Sepsis among Neonates in a Ghanaian Tertiary Military Hospital: Culture Results and Turnaround Times

Int J Environ Res Public Health. 2022 Sep 16;19(18):11659. doi: 10.3390/ijerph191811659.

Abstract

In this study, we described the bacterial profile, antibiotic resistance pattern, and laboratory result turnaround time (TAT) in neonates with suspected sepsis from a tertiary-level, military hospital in Accra, Ghana (2017-2020). This was a cross-sectional study using secondary data from electronic medical records. Of 471 neonates clinically diagnosed with suspected sepsis in whom blood samples were collected, the median TAT from culture request to report was three days for neonates who were culture-positive and five days for neonates who were culture-negative. There were 241 (51%) neonates discharged before the receipt of culture reports, and of them, 37 (15%) were culture-positive. Of 471 neonates, twenty-nine percent (n = 139) were bacteriologically confirmed, of whom 61% (n = 85) had late-onset sepsis. Gram-positive bacterial infection (89%, n = 124) was the most common cause of culture-positive neonatal sepsis. The most frequent Gram-positive pathogen was coagulase-negative Staphylococcus (55%, n = 68) followed by Staphylococcus aureus (36%, n = 45), of which one in two were multidrug resistant. The reasons for large numbers being discharged before the receipt of culture reports need to be further explored. There is a need for improved infection prevention and control, along with ongoing local antimicrobial resistance surveillance and antibiotic stewardship to guide future empirical treatment.

Keywords: antibiotic resistance; bacteria; neonatal intensive care unit; neonatal sepsis; operational research; sort it; turnaround time.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Coagulase / therapeutic use
  • Cross-Sectional Studies
  • Ghana / epidemiology
  • Hospitals, Military*
  • Humans
  • Infant, Newborn
  • Intensive Care Units, Neonatal
  • Microbial Sensitivity Tests
  • Sepsis* / drug therapy
  • Sepsis* / epidemiology
  • United States

Substances

  • Anti-Bacterial Agents
  • Coagulase

Grants and funding

This operational research was conducted in routine operational settings without any additional funds. However, the proposal and manuscript were developed during the participation of the primary (corresponding) author in a SORT IT course. The UK Department of Health and Social Care has contributed designated funding for this SORT IT-AMR initiative, which is branded as the NIHR-TDR partnership. TDR is able to conduct its work thanks to the commitment and support from a variety of funders. A full list of TDR donors is available at: https://tdr.who.int/about-us/our-donors (accessed on 18 July 2022).