ArticlePloS one2019
Surveillance for incidence and etiology of early-onset neonatal sepsis in Soweto, South Africa.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 52 citations in OpenAlex.
- Predictors, aetiology and outcome of early-onset neonatal bloodstream infection: a case-control study in a tertiary hospital in South Africa.Journal of tropical pediatrics · 2026Article
- Prevalence of multidrug-resistant organisms colonizing neonates at a tertiary hospital in Johannesburg, South Africa.Journal of tropical pediatrics · 2026Article
- Predicting risk of early-onset sepsis in low-resource neonatal units using routine healthcare data: development and evaluation of multivariable statistical and machine learning models.BMJ paediatrics open · 2025Article
- Pathogen aetiology and risk factors for death among neonates with bloodstream infections at lower-tier South African hospitals: a cross-sectional study.The Lancet. Microbe · 2025Article
- Streptococcus agalactiae colonization is common among pregnant women with HIV infection and is neither predicted by hospital tier nor trimester in Mwanza, Tanzania.BMC pregnancy and childbirth · 2025Article
- Assessing the Use of Neonatal Sepsis Guidelines and Antibiotic Prescription With Large-Scale Prospective Data From Zimbabwe and Malawi.Journal of the Pediatric Infectious Diseases Society · 2025Article
- Respiratory pathogens detected in children aged <5 years hospitalized with severe respiratory illness, South Africa, 2017.Frontiers in pediatrics · 2025Article
- Precision adjuvants for pediatric vaccines.Science translational medicine · 2024Review
- The clinical Spectrum of Viridans Group Streptococci infections in paediatric patients at a tertiary hospital.Southern African journal of infectious diseases · 2024Article
- Article
- Expression of immune checkpoint molecules on adult and neonatal T-cells.Immunologic research · 2023Article
- Retrospective review of bacteriological profiles and antibiogram in a tertiary neonatal unit.Southern African journal of infectious diseases · 2023Article
- Culture-confirmed neonatal bloodstream infections and meningitis in South Africa, 2014-19: a cross-sectional study.The Lancet. Global health · 2022Article
- Recognising Sepsis as a Health Priority in Sub-Saharan African Country: Learning Lessons from Engagement with Gabon's Health Policy Stakeholders.Healthcare (Basel, Switzerland) · 2022Article
- The association between early-onset sepsis and neonatal encephalopathy.Journal of perinatology : official journal of the California Perinatal Association · 2022Article
- Early-Onset Neonatal Sepsis in Low- and Middle-Income Countries: Current Challenges and Future Opportunities.Infection and drug resistance · 2022Review
- Review
- Etiology of Pediatric Meningitis in West Africa Using Molecular Methods in the Era of Conjugate Vaccines against Pneumococcus, Meningococcus, andThe American journal of tropical medicine and hygiene · 2020Article
- Vaccination strategies to enhance immunity in neonates.Science (New York, N.Y.) · 2020Review
- BCG vaccination-induced emergency granulopoiesis provides rapid protection from neonatal sepsis.Science translational medicine · 2020Article
Corrections and comments
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Authors and funding
17 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGlobally, over 400,000 neonatal deaths in 2015 were attributed to sepsis, however, the incidence and etiologies of these infections are largely unknown in low-middle income countries. We aimed to determine incidence and etiology of community-acquired early-onset (<72 hours age) sepsis (EOS) using culture and molecular diagnostics.
methodsThis was a prospective observational study, in which we conducted a surveillance for pathogens using a combination of blood culture and a polymerase chain reaction (PCR)-based test. Blood culture was performed on all neonates with suspected EOS. Among the subset fulfilling criteria for protocol-defined EOS, blood and nasopharyngeal (NP) respiratory swabs were tested by quantitative real-time reverse-transcriptase PCR using a Taqman Array Card (TAC) with 15 bacterial and 12 viral targets. Blood and NP samples from 312 healthy newborns were also tested by TAC to estimate background positivity rates. We used variant latent-class methods to attribute etiologies and calculate pathogen-specific proportions and incidence rates.
resultsWe enrolled 2,624 neonates with suspected EOS and from these 1,231 newborns met criteria for protocol-defined EOS (incidence- 39.3/1,000 live-births). Using the partially latent-class modelling, only 26.7% cases with protocol-defined EOS had attributable etiology, and the largest pathogen proportion were Ureaplasma spp. (5.4%; 95%CI: 3.6-8.0) and group B Streptococcus (GBS) (4.8%; 95%CI: 4.1-5.8), and no etiology was attributable for 73.3% of cases. Blood cultures were positive in 99/1,231 (8.0%) with protocol-defined EOS (incidence- 3.2/1,000 live-births). Leading pathogens on blood culture included GBS (35%) and viridans streptococci (24%). Ureaplasma spp. was the most common organism identified on TAC among cases with protocol-defined EOS.
conclusionUsing a combination of blood culture and a PCR-based test the common pathogens isolated in neonates with sepsis were Ureaplasma spp. and GBS. Despite documenting higher rates of protocol-defined EOS and using a combination of tests, the etiology for EOS remains elusive.
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