Laboratory-confirmed bloodstream infections in two large neonatal units in sub-Saharan Africa

Abstract

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Keeping It Real: Infection Prevention and Control Problems and Solutions in Low- and Middle-income Countries

“…Neonatal sepsis is one of the most common complications experienced by hospitalized neonates, with frequent outbreaks caused by Gram-negative pathogens such as Klebsiella pneumoniae . 9 , 10 Due to limited availability of hospitals capable of providing advanced care, premature or critically ill neonates are often sent to a regional or national referral centers for care because doctors at smaller hospitals lack experience in caring for preterm babies. This practice can tax the human and material resources of the referral center.…”

Nosocomial SARS-CoV-2 transmission in a neonatal unit in Botswana: chronic overcrowding meets a novel pathogen

“…Beyond SARS-CoV-2 transmission, overcrowding is a risk for transmission of other infections, including nosocomial sepsis, which is a major contributor to neonatal mortality in our setting. 16 As health systems across the world continue to redirect efforts to controlling COVID-19, tackling the problem of overcrowding is a high-yield effort which is cross-beneficial for both pandemic control and control of other endemic problems. While early pandemic response efforts in many LMICs were thwarted by shortages of personal protective equipment, reducing overcrowding in facilities has become an important tool of COVID-19 prevention and control in these settings.…”

“…Overcrowding in neonatal units in LMICs is a problem that predates and will likely outlast the COVID-19 pandemic. Beyond SARS-CoV-2 transmission, overcrowding is a risk for transmission of other infections, including nosocomial sepsis, which is a major contributor to neonatal mortality in our setting 16. As health systems across the world continue to redirect efforts to controlling COVID-19, tackling the problem of overcrowding is a high-yield effort which is cross-beneficial for both pandemic control and control of other endemic problems.…”

Characterizing the bioburden of ESBL-producing organisms in a neonatal unit using chromogenic culture media: a feasible and efficient environmental sampling method

“…In recent decades, infections due to multidrug resistant (MDR) enteric organisms have emerged as the leading causes of neonatal sepsis in sub-Saharan Africa and south Asia [ 1 – 3 ]. In Botswana, the most common causes of laboratory-confirmed bloodstream infection (BSI) among hospitalized neonates are Gram-negative bacteria, most commonly Klebsiella species [ 4 ]. Over 80% of neonatal bloodstream Klebsiella isolates in this setting are reported to be extended spectrum beta-lactamase producing 1 [ 4 ].…”

“…In Botswana, the most common causes of laboratory-confirmed bloodstream infection (BSI) among hospitalized neonates are Gram-negative bacteria, most commonly Klebsiella species [ 4 ]. Over 80% of neonatal bloodstream Klebsiella isolates in this setting are reported to be extended spectrum beta-lactamase producing 1 [ 4 ]. Carbapenem resistance is also emerging as a cause of neonatal sepsis in southern Africa [ 5 , 6 ].…”