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

BackgroundEpidemiological data on neonatal bloodstream infections (BSI) in sub-Saharan Africa are extremely limited.MethodsA comparative analysis of laboratory-confirmed BSI episodes was conducted retrospectively two large units Botswana and South (January 1 to December 31, 2017). Routine laboratory ward register were used determine rates, the pathogen spectrum, outcomes.ResultsIn 2017, Princess Marina Hospital (PMH) Tygerberg (TBH) admitted 1187 2826 neonates, respectively. The incidence rate 12.1/1000 patient-days (95% confidence interval (CI) 10.2–14.3) at PMH 3.5/1000 CI 2.9–4.1) TBH (p < 0.0001). Most hospital-acquired (260/284; 91.6%). blood culture contamination substantially higher than (152/1116 (13.6%) vs 122/2559 (4.8%); p 0.001). crude mortality neonates with 21.2% (53/250) significantly (38/128 (29.7%) 15/122 (12.3%), = Factors independently associated death birth weight <1500 g (adjusted odds ratio (aOR) 2.8, 95% 1.3–6.4; 0.02) male sex (aOR 2.1, 1.1–3.7; 0.01). Klebsiella pneumoniae dominant both units, accounting for two-thirds BSI, a infection outbreak PMH. Antibiotic resistance rates substantial particularly K. (98/122 (80.3%), extended-spectrum beta-lactamase (ESBL)-producers) Staphylococcus aureus (22/33 (66.7%), methicillin-resistant).ConclusionsBSI these Africa. ESBL-producing remains leading pathogen.