Full Text Available
Note: Clicking the button above will open the full text document at the original institutional repository in a new window.
Development and implementation of a neonatal bloodstream infection surveillance programme in a resource-limited setting
Ashton, F. S. 2025. Development and implementation of a neonatal bloodstream infection surveillance programme in a resource-limited setting. Unpublished masters thesis. Stellenbosch: Stellenbosch University [online]. Available: https://scholar.sun.ac.za/items/18af43ad-ac4a-4da6-9076-e85b4c535372
Saved in:
| Main Author: | |
|---|---|
| Other Authors: | |
| Format: | Thesis |
| Language: | English |
| Published: |
Stellenbosch : Stellenbosch University
2025
|
| Subjects: | |
| Tags: |
No Tags, Be the first to tag this record!
|
| _version_ | 1867613769347104768 |
|---|---|
| access_status_str | Open Access |
| author | Ashton, Frances Stevie |
| author2 | Dramowski, Angela |
| author_browse | Ashton, Frances Stevie Dramowski, Angela |
| author_facet | Dramowski, Angela Ashton, Frances Stevie |
| author_sort | Ashton, Frances Stevie |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description | Ashton, F. S. 2025. Development and implementation of a neonatal bloodstream infection surveillance programme in a resource-limited setting. Unpublished masters thesis. Stellenbosch: Stellenbosch University [online]. Available: https://scholar.sun.ac.za/items/18af43ad-ac4a-4da6-9076-e85b4c535372 |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/133108 |
| institution | Stellenbosch University (South Africa) |
| language | English |
| last_indexed | 2026-06-10T12:41:24.431Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2025 |
| publishDateRange | 2025 |
| publishDateSort | 2025 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/133108 Development and implementation of a neonatal bloodstream infection surveillance programme in a resource-limited setting Ashton, Frances Stevie Dramowski, Angela Bekker, Adrie Aucamp, Marina Reddy, Kessendri Whitelaw, Andrew Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Paediatrics and Child Health. Neonatal infections -- Mortality Septicemia in children Nosocomial infections in children Public health surveillance UCTD Ashton, F. S. 2025. Development and implementation of a neonatal bloodstream infection surveillance programme in a resource-limited setting. Unpublished masters thesis. Stellenbosch: Stellenbosch University [online]. Available: https://scholar.sun.ac.za/items/18af43ad-ac4a-4da6-9076-e85b4c535372 The published article is available at https://www.mdpi.com/2079-6382/14/4/392 Thesis (MMed)--Stellenbosch University, 2025. ENGLISH ABSTRACT: Introduction: Data from African neonatal units conducting bloodstream infection (BSI) surveillance is limited. Methods: Prospective clinical and laboratory surveillance of incident BSI episodes was conducted among in-patients at the 132-bed neonatal service at Tygerberg Hospital Cape Town, South Africa (2017 – 2021), describing patient demographics, BSI rates, pathogen profile and empiric antibiotic concordance rates. Results: In total, 842 BSI episodes were identified in 740 neonates; most were preterm (661/740; 89.3%) and of low birth weight (640/740; 86.5%). The early onset BSI rate (<3 days of life) was 2.9/1000 live births, with S. agalactiae, K. pneumoniae and E. coli predominating. Over time, ampicillin plus gentamicin concordance rates for early onset BSI pathogens declined from 93.8% to 63.6%. The healthcare associated BSI rate (onset >3 days of life) was 3.4/1000 in-patient days, with K. pneumoniae, S. aureus and S. marcescens predominating. Antibiotic concordance rates for healthcare associated BSIs improved over time, from 72.2% to 89.2% (piperacillin plus amikacin), and from 68.1% to 84.6% (meropenem). Nearly one-third of BSI episodes were fatal (244/842; 29.0%), with two-thirds of these deaths considered BSI-attributable. Gram-negative BSIs increased mortality (OR 2.88; 95% CI 1.93-4.32) compared to gram-positive BSIs (p<0.001). Discordant empiric antibiotic therapy (OR 1.55; 95% CI 1.10-2.17) increased risk of death compared to concordant therapy (p = 0.012). Conclusion: Neonatal BSI surveillance demonstrated that gram-negative pathogens remain important causes of early onset and healthcare associated BSIs in this resource-limited neonatal service. Declining empiric antibiotic coverage of early onset BSIs requires a change in treatment guidelines to minimise discordant therapy rates. AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar. Masters 2025-07-18T06:12:09Z 2025-07-18T06:12:09Z 2025-03 Thesis https://scholar.sun.ac.za/handle/10019.1/133108 en Stellenbosch University 45 pages : illustrations application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Neonatal infections -- Mortality Septicemia in children Nosocomial infections in children Public health surveillance UCTD Ashton, Frances Stevie Development and implementation of a neonatal bloodstream infection surveillance programme in a resource-limited setting |
| title | Development and implementation of a neonatal bloodstream infection surveillance programme in a resource-limited setting |
| title_full | Development and implementation of a neonatal bloodstream infection surveillance programme in a resource-limited setting |
| title_fullStr | Development and implementation of a neonatal bloodstream infection surveillance programme in a resource-limited setting |
| title_full_unstemmed | Development and implementation of a neonatal bloodstream infection surveillance programme in a resource-limited setting |
| title_short | Development and implementation of a neonatal bloodstream infection surveillance programme in a resource-limited setting |
| title_sort | development and implementation of a neonatal bloodstream infection surveillance programme in a resource limited setting |
| topic | Neonatal infections -- Mortality Septicemia in children Nosocomial infections in children Public health surveillance UCTD |
| url | https://scholar.sun.ac.za/handle/10019.1/133108 |
| work_keys_str_mv | AT ashtonfrancesstevie developmentandimplementationofaneonatalbloodstreaminfectionsurveillanceprogrammeinaresourcelimitedsetting |