was documented between 2014
and 2018 (p = 0.005).
Conclusion
High resistance rates were seen for first- and second-line antibiotics used for the treatment of
neonatal sepsis. Ongoing microbial surveillance is essential to tailor empiric antimicrobial
choices in individual units.
Description
Masters Degree. University of KwaZulu-Natal, Durban.