Susan Meiring (South Africa)
National Institute for Communicable Diseases
Division of Public Health Surveillance and Response
Dr Meiring is the Clinical Coordinator for the GERMS-SA surveillance network. GERMS-SA coordinates and runs national and sentinel, laboratory-based and clinical surveillance programmes of ‘diseases-of-public-health-importance’ for the National Institute for Communicable Diseases. From the many surveillance programmes, special studies arise which are planned and coordinated by the GERMS-SA staff. Dr Meiring has been the principal investigator for three special studies, namely i. meningococcal carriage study in university students, ii. Baby GERMS: neonatal bloodstream infections and meningitis study in secondary level institutions, and iii. SARS-CoV-2 clinical characterisation and evaluation of shedding duration amongst patients hospitalised with COVID-19; and a co-investigator on many other surveillance studies.

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 Conference Calendar

HEALTHCARE-ASSOCIATED INFECTIONS AMONGST NEONATES IN NON-TERTIARY HOSPITALS, SOUTH AFRICA

Session Name
0600 - Oral Presentations: PUBLIC HEALTH AND EPIDEMIOLOGY (ID 58)
Session Type
Oral Presentations
Date
Thu, 24.02.2022
Session Time
10:00 AM - 11:00 AM
Room
Sala C
Session Icon
Pre-Recorded with Live Q&A
Presenter
Lecture Time
10:00 AM - 10:10 AM

Abstract

Background

BackgroundBackground
In low- and middle-income countries, infection is a major contributor to neonatal mortality, and aetiological data from non-central hospitals are scarce.

Aims

We conducted enhanced laboratory surveillance for culture-confirmed bloodstream infections and meningitis among neonates aged <28days at six non-tertiary level neonatal units in South Africa

Methods

From October 2019 through September 2020, clinical data and isolate(s) were collected. Healthcare-associated-infections (HAI) were those diagnosed in a neonate aged ≥3days and hospitalised for ≥48hours prior to specimen collection.

Results

Of 933 episodes of neonatal infection, clinical data were available for 812. Of these 30% (243/812) were early-onset sepsis (EOS: aged <3days), 14% (111/812) were community-associated infections (CAI: aged >3days and hospitalised <48hours) and 56% (n=458/812) were HAI. Day 28 mortality was 21% amongst EOS, 20% amongst CAI and 29% amongst HAI (p=0.01).
259/458 (57%) HAI cases had isolates available for characterisation. Of these, 79% (205) were Gram-negative bacteria (GN), 15% (39) Gram-positive bacteria (GP) and 6% (15) fungal isolates. The top four aetiologies were Klebsiella pneumoniae (102, 39%), Acinetobacter baumannii (58, 22%), Enterobacter cloacae (19, 7%) and Staphylococcus aureus (18, 7%),
Amongst HAIs, 48% (93/195) GN and 65% (24/37) GP were susceptible to at least one first-line antibiotic (ampicillin and gentamicin). Eight-five percent (162/191) GN and 89% (32/36) of GP were susceptible to at least one second-line antibiotic (piperacillin-tazobactam and amikacin). Fifty percent (98/196) GN and 78% (28/36) GP were susceptible to meropenem.

Conclusions

Neonatal HAI was associated with a high mortality, with high prevalence of GN infections and substantial resistance to WHO-recommended antibiotic therapy.

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