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. 2022 Oct 10;19(19):12968.
doi: 10.3390/ijerph191912968.

Pattern of Antimicrobial Susceptibility and Antimicrobial Treatment of Neonates Admitted with Suspected Sepsis in a Teaching Hospital in Ghana, 2021

Kwaku Anim Omenako  1   2 , Anthony Enimil  3   4 , Afia Frimpomaa Asare Marfo  2 , Collins Timire  5 , Palanivel Chinnakali  6 , Ama Pokuaa Fenny  7 , Kathiresan Jeyashree  8 , Kwame Ohene Buabeng  2
Affiliations

Pattern of Antimicrobial Susceptibility and Antimicrobial Treatment of Neonates Admitted with Suspected Sepsis in a Teaching Hospital in Ghana, 2021

Kwaku Anim Omenako et al. Int J Environ Res Public Health. .

Abstract

Neonatal sepsis is a life-threatening emergency, and empirical antimicrobial prescription is common. In this cross-sectional study of neonates admitted with suspected sepsis in a teaching hospital in Ghana from January-December 2021, we described antimicrobial prescription patterns, compliance with national standard treatment guidelines (STG), blood culture testing, antimicrobial resistance patterns and treatment outcomes. Of the 549 neonates admitted with suspected sepsis, 283 (52%) were males. Overall, 529 (96%) received empirical antimicrobials. Most neonates (n = 407, 76.9%) were treated empirically with cefuroxime + gentamicin, while cefotaxime was started as a modified treatment in the majority of neonates (46/68, 67.6%). Only one prescription complied with national STGs. Samples of 257 (47%) neonates underwent blood culture testing, of which 70 (27%) were positive. Isolates were predominantly Gram-positive bacteria, with coagulase-negative Staphylococcus and Staphylococcus aureus accounting for 79% of the isolates. Isolates showed high resistance to most penicillins, while resistance to aminoglycosides and quinolones was relatively low. The majority of neonates (n = 497, 90.5%) were discharged after successfully completing treatment, while 50 (9%) neonates died during treatment. Strengthening of antimicrobial stewardship programmes, periodic review of STGs and increased uptake of culture and sensitivity testing are needed to improve management of sepsis.

Keywords: SORT IT; antimicrobial resistance; compliance; empirical antimicrobial treatment; neonatal sepsis; operational research; prescription; standard treatment guidelines.

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Conflict of interest statement

The authors declare no conflict of interest. In accordance with WHO’s open-access publication policy for all work funded by WHO or authored/co-authored by WHO staff members, WHO retains the copyright of this publication through a Creative Commons Attribution IGO license (http://creativecommons.org/licenses/by/3.0/igo/legalcode (accessed on 14 August 2022)), which permits unrestricted use, distribution and reproduction in any medium provided the original work is properly cited. There should be no suggestion that WHO endorses any specific organization, products or services. The views expressed in this article are those of the authors and do not necessarily reflect those of their affiliated institutions. The use of the WHO logo is not permitted. This notice should be preserved along with the article’s original URL.

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