Neonatal and Young Infant Sepsis in a Regional Hospital in Ghana

Abstract

Background: Neonatal sepsis is a global health problem that mainly affects low-and middle-income countries. We have previously shown that early neonatal mortality is high at the Ho Teaching Hospital (HTH) of Ghana. We sought to determine the prevalence of neonatal sepsis, sepsis-related mortality, and bacterial species patterns in neonatal and young infant sepsis in this hospital. Methods: A hospital-based study was conducted in the hospital's neonatal intensive care unit (NICU) from March to June 2018. Blood samples from 96 babies clinically diagnosed with or at risk of sepsis were cultured using the BACTEC 9050® machine. Clinical data including gravida, parity and antibiotic medication before delivery of mother and delivery type, gestation, birth weight and antibiotic medication status were collected for analysis. MALDI-TOF MS identified bacterial isolates, and their identities were confirmed via tuf gene sequence typing. The data were analyzed using GraphPad Prism 8.0.2. Results: Blood cultures were positive in 28 of the babies, with 14 and 12 representing early-onset and late-onset neonatal sepsis, respectively, and two cases of unknown sepsis type. Of the bacterial species that caused sepsis in the babies, coagulase-negative staphylococcus (CoNS) was the most prevalent isolate in 22 cases, followed by Klebsiella pneumoniae in two and Staphylococcus aureus, Streptococcus agalactiae, the Acinetobacter species,

Antimicrobial profile of coagulase-negative staphylococcus isolates from categories of individuals at a neonatal intensive care unit of a tertiary hospital-Ghana

“…Regarding S. haemolyticus , teicoplanin resistance was seen among the isolates of young infants and mothers, while isolates from hospital staff had the highest resistance to the fluoroquinolone class of antibiotics. We have previously reported the antibiotics prescribed for young infants in the NICU of the HTH to include: ampicillin, amikacin, benzylpenicillin, cefotaxime, flucloxacillin, gentamicin and metronidazole [ 7 ]. Fluoroquinolones are not prescribed in the NICU hence we find it difficult to explain the high resistance of this class of antibiotics among the clinical staff of the HTH and calls for further research.…”

“…Blood cultures were done for the babies, while nasal swab cultures were done for mothers, clinical staff, and students from the UHAS. We have previously described how these samples were cultured, stored, and shipped to Germany for further analyses [ 7 ].…”

Neonatal sepsis in a tertiary health facility in Cape Coast, Ghana

“…Although prior studies on neonatal sepsis and associated factors in LMICs abound, there is limited literature on the subject in Ghana. The few prior studies [13][14][15] in Ghana have mainly been conducted within the context of the nation's capital, Accra, with little insights from other regions. With the view to extending the discourse neonatal sepsis in Ghana, the current study sought to ascertain the prevalence of neonatal sepsis and associated factors based on analysis of institutional records from Cape Coast Teaching hospital (CCTH) in Ghana.…”