Antimicrobial resistance patterns in neonatal sepsis cases at Chris Hani Baragwanath Academic Hospital
No Thumbnail Available
Date
2021
Authors
Opiecabo, Ronald
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
The purpose of this study was to describe the antimicrobial resistance (AMR) patterns of
clinical isolates from neonatal sepsis cases admitted at Chris Hani Baragwanath Academic
Hospital (CHBAH) from January 2016 to December 2019. Globally, 214 000 – 690 000
neonatal deaths (death in first 28 days after birth) are associated with sepsis, 31% of the deaths
are potentially attributed to AMR, with the highest burden experienced in sub-Saharan Africa.
Methods
This study used descriptive data analysis which involved a retrospective review of the neonatal
hospital database, drug susceptibility test results, and neonatal sepsis discharge summary at
CHBAH.
Results
Bacteria and fungi were the two organism types identified among neonatal sepsis cases at
CHBAH. Gram-negative bacteria 317(52.93%) were the most predominant bacterial isolates
among neonatal sepsis cases compared to gram-positive bacteria 282(47.08%), but the
difference was not statistically significant (P=0.3961). The leading gram-negative bacteria
causing AMR sepsis at CHBAH were Acinetobacter baumannii 194(28.4%), Klebsiella
pneumoniae 96(14.69%), and Escherichia coli 6(0.88%). The most prevalent gram-positive
bacteria were Staphylococcus aureus 109(16.0%), and Coagulase-negative staphylococci
106(15.5%). With regards to fungi, Candida parapsilosis 27(3.95%), Candida albicans
18(2.64%), and Candida tropicalis 1(0.15%) being the most common causes of candidemia.
Acinetobacter baumannii was found to have very high resistance to amikacin (71.05%),
meropenem (91.3%), and ceftazidime (82.46%). A high prevalence (73%) of extended
spectrum beta-lactamase (ESBL) production was noted amongst the Klebsiella pneumoniae. A
high prevalence of carbapenemase-producing Enterobacteriaceae(CPE)were noted amongthe
Klebsiella pneumoniae as demonstrated by the 46.7% resistance to meropenem. Thirty five
percent of the Staphylococcus aureus were resistant to methicillin
Low susceptibility of the leading causes of AMR sepsis to the recommended empirical
therapeutic options was noted. Overall, there was a 30% mortality rate among neonatal sepsis
cases admitted..
Conclusion
v
Neonatal mortality associated with AMR sepsis remains significantly high at CHBAH and
Acinetobacter baumannii was responsible for almost half the deaths. This was possibly
attributed to poor therapeutic outcomes owing to the high resistance of the leading c auses of
neonatal sepsis to empiric treatment and the recommended therapeutic choices
Description
A research report submitted in fulfilment of the requirements for the degree Masters of Science in Vaccinology to the Faculty of Health Sciences, School of Pathology, University of the Witwatersrand, Johannesburg, 2021