Table of Contents
ISRN Pediatrics
Volume 2012 (2012), Article ID 508512, 6 pages
http://dx.doi.org/10.5402/2012/508512
Research Article

Bacterial Bloodstream Infections in Neonates in a Developing Country

1Department of Paediatrics and Child Health, University of the Witwatersrand, PO Wits, Johannesburg 2050, South Africa
2Department of Clinical Microbiology and Infectious Diseases, National Health Laboratory Services, P.O. Box 1038, Johannesburg 2000, South Africa

Received 3 May 2012; Accepted 19 June 2012

Academic Editors: C. D. Berkowitz and B. Vasarhelyi

Copyright © 2012 Daynia E. Ballot et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Ongoing surveillance of antimicrobial sensitivity patterns of bacteria isolated in bloodstream infections guides empiric antibiotic therapy in neonatal sepsis. Methods. Sensitivity profiles of neonatal bacterial bloodstream infections in a tertiary hospital were reviewed between 01/06/2009 and 30/06/2010 . Results. There were 246 episodes of bloodstream infection in 181 individuals—(14.06 episodes in10.35 patients/1000 patient days or 14.4 episodes in 10.6 babies/1000 live births. The majority were (93.5%) were late onset and most (54.9%) were gram positive. There were 2.28 sepsis-related deaths /1000 patient days or 2.3/1000 live births. Death was significantly associated with gram-negative infections ( 𝑃 < 0 . 0 0 1 ), multiple gestation ( 𝑃 < 0 . 0 0 1 ), shock ( 𝑃 = 0 . 0 0 8 ), NEC ( 𝑃 = 0 . 0 0 2 ), and shorter duration of hospital stay ( 𝑃 < 0 . 0 0 1 ). Coagulase-negative staphylococcus was isolated in 19.1%, K. pneumoniae ESBL in 12.1%, and A. baumanni in 10.9%. S. agalactiae predominated in early onset sepsis. Methicillin resistance was present in 86% of CoNS and 69.5% of S. aureus; 46% enterococcal isolates were ampicillin resistant. The majority (65%) of K. pneumoniae isolates were ESBL producers. Ampicillin resistance was present in 96% of E. coli. Conclusions. Penicillin and an aminoglycoside would be suitable empiric therapy for early onset sepsis and meropenem with gentamycin or ceftazidime with amikacin for late onset sepsis.