SOUTH AFRICA – The National Health Laboratory Service (NHLS), the largest diagnostic pathology service in South Africa, has reported a significant rise in culture-confirmed neonatal bacterial bloodstream infections and meningitis in the country.
The NHLS has the responsibility of supporting the national and provincial health departments in the delivery of healthcare. It provides laboratory and related public health services to over 80% of the population through a national network of laboratories.
The South African national government institution features specialized institutes namely the National Institute for Communicable Diseases (NICD), the National Institute for Occupational Health, Forensic Chemistry Laboratories and the South African Vaccine Producers, as the institution’s subsidiary.
The National Health Laboratory Service has published a six-year study conducted by experts affiliated with the NICD and the Baby GERMS-SA team with an aim to estimate the burden of culture-confirmed neonatal bloodstream infections and meningitis in South Africa.
Globally, almost half of pathogens causing invasive neonatal infections are resistant to the WHO-recommended first-line and second-line regimens such as penicillin plus gentamicin, and third-generation cephalosporins
The research paper is the first national population-level analysis of invasive newborn infections in the local public health sector and involved babies younger than 28-days who were admitted between January 2014 and December 2019.
According to the United Nations International Children’s Emergency Fund (UNICEF), newborn babies accounted for almost half of all deaths in young children in 2019 with an estimated 6,700 newborn deaths recorded daily.
“Moreover, 42% of deaths occurred in sub-Saharan Africa and infections were a major cause of these deaths. Newborn mortality rates remain high despite global efforts to reduce deaths in children aged,” UNICEF further states.
The research study funded by the Bill and Melinda Gates Foundation involved an analysis of blood and cerebrospinal fluid culture pathology records from newborn babies at 256 public-sector hospitals in an effort to reduce neonatal mortality rates.
The study led by experts from the NICD revealed that most neonatal bloodstream infections occurred after day 3 of life and that the infections were probably acquired in hospital, noting that a large proportion of infections were caused by multi-drug-resistant bacteria.
The report pointed out that around 70% of neonatal infections cases were caused by three bacterial pathogens namely Klebsiella pneumoniae, Acinetobacter baumannii and Staphylococcus aureus which cannot be prevented by vaccines and a large proportion of which were resistant to antibiotics.
There was an increase in the national annual incidence risk over the study period; this is a measure of new cases of invasive neonatal infections as a proportion of annual registered live births. Almost half of neonatal cases of infection were diagnosed at regional hospitals. The incidence risk of late-onset
The medical case report advised that infection prevention and control measures need to be strengthened coupled with antimicrobial stewardship programmes in neonatal units to address a crucial knowledge gap in testing, diagnosis and treatment.
In addition, the medical experts emphasized on the importance of distributing resources appropriately across the various tiers of public sector health facilities in prevention of infection in neonates and ultimately reducing newborn infection.
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