Author(s)

Innocent Afeke^1,2*, Misa Hirose¹, Kokou Hefoume Amegan-Aho³, Christoph Haertel⁴, Mareike Becker¹, Ahmed Moustafa⁵, Paul Schilf¹, Mohamed Tarek Badr⁶, Graceful Lord Mensah⁷, Hintermann Kobina Mbroh⁸, Jan Rupp⁹, Saleh Ibrahim¹

¹Luebeck Institute for Experimental Dermatology, University of Luebeck, Luebeck, Germany.
²Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Volta Region, Ho, Ghana.
³Department of Paediatrics, School of Medicine, University of Health and Allied Sciences, Ho, Volta Region, Ho, Ghana.
⁴Department of Paediatrics, University Hospital Würzburg, University of Würzburg, Würzburg, Germany.
⁵Department of Biology, Bioinformatics and Integrative Genomics Laboratory, American University in Cairo, New Cairo, Egypt.
⁶Institute of Medical Microbiology and Hygiene, Medical Center-University of Freiburg, Faculty of Medicine, Freiburg, Germany.
⁷Department of Paediatrics, Ho Teaching Hospital, Volta Region, Ho, Ghana.
⁸Department of Obstetrics and Gynaecology, Ho Teaching Hospital, Volta Region, Ho, Ghana.
⁹Department of Infectious Diseases and Microbiology, University of Luebeck, Luebeck, Germany.

Background: Neonatal sepsis is a global health problem that mainly affects low- and middle-income countries. We have previously shown that early neonatal mortality is high at the Ho Teaching Hospital (HTH) of Ghana. We sought to determine the prevalence of neonatal sepsis, sepsis-related mortality, and bacterial species patterns in neonatal and young infant sepsis in this hospital. Methods: A hospital-based study was conducted in the hospital’s neonatal intensive care unit (NICU) from March to June 2018. Blood samples from 96 babies clinically diagnosed with or at risk of sepsis were cultured using the BACTEC 9050^® machine. Clinical data including gravida, parity and antibiotic medication before delivery of mother and delivery type, gestation, birth weight and antibiotic medication status were collected for analysis. MALDI-TOF MS identified bacterial isolates, and their identities were confirmed via tuf gene sequence typing. The data were analyzed using GraphPad Prism 8.0.2. Results: Blood cultures were positive in 28 of the babies, with 14 and 12 representing early-onset and late-onset neonatal sepsis, respectively, and two cases of unknown sepsis type. Of the bacterial species that caused sepsis in the babies, coagulase-negative staphylococcus (CoNS) was the most prevalent isolate in 22 cases, followed by Klebsiella pneumoniae in two and Staphylococcus aureus, Streptococcus agalactiae, the Acinetobacter species, and Escherichia coli in the rest (one each). Of the CoNS, S. haemolyticus and S. epidermidis were the most prevalent species, found in eight and six cases, respectively. Thirteen neonates died, of whom seven had positive blood cultures, and two were referred. A case fatality rate of 7/26 was estimated. Neonatal mortality caused by Gram-negative bacterial infection was higher than that caused by Gram-positive bacteria. Conclusions: These data suggest a significant burden of sepsis among neonates and young infants and are associated with substantial morbidity and mortality at the HTH. There is a need to investigate risk factors associated with the increased sepsis rate in this hospital to inform measures to reduce the neonatal sepsis rate.

Neonatal Sepsis, Neonatal Mortality, Healthcare-Associated Infections, Neonatal Intensive Care Unit, Ho Teaching Hospital of Ghana

Afeke, I. , Hirose, M. , Amegan-Aho, K. , Haertel, C. , Becker, M. , Moustafa, A. , Schilf, P. , Badr, M. , Mensah, G. , Mbroh, H. , Rupp, J. and Ibrahim, S. (2021) Neonatal and Young Infant Sepsis in a Regional Hospital in Ghana. Open Journal of Pediatrics, 11, 281-300. doi: 10.4236/ojped.2021.112027.