ArticlePloS one2021
A retrospective analysis of pathogen profile, antimicrobial resistance and mortality in neonatal hospital-acquired bloodstream infections from 2009-2018 at Tygerberg Hospital, South Africa.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 3 of them syntheses that pooled it.
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Who cites it
33 citing papers in PubMed, 3 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- Prevalence of Antimicrobial Resistance in Klebsiella pneumoniae in the South African Populations: A Systematic Review and Meta-Analysis of Surveillance Studies.MicrobiologyOpen · 2025Pooled it
- Prevalence of carbapenem-resistant gram-negative bacteria among neonates suspected for sepsis in Africa: a systematic review and meta-analysis.BMC infectious diseases · 2024Pooled it
- Prevalence and clonal diversity of carbapenem-resistant Klebsiella pneumoniae causing neonatal infections: A systematic review of 128 articles across 30 countries.PLoS medicine · 2023Pooled it
- Infectious pathogens associated with stillbirth and under-five mortality by sickle cell disease in Western Kenya: a cross-sectional study.BMC infectious diseases · 2026Article
- Risk factors for carbapenem-resistant Acinetobacter baumannii infection in children and A. baumannii-related mortality in the PICU: a retrospective study in Guangxi, China.BMC infectious diseases · 2026Article
- Antimicrobial prescribing patterns at a South African tertiary referral hospital: Insights from three global point prevalence surveys.Epidemiology and infection · 2026Article
- Distribution and antimicrobial resistance profiles of common blood culture isolates in a maternal and child health specialty hospital, Shenzhen (January 2021-October 2025), China.Frontiers in microbiology · 2026Article
- Article
- Genomic Characterization ofOpen forum infectious diseases · 2026Article
- Microbiological profile of sterile site organisms and culture positivity rates from a decade of paediatric admissions at a tertiary hospital in South Africa: A lower and middle-income country perspective.New microbes and new infections · 2025Article
- In Vitro Evaluation of Antimicrobial Synergy Against Multidrug-Resistant Gram-Negative Paediatric Bloodstream Pathogens in South Africa.Antibiotics (Basel, Switzerland) · 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
- Ten-year review of hospital-acquired neonatal meningitis in a tertiary-level NICU: the important role of acinetobacter species.BMC infectious diseases · 2025Article
- Development of a Bloodstream Infection Surveillance Programme at a Resource-Limited South African Neonatal Unit.Antibiotics (Basel, Switzerland) · 2025Article
- Risk factors and outcomes of infants with necrotizing enterocolitis: a case-control study.Frontiers in pediatrics · 2025Article
- Whole-genome sequencing-based source tracing and infection control ofFrontiers in microbiology · 2025Article
- Epidemiology of healthcare-associated bloodstream infection in South African neonatal units.BMC infectious diseases · 2024Article
- The burden of hospital-acquired infections (HAI) in sub-Saharan Africa: a systematic review and meta-analysis.EClinicalMedicine · 2024Article
- Case Study Protocol to Evaluate the Impact of Training Intervention on Cleaners' Knowledge Level, Perceptions and Practices regarding Correct Cleaning Techniques at Selected Care Facilities in Limpopo Province, South Africa.Nursing reports (Pavia, Italy) · 2024Article
- Bacterial profiles and their antibiotic susceptibility patterns in neonatal sepsis at the University of Gondar Comprehensive Specialized Hospital, Ethiopia.Frontiers in microbiology · 2024Article
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5 authors at 2 institutions in 1 country.
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Abstract
backgroundAnalysis of hospital-acquired bloodstream infection (HA-BSI) trends is important to monitor emerging antimicrobial resistance (AMR) threats and guide empiric antibiotic choices.
methodsA retrospective 10-year review of neonatal HA-BSI was performed at Tygerberg Hospital's neonatal unit in Cape Town, South Africa. Neonatal clinical and laboratory data from 2014 to 2018 (Period 2) was compared with published data from 2009 to 2013 (Period 1).
resultsThe neonatal unit's HA-BSI rate declined between periods from 3.9/1000 inpatient-days in Period 1 to 3.3/1000 inpatient-days in Period 2 (p = 0.002). Pathogen yield and blood culture contamination rate were unchanged (11.0% to 10.4%, p = 0.233; 5.1% to 5.3%, p = 0.636 respectively). Gram-negative pathogens predominated (1047/1636; 64.0%); Klebsiella species, Staphylococcus aureus, Serratia marcescens, Enterococcus species and Acinetobacter baumannii were the most frequent pathogens. Extended spectrum beta-lactamase production was observed in 319/432 (73.8%) of Klebsiella species, methicillin resistance in 171/246 (69.5%) of Staphylococcus aureus and extensive drug resistance in 115/137 (83.9%) of Acinetobacter species (2009-2018). The crude mortality rate of neonatal HA-BSI episodes increased from Period 1 to Period 2 from 139/717 (19.4%) to 179/718 (24.9%) (p = 0.014), but HA-BSI attributable mortality remained unchanged (97/139 [69.8%] vs 118/179 [65.9%], p = 0.542). The in-vitro activity of piperacillin-tazobactam and amikacin declined during Period 2 (74.6% to 61.4%; p<0.001).
conclusionAlthough HA-BSI rates declined in the neonatal unit, antimicrobial resistance rates in BSI pathogens remained high. Continuous BSI surveillance is a valuable tool to detect changes in pathogen and AMR profiles and inform empiric antibiotic recommendations for neonatal units in resource-limited settings.
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