Estimates suggest that over a million babies die within the first month of their lives in Africa.Friedrich Stark / Alamy Stock Photo
While the neonatal death rate has fallen significantly over the past two decades, it is still a significant risk in low- and middle-income countries (LMICs), where 98% of recorded neonatal deaths occur. Fatalities are usually caused by infections in healthcare facilities. Despite the high incidence of neonatal sepsis in LMICs, accurate information on its causes and consequences is scarce.
Now, a large international study, BARNARDS, involving more than 160 research and medical staff, set out to study antimicrobial resistance of pathogens causing newborn sepsis. They collected blood samples from 36,285 infants collected over two years from four African and three South Asian countries.
The team, led by Kirsty Sands, a postdoctoral researcher at the University of Oxford, in the United Kingdom, performed whole genome sequencing on gram-negative bacteria that were collected. “We were able to highlight the large diversity of bacterial species causing neonatal sepsis and the occurrence of multiple outbreaks of different species across many of the countries in the study.”
The study found that Klebsiella, E. coli and Enterobacter were the main gram-negative bacteria species responsible for sepsis in newborns.
It also found that over half of these bacteria isolates were resistant to treatments recommended by the World Health Organisation, first-line ampicillin plus gentamicin, and second-line cephalosporins. Thus the treatments are unlikely to be curative.
“Thousands of neonates die every year after contracting sepsis, predominantly in sub-Saharan Africa and South Asia,” says Sands. The researchers suggest that improving infection control practices in hospitals is important to decrease neonatal sepsis and mortality. They also hope their work can help develop new antimicrobial therapies that are effective in controlling resistant bacteria.
