Evidence map›Paper›PMID 39833703›Full record

ArticleBMC infectious diseases2025

Early onset neonatal bloodstream infections in South African hospitals.

Genevieve Theron, Adrie Bekker, Larisse Bolton, Andrew Whitelaw, Arnoldus Engelbrecht, Louisa Erasmus, Aaqilah Fataar, Chandre Geldenhuys, Marlize Kunneke, Dave Le Roux and 7 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Genevieve TheronDepartment of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town, 8000, South Africa.
Adrie BekkerDepartment of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town, 8000, South Africa.
Larisse BoltonSouth African Centre for Epidemiological Modelling and Analysis (SACEMA), School for Data Science and Computational Thinking, Stellenbosch University, Cape Town, South Africa.
Andrew WhitelawDivision of Medical Microbiology and Immunology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Arnoldus EngelbrechtDepartment of Paediatrics, Worcester Provincial Hospital, Worcester, South Africa.
Louisa ErasmusDepartment of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town, 8000, South Africa.
Aaqilah FataarDepartment of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town, 8000, South Africa.
Chandre GeldenhuysDepartment of Paediatrics, Paarl Hospital, Paarl, South Africa.
Marlize KunnekeDepartment of Paediatrics, Worcester Provincial Hospital, Worcester, South Africa.
Dave Le RouxDepartment of Paediatrics, New Somerset Hospital, Cape Town, South Africa.
Natasha O'ConnellDepartment of Paediatrics, Khayelitsha District Hospital, Cape Town, South Africa.
Kessendri ReddyDivision of Medical Microbiology and Immunology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Natasha RhodaDepartment of Neonatology, Cape Town, School of Child and Adolescent Health, Faculty of Health Sciences, Mowbray Maternity Hospital, University of Cape Town, Cape Town, South Africa.
Lloyd TookeDepartment of Neonatology, Groote Schuur Hospital, Cape Town, South Africa.
Mark WatesDepartment of Paediatrics, Karl Bremer Hospital, Cape Town, South Africa.
Thandi WesselsDepartment of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town, 8000, South Africa.
Angela DramowskiDepartment of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town, 8000, South Africa. dramowski@sun.ac.za.

Funding

Developing a care bundle for neonatal sepsis prevention in low-resource settingsK43TW010682 · FIC · STELLENBOSCH UNIVERSITY · PI DRAMOWSKI, ANGELA · 2017 to 2020
$454k
FIC NIH HHS K43 TW010682National Institutes of Health Fogarty Emerging Global Leader Award (K43) TW010682Science for Africa Foundation via the Gates Grand Challenges Africa Programme GCA/MNCH/Round6/055/003
6 · The paper itself

Abstract

backgroundNeonatal sepsis is a leading cause of death in low- and middle- income countries (LMIC). Increasing antibiotic resistance in early onset (< 72 h of life) bloodstream infection (EO-BSI) pathogens in LMIC has reduced the effectiveness of the recommended empiric antibiotic regimen (ampicillin plus gentamicin).

methodsWe retrospectively analysed blood culture-confirmed EO-BSI episodes at nine neonatal units from three central and six peripheral hospitals in the Western Cape Province, South Africa between 1 January 2017 and 31 December 2018. Clinical and electronic laboratory records were reviewed to determine pathogen profile, empiric antibiotic coverage rates and factors associated with EO-BSI attributable mortality, stratified by hospital type.

resultsOf the 8252 blood culture specimens submitted for the investigation of suspected EO-BSI, 136 EO-BSI episodes yielding 141 pathogens were identified with an EO-BSI rate of 1.3 and 0.5 episodes/1000 live births at central and peripheral hospitals respectively. Preterm (93/136; 68.3%) and low birth weight (84/136; 61.8%) neonates were most affected. The predominant pathogens were Streptococcus agalactiae (46/136; 34%), Klebsiella pneumoniae (17/136; 13%), Listeria monocytogenes (11/136; 8%), Acinetobacter baumannii (11/136; 8%) and Escherichia coli (11/136; 8%). The empiric antibiotic (ampicillin plus gentamicin) coverage rate was 64% (95% CI 51-74) at central hospitals and 84% (95% CI 74-94) at peripheral hospitals. Neonates with Gram-negative EO-BSI and discordant empiric antibiotic therapy had almost four-fold and three-fold higher odds of death respectively.

conclusionPreterm and low birth weight neonates are most vulnerable to EO-BSI and have higher odds of death with Gram-negative pathogens and discordant empiric antibiotic therapy.

Indexed as

BacteremiaNeonatal SepsisAnti-Bacterial AgentsFemaleHospitalsHumansInfant, NewbornMaleRetrospective StudiesSouth AfricaAnti-Bacterial AgentsAntimicrobial resistanceEarly onset bloodstream infectionEmpiric antibioticNeonateSepsis

Identifiers

PMID39833703
PMCPMC11744941

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.