{"id":38903,"date":"2019-10-01T10:33:25","date_gmt":"2019-10-01T14:33:25","guid":{"rendered":"https:\/\/www.healthynewbornnetwork.org\/?post_type=resource&#038;p=38903"},"modified":"2019-09-18T10:36:28","modified_gmt":"2019-09-18T14:36:28","slug":"sepsis-a-review-of-multidrug-resistant-enterobacteriaceae-in-a-neonatal-unit-in-johannesburg-south-africa","status":"publish","type":"resource","link":"https:\/\/www.healthynewbornnetwork.org\/resource\/sepsis-a-review-of-multidrug-resistant-enterobacteriaceae-in-a-neonatal-unit-in-johannesburg-south-africa\/","title":{"rendered":"Sepsis: A review of multidrug-resistant Enterobacteriaceae in a neonatal unit in Johannesburg, South Africa"},"content":{"rendered":"<h2 class=\"c-article__sub-heading u-h3\" data-test=\"abstract-sub-heading\">Background<\/h2>\n<p>Multi-drug resistant organisms are an increasingly important cause of <a href=\"https:\/\/www.healthynewbornnetwork.org\/issue\/severe-infections\/\">neonatal sepsis<\/a>.<\/p>\n<h2 class=\"c-article__sub-heading u-h3\" data-test=\"abstract-sub-heading\">Aim<\/h2>\n<p>This study aimed to review neonatal sepsis caused by multi-drug resistant Enterobacteriaceae (MDRE) in neonates in Johannesburg, <a href=\"https:\/\/www.healthynewbornnetwork.org\/country\/south-africa\/\">South Africa<\/a>.<\/p>\n<h2 class=\"c-article__sub-heading u-h3\" data-test=\"abstract-sub-heading\">Methods<\/h2>\n<p>This was a cross sectional retrospective review of MDRE in neonates admitted to a tertiary neonatal unit between 1 January 2013 and 31 December 2015.<\/p>\n<h2 class=\"c-article__sub-heading u-h3\" data-test=\"abstract-sub-heading\">Results<\/h2>\n<p>There were 465 infections in 291 neonates. 68.6% were very low birth weight (&lt;\u20091500\u2009g). The median age of infection was 14.0\u2009days. Risk factors for MDRE included <a href=\"https:\/\/www.healthynewbornnetwork.org\/issue\/preterm-birth-complications\/\">prematurity<\/a> (<i>p<\/i>\u2009=\u20090.01), lower birth weight (<i>p<\/i>\u2009=\u20090.04), maternal HIV infection (<i>p<\/i>\u2009=\u20090.02) and oxygen on day 28 (<i>p<\/i>\u2009&lt;\u20090.001). The most common isolate was <i>Klebsiella pneumoniae<\/i> (66.2%). Total MDRE isolates increased from 0.39 per 1000 neonatal admissions in 2013 to 1.4 per 1000 neonatal admissions in 2015 (<i>p<\/i>\u2009&lt;\u20090.001). There was an increase in carbapenem-resistant Enterobacteriaceae (CRE) from 2.6% in 2013 to 8.9% in 2015 (<i>p<\/i>\u2009=\u20090.06). Most of the CRE were New Delhi metallo\u2014\u03b2 lactamase- (NDM) producers.<\/p>\n<p>The all-cause mortality rate was 33.3%. Birth weight (<i>p<\/i>\u2009=\u20090.003), necrotising enterocolitis (<i>p<\/i>\u2009&lt;\u20090.001) and mechanical ventilation (<i>p<\/i>\u2009=\u20090.007) were significantly associated with mortality. <i>Serratia marcescens<\/i> was isolated in 55.2% of neonates that died.<\/p>\n<h2 class=\"c-article__sub-heading u-h3\" data-test=\"abstract-sub-heading\">Conclusions<\/h2>\n<p>There was a significant increase in MDRE in neonatal sepsis during the study period, with the emergence of CRE. This confirms the urgent need to intensify <a href=\"https:\/\/www.healthynewbornnetwork.org\/issue\/treatment-of-possible-severe-bacterial-infection\/\">antimicrobial stewardship<\/a> efforts and address infection control and prevention in neonatal units in LMICs. Overuse of broad- spectrum antibiotics should be prevented.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background Multi-drug resistant organisms are an increasingly important cause of neonatal sepsis. Aim This study aimed to review neonatal sepsis caused by multi-drug resistant Enterobacteriaceae (MDRE) in neonates in Johannesburg, South Africa. Methods This was a cross sectional retrospective review of MDRE in neonates admitted to a tertiary neonatal unit between 1 January 2013 and &hellip; <a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/sepsis-a-review-of-multidrug-resistant-enterobacteriaceae-in-a-neonatal-unit-in-johannesburg-south-africa\/\">Continued<\/a><\/p>\n","protected":false},"author":7211,"featured_media":38905,"comment_status":"open","ping_status":"closed","template":"","toolkit":[],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Healthy Newborn Network<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/sepsis-a-review-of-multidrug-resistant-enterobacteriaceae-in-a-neonatal-unit-in-johannesburg-south-africa\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Sepsis: A review of multidrug-resistant Enterobacteriaceae in a neonatal unit in Johannesburg, South Africa - Healthy Newborn Network\" \/>\n<meta property=\"og:description\" content=\"Background Multi-drug resistant organisms are an increasingly important cause of neonatal sepsis. Aim This study aimed to review neonatal sepsis caused by multi-drug resistant Enterobacteriaceae (MDRE) in neonates in Johannesburg, South Africa. Methods This was a cross sectional retrospective review of MDRE in neonates admitted to a tertiary neonatal unit between 1 January 2013 and &hellip; Continued\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.healthynewbornnetwork.org\/resource\/sepsis-a-review-of-multidrug-resistant-enterobacteriaceae-in-a-neonatal-unit-in-johannesburg-south-africa\/\" \/>\n<meta property=\"og:site_name\" content=\"Healthy Newborn Network\" \/>\n<meta property=\"article:modified_time\" content=\"2019-09-18T14:36:28+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/CH1329591.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"800\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.healthynewbornnetwork.org\/resource\/sepsis-a-review-of-multidrug-resistant-enterobacteriaceae-in-a-neonatal-unit-in-johannesburg-south-africa\/\",\"url\":\"https:\/\/www.healthynewbornnetwork.org\/resource\/sepsis-a-review-of-multidrug-resistant-enterobacteriaceae-in-a-neonatal-unit-in-johannesburg-south-africa\/\",\"name\":\"Sepsis: A review of multidrug-resistant Enterobacteriaceae in a neonatal unit in Johannesburg, South Africa - Healthy Newborn Network\",\"isPartOf\":{\"@id\":\"https:\/\/www.healthynewbornnetwork.org\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/www.healthynewbornnetwork.org\/resource\/sepsis-a-review-of-multidrug-resistant-enterobacteriaceae-in-a-neonatal-unit-in-johannesburg-south-africa\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/www.healthynewbornnetwork.org\/resource\/sepsis-a-review-of-multidrug-resistant-enterobacteriaceae-in-a-neonatal-unit-in-johannesburg-south-africa\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/CH1329591.jpg\",\"datePublished\":\"2019-10-01T14:33:25+00:00\",\"dateModified\":\"2019-09-18T14:36:28+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/www.healthynewbornnetwork.org\/resource\/sepsis-a-review-of-multidrug-resistant-enterobacteriaceae-in-a-neonatal-unit-in-johannesburg-south-africa\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/www.healthynewbornnetwork.org\/resource\/sepsis-a-review-of-multidrug-resistant-enterobacteriaceae-in-a-neonatal-unit-in-johannesburg-south-africa\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/www.healthynewbornnetwork.org\/resource\/sepsis-a-review-of-multidrug-resistant-enterobacteriaceae-in-a-neonatal-unit-in-johannesburg-south-africa\/#primaryimage\",\"url\":\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/CH1329591.jpg\",\"contentUrl\":\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/CH1329591.jpg\",\"width\":1200,\"height\":800,\"caption\":\"Medication used to treat pneumonia on the pediatric ward, Lodwar County hospital, Turkana region, Kenya\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/www.healthynewbornnetwork.org\/resource\/sepsis-a-review-of-multidrug-resistant-enterobacteriaceae-in-a-neonatal-unit-in-johannesburg-south-africa\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/www.healthynewbornnetwork.org\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Sepsis: A review of multidrug-resistant Enterobacteriaceae in a neonatal unit in Johannesburg, South Africa\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/www.healthynewbornnetwork.org\/#website\",\"url\":\"https:\/\/www.healthynewbornnetwork.org\/\",\"name\":\"Healthy Newborn Network\",\"description\":\"Addressing critical knowledge gaps in newborn health.\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/www.healthynewbornnetwork.org\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Healthy Newborn Network","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.healthynewbornnetwork.org\/resource\/sepsis-a-review-of-multidrug-resistant-enterobacteriaceae-in-a-neonatal-unit-in-johannesburg-south-africa\/","og_locale":"en_US","og_type":"article","og_title":"Sepsis: A review of multidrug-resistant Enterobacteriaceae in a neonatal unit in Johannesburg, South Africa - Healthy Newborn Network","og_description":"Background Multi-drug resistant organisms are an increasingly important cause of neonatal sepsis. Aim This study aimed to review neonatal sepsis caused by multi-drug resistant Enterobacteriaceae (MDRE) in neonates in Johannesburg, South Africa. Methods This was a cross sectional retrospective review of MDRE in neonates admitted to a tertiary neonatal unit between 1 January 2013 and &hellip; Continued","og_url":"https:\/\/www.healthynewbornnetwork.org\/resource\/sepsis-a-review-of-multidrug-resistant-enterobacteriaceae-in-a-neonatal-unit-in-johannesburg-south-africa\/","og_site_name":"Healthy Newborn Network","article_modified_time":"2019-09-18T14:36:28+00:00","og_image":[{"width":1200,"height":800,"url":"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/CH1329591.jpg","type":"image\/jpeg"}],"twitter_card":"summary_large_image","twitter_misc":{"Est. reading time":"1 minute"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/www.healthynewbornnetwork.org\/resource\/sepsis-a-review-of-multidrug-resistant-enterobacteriaceae-in-a-neonatal-unit-in-johannesburg-south-africa\/","url":"https:\/\/www.healthynewbornnetwork.org\/resource\/sepsis-a-review-of-multidrug-resistant-enterobacteriaceae-in-a-neonatal-unit-in-johannesburg-south-africa\/","name":"Sepsis: A review of multidrug-resistant Enterobacteriaceae in a neonatal unit in Johannesburg, South Africa - Healthy Newborn Network","isPartOf":{"@id":"https:\/\/www.healthynewbornnetwork.org\/#website"},"primaryImageOfPage":{"@id":"https:\/\/www.healthynewbornnetwork.org\/resource\/sepsis-a-review-of-multidrug-resistant-enterobacteriaceae-in-a-neonatal-unit-in-johannesburg-south-africa\/#primaryimage"},"image":{"@id":"https:\/\/www.healthynewbornnetwork.org\/resource\/sepsis-a-review-of-multidrug-resistant-enterobacteriaceae-in-a-neonatal-unit-in-johannesburg-south-africa\/#primaryimage"},"thumbnailUrl":"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/CH1329591.jpg","datePublished":"2019-10-01T14:33:25+00:00","dateModified":"2019-09-18T14:36:28+00:00","breadcrumb":{"@id":"https:\/\/www.healthynewbornnetwork.org\/resource\/sepsis-a-review-of-multidrug-resistant-enterobacteriaceae-in-a-neonatal-unit-in-johannesburg-south-africa\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.healthynewbornnetwork.org\/resource\/sepsis-a-review-of-multidrug-resistant-enterobacteriaceae-in-a-neonatal-unit-in-johannesburg-south-africa\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/www.healthynewbornnetwork.org\/resource\/sepsis-a-review-of-multidrug-resistant-enterobacteriaceae-in-a-neonatal-unit-in-johannesburg-south-africa\/#primaryimage","url":"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/CH1329591.jpg","contentUrl":"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/CH1329591.jpg","width":1200,"height":800,"caption":"Medication used to treat pneumonia on the pediatric ward, Lodwar County hospital, Turkana region, Kenya"},{"@type":"BreadcrumbList","@id":"https:\/\/www.healthynewbornnetwork.org\/resource\/sepsis-a-review-of-multidrug-resistant-enterobacteriaceae-in-a-neonatal-unit-in-johannesburg-south-africa\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.healthynewbornnetwork.org\/"},{"@type":"ListItem","position":2,"name":"Sepsis: A review of multidrug-resistant Enterobacteriaceae in a neonatal unit in Johannesburg, South Africa"}]},{"@type":"WebSite","@id":"https:\/\/www.healthynewbornnetwork.org\/#website","url":"https:\/\/www.healthynewbornnetwork.org\/","name":"Healthy Newborn Network","description":"Addressing critical knowledge gaps in newborn health.","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.healthynewbornnetwork.org\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"}]}},"featured_image":"<img width=\"768\" height=\"512\" src=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/CH1329591-768x512.jpg\" class=\"attachment-medium_large size-medium_large\" alt=\"\" decoding=\"async\" srcset=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/CH1329591-768x512.jpg 768w, https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/CH1329591-300x200.jpg 300w, https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/CH1329591-1024x683.jpg 1024w, https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/CH1329591.jpg 1200w\" sizes=\"(max-width: 768px) 100vw, 768px\" \/>","author_name":"HNN Team","author_image":"<img src=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/themes\/hnn\/dist\/images\/member-default.jpg\" alt=\"\" class=\"avatar avatar-32 photo\" height=\"32\" width=\"32\"\/>","acf_custom_fields":{"publication_date":"20190907","authors":false,"additional_authors":"Daynia E. Ballot, Rosella Bandini, Trusha Nana, Noma Bosman, Teena Thomas, Victor A. Davies, Peter A. Cooper, Mervyn Mer, Jeffrey Lipman ","type":"articles","language":["en"],"external_links":[{"link":"https:\/\/doi.org\/10.1186\/s12887-019-1709-y"}],"files":[{"file":"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/A-review-of-multidrug-resistant-Enterobacteriaceae-in-a-neonatal-unit-in-Johannesburg-South-Africa.pdf"}],"partners":[],"other_organizations":"University of the Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital, Critical Care Infection Collaboration","issues":[{"ID":411,"post_author":"7211","post_date":"2016-01-20 18:01:00","post_date_gmt":"2016-01-20 18:01:00","post_content":"[vc_row full_width=\"stretch_row\" css=\".vc_custom_1453403441710{margin-top: -60px !important;padding-top: 30px !important;padding-bottom: 30px !important;background-color: #ffffff !important;}\"][vc_column width=\"1\/2\"][vc_column_text]\r\n<h2>Identification of possible serious bacterial infection (PSBI) and timely initiation of appropriate antibiotic treatment can dramatically increase a newborn\u2019s chance of survival.<\/h2>\r\nRecent research has shown that when hospitalization is not possible, a safe, effective, and simpler antibiotic treatment can be provided in lower-level facilities.[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\" el_class=\"issue-stats\"][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-red\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">600<\/span>k<\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1666120914939{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">number of <a href=\"https:\/\/www.who.int\/publications\/i\/item\/9789241512930\">neonatal deaths attributed to severe infections<\/a> annually<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-yellow\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">10<\/span><\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1666120847543{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">percent of newborns who <a href=\"https:\/\/www.who.int\/publications\/i\/item\/9789241512930\">develop signs of PSBI and require treatment<\/a>\u00a0<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner][vc_column_text]\r\n<h6 style=\"text-align: center;\"><span style=\"font-style: italic;\">All data on this page represents the most recent data available, unless otherwise noted. Please visit our\u00a0<\/span><a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\"><span style=\"font-style: italic;\">Newborn Numbers<\/span><\/a><span style=\"font-style: italic;\">\u00a0page and download the Excel spreadsheet to explore the data further.<\/span><\/h6>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row css=\".vc_custom_1455919301204{margin-top: 30px !important;margin-bottom: 30px !important;}\"][vc_column][vc_column_text]\r\n<h2><b>PSBI Community of Practice <\/b><strong>(CoP)<\/strong><\/h2>\r\nThe PSBI CoP defines itself as \u201cgroups of people who share a concern or passion for something they do and learn how to do it better as they interact regularly.\u201d These groups facilitate the collective pursuit of a shared interest through relationship building, learning and information sharing about a specific practice area or need. They also stimulate dialogue, capture and diffuse existing knowledge, support collaboration, organize members around purposeful action, generate new knowledge and help to connect people who might not ordinarily interact. Given these features, COPs are uniquely positioned to help drive the research-to-use process by supporting stakeholder engagement, knowledge management, research translation, and research dissemination.[\/vc_column_text][vc_text_separator title=\"Key resources\"][vc_column_text]\r\n<ul>\r\n \t<li><a href=\"http:\/\/apps.who.int\/iris\/bitstream\/10665\/181426\/1\/9789241509268_eng.pdf\">Managing possible serious bacterial infection in young infants when referral is not feasible.<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/operationalizing-management-of-sick-young-infants-with-possible-serious-bacterial-infection-psbi-when-referral-is-not-feasible-in-the-context-of-existing-maternal-newborn-and-child-health-programm\/\">Operationalizing management of sick young infants with possible serious bacterial infection (PSBI) when referral is not feasible in the context of existing maternal, newborn, and child health programmes<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.thelancet.com\/pdfs\/journals\/langlo\/PIIS2214-109X(14)70347-X.pdf\">Safety and efficacy of alternative antibiotic regimens compared with 7-day injectable procaine benzyl penicillin and gentamicin for outpatient treatment of neonates and young infants with clinical signs of severe infection when referral is not possible: a randomized, open-label, equivalence trial.<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(14)62284-4\/abstract\">Simplified antibiotic regimens compared with injectable procaine benzyl penicillin plus gentamicin for treatment of neonates and young infants with clinical signs of possible serious bacterial infection when referral is not possible: a randomized, open-label, equivalence trial.<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(14)62285-6\/abstract\" target=\"_blank\" rel=\"noopener noreferrer\">Oral amoxicillin compared with injectable procaine benzyl penicillin plus gentamicin for treatment of neonates and young infants with fast breathing when referral is not possible: a randomized, open-label, equivalence trial<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(14)62285-6\/abstract\" target=\"_blank\" rel=\"noopener noreferrer\"> Outpatient treatment for neonates and young infants with clinically suspected severe infection<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/institutionalizing-the-management-of-sick-young-infants-kenyas-experience-in-revising-national-guidelines-on-integrated-management-of-newborn-and-childhood-illnesses\/\">Institutionalizing the Management of Sick Young Infants: Kenya\u2019s Experience in Revising National Guidelines on Integrated Management of Newborn and Childhood Illnesses<\/a><\/li>\r\n<\/ul>\r\n[\/vc_column_text][\/vc_column][vc_column][\/vc_column][\/vc_row]","post_title":"Treatment of possible severe bacterial infection (PSBI)","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"treatment-of-possible-severe-bacterial-infection","to_ping":"","pinged":"","post_modified":"2023-11-13 11:49:50","post_modified_gmt":"2023-11-13 16:49:50","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=issue&#038;p=411","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"},{"ID":126,"post_author":"7211","post_date":"2015-10-21 15:19:14","post_date_gmt":"2015-10-21 15:19:14","post_content":"[vc_row full_width=\"stretch_row\" css=\".vc_custom_1453403441710{margin-top: -60px !important;padding-top: 30px !important;padding-bottom: 30px !important;background-color: #ffffff !important;}\"][vc_column width=\"1\/2\"][vc_column_text]\r\n<h2>Severe newborn infections\u2014including sepsis, meningitis, and <a href=\"https:\/\/www.healthynewbornnetwork.org\/issue\/pneumonia\/\">pneumonia<\/a>\u2014are a major cause of morbidity and mortality among newborns in low- and middle-income countries.<\/h2>\r\nRecent analyses estimate that globally, approximately 400,000 newborns die each year as a result of severe infections, over one-sixth of the total burden of newborn deaths. Most of these deaths could be averted through:\r\n<ol>\r\n \t<li>preventive measures, such as improving hygiene practices, and<\/li>\r\n \t<li>timely and appropriate care for sick newborns.<\/li>\r\n<\/ol>\r\n[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\" el_class=\"issue-stats\"][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-red\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">17<\/span><\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1456252549558{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">percentage of neonatal deaths caused by severe bacterial infections<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-yellow\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">400<\/span>k<\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1456252596727{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">number of newborns who die each year as a result of severe infections<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-blue\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><b><span class=\"ticker\">8<\/span><\/b><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1653422219529{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\">percentage of neonatal deaths caused by pneumonia<\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner][vc_column_inner][vc_column_text]\r\n<h6 style=\"text-align: center;\"><em>All data on this page represents the most recent data available, unless otherwise noted. Please visit our <a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\">Newborn Numbers<\/a>\u00a0page and download the Excel spreadsheet to explore the data further.<\/em><\/h6>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" css=\".vc_custom_1453407008439{padding-top: 0px !important;padding-bottom: 0px !important;background-color: #f6f6f6 !important;}\"][vc_column][vc_text_separator title=\"Prevention\"][vc_row_inner equal_height=\"yes\"][vc_column_inner][vc_column_text]Preventive measures during the antenatal and intrapartum periods can reduce the risk of congenital and newborn infections while protecting the health of the mother. Before and during pregnancy, women can be screened and treated for syphilis and vaccinated against diseases like tetanus. In addition to preventing subsequent infection in the newborn, treating maternal infections during pregnancy \u2013 such as antibiotics for prolonged, preterm rupture of membranes or chorioamnionitis -- can also greatly reduce the risk for preterm birth, a leading cause of newborn mortality as well as prevent serious newborn infection.\r\n\r\nClean birth practices reduce the rate of newborn infections at home and implementation of consistent, high-quality infection control practices reduces newborn infections in facility settings. Hygienic umbilical cord care, including using a sterile instrument to cut the cord and, when appropriate and per national guidelines, <a href=\"https:\/\/www.healthynewbornnetwork.org\/issue\/chlorhexidine-for-umbilical-cord-care\/\">applying chlorhexidine to the newborn cord stump<\/a>, can also reduce infection and preventable death. <a href=\"https:\/\/www.healthynewbornnetwork.org\/issue\/breastfeeding-and-feeding-of-small-and-sick-newborns\/\">Early and exclusive breastfeeding<\/a> also reduces the likelihood of newborn infections in several ways, including providing critical support to boost immune system development and avoiding the introduction of potentially harmful substances to the immature gut.\r\n\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" css=\".vc_custom_1453407008439{padding-top: 0px !important;padding-bottom: 0px !important;background-color: #f6f6f6 !important;}\"][vc_column][vc_text_separator title=\"Management\"][vc_row_inner equal_height=\"yes\"][vc_column_inner][vc_column_text]WHO recommends that newborns and young infants should be hospitalized when they have signs of possible <a href=\"https:\/\/www.healthynewbornnetwork.org\/issue\/treatment-of-possible-severe-bacterial-infection\/\">serious bacterial infection, and treated<\/a> with 7 days of a combination of injectable antibiotics \u2013 gentaminin and ampicillin (or penicillin). In many or most low and middle-income countries (LMICs), such hospital-based treatment is not routinely feasible for many families for a number of cultural, geographic, and financial barriers. In these circumstances, recent evidence has led WHO to recommend outpatient antibiotics to such newborns and young infants to successfully treat the illness. The recommended antibiotic course is a combination of injectable and oral antibiotics: 2 days of once-daily gentamicin combined with 7 days of twice-daily oral amoxicillin. A follow up visit at 4 days of treatment is recommended to ensure adherence to the antibiotics and to ensure improvement in the newborn\u2019s condition. When referral from outpatient facility to hospital is accepted by families, the health center provider should ensure that the newborn or young infant is first given a dose of gentamicin and amoxicillin since even short delays in initiation of treatment can mean the difference between life and death.\r\n\r\nSaving newborn lives from life-threatening infections is now indeed feasible, acceptable, and effective in reducing preventable newborn and young infant deaths, and should be a top public health priority.\r\n\r\n<strong>Key Resources:\u00a0<\/strong>\r\n<ul>\r\n \t<li><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/25274969\/\">Respiratory Distress in the Newborn <\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.everypreemie.org\/wp-content\/uploads\/2019\/09\/SafeOxygen_english_7.6.17.pdf\">Safe and effective oxygen use for inpatient care of newborns<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.everypreemie.org\/wp-content\/uploads\/2019\/09\/InfectionPrevention_english_7.6.17.pdf\">Safe and effective infection prevention for inpatient newborn care<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.everypreemie.org\/wp-content\/uploads\/2019\/07\/DNH_TechBrief_MgmtNewbornInfection_7.15.19.pdf\">Management of newborn infections during inpatient care<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.nature.com\/articles\/pr2013207\">Neonatal severe bacterial infection impairment estimates in South Asia, sub-Saharan Africa, and Latin America for 2010<\/a><\/li>\r\n<\/ul>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row]","post_title":"Severe infections","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"severe-infections","to_ping":"","pinged":"","post_modified":"2022-10-18 14:43:52","post_modified_gmt":"2022-10-18 18:43:52","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=issue&#038;p=126","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"}],"regions":[{"ID":247,"post_author":"7211","post_date":"2015-11-22 21:37:22","post_date_gmt":"2015-11-22 21:37:22","post_content":"","post_title":"Africa","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"africa","to_ping":"","pinged":"","post_modified":"2016-02-11 21:42:43","post_modified_gmt":"2016-02-11 21:42:43","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=region&#038;p=247","menu_order":0,"post_type":"region","post_mime_type":"","comment_count":"0","filter":"raw"}],"countries":[{"ID":223,"post_author":"7211","post_date":"2015-10-21 22:04:20","post_date_gmt":"2015-10-21 22:04:20","post_content":"[vc_row][vc_column css=\".vc_custom_1453305596740{padding-top: 30px !important;padding-bottom: 30px !important;}\"][vc_text_separator title=\"Leading causes of neonatal deaths in South Africa (2020)\" el_class=\"transform:upperclass\"][vc_row_inner][vc_column_inner][vc_round_chart type=\"doughnut\" stroke_width=\"1\" stroke_color=\"custom\" values=\"%5B%7B%22title%22%3A%220%25%20Diarrhoea%22%2C%22value%22%3A%220%25%22%2C%22color%22%3A%22vista-blue%22%7D%2C%7B%22title%22%3A%220%25%20Tetanus%22%2C%22value%22%3A%220%25%22%2C%22color%22%3A%22mulled-wine%22%2C%22custom_color%22%3A%22%238d6dc4%22%7D%2C%7B%22title%22%3A%225%25%20Pneumonia%22%2C%22value%22%3A%225%25%22%2C%22color%22%3A%22peacoc%22%7D%2C%7B%22title%22%3A%2236%25%20Preterm%20birth%20complications%22%2C%22value%22%3A%2236%25%22%2C%22color%22%3A%22blue%22%7D%2C%7B%22title%22%3A%2220%25%20Intrapartum%20related%20events%22%2C%22value%22%3A%2220%25%22%2C%22color%22%3A%22turquoise%22%7D%2C%7B%22title%22%3A%2214%25%20Sepsis%20and%20other%20infectious%20conditions%20of%20the%20newborn%22%2C%22value%22%3A%2214%25%22%2C%22color%22%3A%22pink%22%7D%2C%7B%22title%22%3A%2210%25%20Congenital%20abnormalities%5Ct%22%2C%22value%22%3A%2210%25%22%2C%22color%22%3A%22violet%22%7D%2C%7B%22title%22%3A%2215%25%20Other%20conditions%22%2C%22value%22%3A%2215%25%22%2C%22color%22%3A%22chino%22%7D%5D\" custom_stroke_color=\"#f6f6f4\" css=\".vc_custom_1686335375365{padding-right: 30px !important;padding-left: 30px !important;background-position: center !important;background-repeat: no-repeat !important;background-size: contain !important;}\"][\/vc_column_inner][\/vc_row_inner][vc_column_text]\r\n<h6 style=\"text-align: left;\">Source: Estimates for causes of death 2000-2020 generated by the WHO and Maternal and Child Epidemiology Estimation Group (MCEE) 2023 and downloaded from <a href=\"http:\/\/data.unicef.org\/\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=http:\/\/data.unicef.org&amp;source=gmail&amp;ust=1551964625737000&amp;usg=AFQjCNFsFTtu9FzS8H64YC88NPOzQVbPwQ\">http:\/\/data.unicef.org<\/a><\/h6>\r\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" gap=\"5\" css=\".vc_custom_1453306441839{background-image: url(\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/country-stat-bkgr.jpg?id=389) !important;background-position: center !important;background-repeat: no-repeat !important;background-size: cover !important;}\"][vc_column css=\".vc_custom_1453306493120{margin-top: 30px !important;margin-bottom: 30px !important;}\"][vc_text_separator title=\"key indicators\" el_class=\"transform:uppercase text-white\"][vc_row_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1552412356987{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #e05533;\"><strong><span class=\"ticker\">11<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Newborn mortality rate (deaths per 1,000 live births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686335292465{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #d9a23b;\"><strong><span class=\"ticker\">2.2<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Annual reduction in newborn mortality rate 2000-2021 (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1650980934354{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #41aaab;\"><strong><span class=\"ticker\">33<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Proportion of under-5 child deaths that are newborn (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686335304276{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #e05533;\"><strong><span class=\"ticker\">16.2<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Stillbirth rate (deaths per 1,000 births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_row_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686335350088{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #d9a23b;\"><strong><span class=\"ticker\">96.7<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Skilled birth attendance (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1578918718172{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #41aaab;\"><strong><span class=\"ticker\">67<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Early initiation of breastfeeding (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1698697104922{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #e05533;\"><strong><span class=\"ticker\">13<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Preterm birth rate (births &lt;37 weeks per 100 live births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686335328630{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #d9a23b;\"><strong><span class=\"ticker\">127<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Maternal mortality ratio (deaths per 100,000 live births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_column_text css=\".vc_custom_1456677993474{margin-top: 20px !important;}\"]\r\n<h5 style=\"text-align: center;\"><span style=\"color: #ffffff;\">Visit our<\/span> <a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\">Newborn numbers<\/a> <span style=\"color: #ffffff;\">page to explore the most recent data further<\/span><\/h5>\r\n[\/vc_column_text][\/vc_column][\/vc_row]","post_title":"South Africa","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"south-africa","to_ping":"","pinged":"","post_modified":"2023-10-30 16:17:00","post_modified_gmt":"2023-10-30 20:17:00","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=country&#038;p=223","menu_order":0,"post_type":"country","post_mime_type":"","comment_count":"0","filter":"raw"}],"views":"922"},"_links":{"self":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/resource\/38903"}],"collection":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/resource"}],"about":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/types\/resource"}],"author":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/users\/7211"}],"replies":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/comments?post=38903"}],"version-history":[{"count":0,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/resource\/38903\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media\/38905"}],"wp:attachment":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media?parent=38903"}],"wp:term":[{"taxonomy":"toolkit","embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/toolkit?post=38903"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}