The incidence, clinical profile and antimicrobial susceptibility pattern of Acinetobacter baumannii sepsis in premature neonates at Universitas Academic Hospital for the period 1 January 2016 to 31 December 2018, a retrospective descriptive study

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dc.contributor.advisorPienaar, Michael A.
dc.contributor.authorMoodley, Mark
dc.date.accessioned2022-06-29T10:26:04Z
dc.date.available2022-06-29T10:26:04Z
dc.date.issued2021-02
dc.description.abstractBACKGROUND: Acinetobacter baumannii is an emerging and challenging pathogen in neonatal units, due to its ability to develop resistance against antibiotics. Studies on Acinetobacter baumannii infection in premature neonates are lacking in developing countries. OBJECTIVES: To determine the incidence, clinical presentation, antibiotic susceptibility profiles and the morbidity and mortality rate of premature neonates with Acinetobacter baumannii infection. METHODS: We conducted a retrospective descriptive study at a tertiary hospital in Bloemfontein, South Africa. Medical records were reviewed over 36 months. Premature neonates admitted to the neonatal intensive care unit with positive blood, urine or cerebrospinal culture for Acinetobacter baumannii were identified through the National Health Laboratory Services. RESULTS: Fifty premature neonates were enrolled. There was an incidence of 103 cases per 1000 admissions/ year. The median age at the onset of sepsis was 17 days (IQR 9-26). Known risks such as central venous catheters and parental nutrition were found in 78% (39/50), and 68% (34/50) respectively. Respiratory distress (56% [28/50]) and abdominal distension (50% [25/50]) were the most common clinical signs. Of all the isolates, 86% (43/50) were susceptible to colistin only. Supportive therapy was frequently required, 48% (24/50) received vasoactive drugs, and 70% (35/50) were mechanically ventilated. Mortality related to infection was 36% (18/50). CONCLUSION: There was a high incidence of Acinetobacter baumannii sepsis in premature neonates at Universitas Academic Hospital. A significant number of neonates had a central catheter and received parental nutrition. Most isolates were resistant to the carbapenems but susceptible to colistin. Vasoactive drugs and mechanical ventilation were frequently required. The mortality rate was high from Acinetobacter infection which is in keeping with most studies. Strict infection control and antibiotic stewardship are imperative.en_ZA
dc.identifier.urihttp://hdl.handle.net/11660/11732
dc.language.isoenen_ZA
dc.publisherUniversity of the Free Stateen_ZA
dc.rights.holderUniversity of the Free Stateen_ZA
dc.subjectDissertation (M.Med. (Paediatrics and Child Health))--University of the Free State, 2021en_ZA
dc.subjectNeonateen_ZA
dc.subjectNeonatal sepsisen_ZA
dc.subjectPrematurityen_ZA
dc.subjectAcinetobacter baumanniien_ZA
dc.subjectMulti-drug resistanceen_ZA
dc.subjectVasoactive drugsen_ZA
dc.subjectVentilationen_ZA
dc.subjectAntibiotic stewardshipen_ZA
dc.subjectInfection controlen_ZA
dc.subjectColistinen_ZA
dc.titleThe incidence, clinical profile and antimicrobial susceptibility pattern of Acinetobacter baumannii sepsis in premature neonates at Universitas Academic Hospital for the period 1 January 2016 to 31 December 2018, a retrospective descriptive studyen_ZA
dc.typeDissertationen_ZA
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