Abstractobjective To evaluate safety and haematological effects of delayed cord clamping (DCC) in infants with expected low birthweight born in a resource-poor setting.methods Randomised controlled trial involving pregnant women in early labour ≥18 years with intrapartum symphysal-fundal height ≤32 cm. Mothers were randomised for either early cord clamping (ECC, <30 s) or DCC (2-3 min after birth).results We included 104 vigorous infants born by vaginal delivery, of whom 39% had a birthweight <2500 g. Infant haemoglobin (Hb) levels 24 h after birth were significantly higher in the DCC group (18.0 g/dl vs 16.8 g/dl, P = 0.006). Despite successful placental transfusion, hyperbilirubinemia and hyperviscosity were not observed. Two months after birth, there were no differences in Hb between groups (9.9 g/dl vs 9.8 g/dl, P = 0.60), but the infants in the DCC group had better weight gain from baseline than those with ECC (2.2 kg vs 1.9 kg, P = 0.058).conclusions In this South African cohort of newborns with a subnormal distribution of birthweight delayed cord clamping was a safe procedure. Two months after birth the effect of DCC on Hb was not detectable anymore. DCC should be promoted in every singleton delivery in a resource-poor setting irrespective of the birthweight.

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Introduction: Antimicrobial stewardship practices are crucial for the regular surveillance to change the antimicrobial policy. This study was conducted to decide the prevalence of common bacteria and their antibiogram regarding antimicrobial stewardship program within one year, at the regional and district, Stanger hospital in South Africa. Methodology: It was based the study on clinical data and laboratory records of the patients. It reviewed the clinical and laboratory data. The prevalence/proportion rate was calculated and correlated with the majority of microorganism vs empirical therapy. Results: The prevalence of MRSA, MRSE, VRSA, ESBL+ K. pneumoniae; E. coli cultured from the blood was 25%, 49%, 2%, 62% and 27% respectively. Similarly, we analysed for other targeted MDROs organisms (Acinetobacter species and P. aeruginosa, CRE, CPE) isolated from blood culture and endotracheal aspirate. The prevalence of MDR Acinetobacter species exceeded 61%, 33% from the blood and ETA respectively. The prevalence of MDR P. aeruginosa was 10% from ETA. The MRSA, MRSE, VRSA, VRE were observed in blood specimen. The majority of the microorganisms cultured from the CSF was Cryptococcus neoformans and followed by bacteria: Streptococcus pneumonia, Streptococcus group B and Haemorphilus influenza. Conclusion: The selection of empirical antimicrobial therapy relates not only the institutions or unit-specific antibiogram but also the site of infection. We can further suggest continuing to do surveillance of antibiogram and prevalence of MDR organisms for infection control as well as for empirical therapy, part of the antimicrobial  stewardship program based on yearly records to change the local hospital antibiotic policy.