Background Sepsis is a major contributor to neonatal mortality, particularly in low-income and middle-income countries (LMICs). WHO advocates ampicillin-gentamicin as first-line therapy for the management of neonatal sepsis. In the BARNARDS observational cohort study of neonatal sepsis and antimicrobial resistance in LMICs, common sepsis pathogens were characterised via whole genome sequencing (WGS) and antimicrobial resistance profiles. In this substudy of BARNARDS, we aimed to assess the use and efficacy of empirical antibiotic therapies commonly used in LMICs for neonatal sepsis.Methods In BARNARDS, consenting mother-neonates aged 0-60 days dyads were enrolled on delivery or neonatal presentation with suspected sepsis at 12 BARNARDS clinical sites in

Catheter-related blood stream infections comprise a major concern in hemodialysis patients, leading to increased mortality, morbidity, and cost of treatment. Prompt appropriate systemic antibiotics treatment, which includes administration of appropriate systemic antibiotics and, frequently, catheter removal and replacement, is warranted. However, in hemodialysis patients, repeated catheter insertions may cause central vein stenosis and thrombosis which limits the future availability of hemodialysis access. Lock solutions containing antibiotics and anticoagulants, instilled directly into the catheter lumen after each dialysis, have been successfully utilized for catheter salvage but higher rates of recurrence and complications were observed in infections resulting from staphylococcal species. We report several cases of catheter salvage using antibiotic lock solution in staphylococcal bacteremia with the purpose of stimulating the interest in randomized clinical trials. Evaluating the risk and benefits of catheter salvage in this patient subset in light of optimized systemic antibiotic dosing, improved lock solution use, and multidisciplinary involvement, balanced with the critical need to prevent unnecessary vascular trauma, is of great importance.

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There are numerous reported cases of extended spectrum beta lactamases (ESBLs) producing Enterobacteriaceae in Nigeria, with little effort done on the molecular detection. Epidemiological studies around the world have investigated the prevalence of ESBL-producing enterobacteriaceae and they have seen multiple mechanisms of drug-resistance. Our study was designed to detect ESBLs genes such as CTX-M, SHV, and TEM using PCR from clinical isolates in a tertiary hospital in Sokoto metropolis. Clinical isolates from the Microbiology laboratory of the tertiary hospital was collected for 3 months. These isolates were identified using standard microbiological methods. They were tested against 8 antibiotics using the modified Kirby Bauer disc diffusion method. Multidrug resistant isolates were screened for ESBL production, and further confirmed by the Double Disc Synergy Test (DDST). Genotypic confirmation was carried out using multiplex Polymerase Chain Reaction (PCR). A total of 47 isolates made up of 21 E. coli (44.6%), 13 Klebsiella spp (27.6%), 7 Salmonella spp (14.9%), 5 Proteus mirabilis (10.6%), and 1 Enterobacter spp (2.1%) were obtained from urine, stool, and wound swab. Out of the 47 isolates, (45) 95.7% were multidrug resistant. Twenty-five (53.2%) were potential ESBL producers, while only 5 (20.0%) were confirmed phenotypically using a DDST. PCR results revealed 4 out of 5 of the isolates were possessing ESBL genes. It also revealed that 3 isolates co-produce TEM and SHV at 403bp and 293bp respectively. Only 1 isolate produced CTX-M gene at 569bp. The prevalence of ESBL production in the Gram negative enterobacteriaceae in our study did not indicate a high prevalence as reported by some studies in Sokoto and Northwest Nigeria.