CHANGING PATTERN OF BACTERIAL ISOLATES AND ANTIMICROBIAL SUSCEPTIBILITY IN NEONATAL INFECTIONS IN KORLE BU TEACHING HOSPITAL, GHANA

Background: Most neonatal deaths in developing countries are caused by infections, birth asphyxiaand prematurity. Even though most of these deaths occur at home, newborns admitted to hospitalneonatal units have a high risk of contracting fatal multi-drug resistant infections.Objective: To compare the type of bacteria and the pattern of antimicrobial susceptibility oforganisms causing neonatal infections in 2001/02 with 1991/92 in the same neonatal unit.Design: We reviewed the hospital records of newborns admitted to the neonatal unit in 2001/02 thathad positive blood cultures and compared the findings with similar work done 1991/92.Setting: Neonatal Unit, Korle Bu Teaching Hospital, Ghana.Results: Gram negative organisms (predominantly Enterobacter, Klebsiella and Acinetobacter)remained the predominant cause of neonatal infection. There was a reduction in the proportionof gram negative bacteraemia [70.9% in 1991/92 vs. 54.2% in 2001/02 (p<0.001)] due to the increasedprevalence of coagulase negative staphylococcus (31.9% in 2001/02 vs. 0% in 1991/92) as a cause ofneonatal bacteraemia ten years later. In 1991/92 as 2001/02 all bacterial isolates showed less than40% susceptibility to ampicillin. The susceptibility of Klebsiella and Enterobacter to commonlyused aminoglycosides and cephalosporins had decreased from over 80% in 1991/92 to less than35% in 2001/02.Conclusion: Bacterial causes of neonatal infections change over time and antimicrobial resistance isa major cause for concern in neonatal units in resource-poor hospitals. Improving infection controlpractices and instituting systems to monitor antimicrobial use and resistance will complimentcommunity efforts to reduce neonatal mortality

THE CHANGING PATTERN OF BACTERIAL ISOLATES AND ANTIMICROBIAL SUSCEPTIBILITY IN NEONATAL INFECTIONS IN KORLE BU TEACHING HOSPITAL, GHANA

Background: Most neonatal deaths in developing countries are caused by infections, birth asphyxiaand prematurity. Even though most of these deaths occur at home, newborns admitted to hospitalneonatal units have a high risk of contracting fatal multi-drug resistant infections.Objective: To compare the type of bacteria and the pattern of antimicrobial susceptibility oforganisms causing neonatal infections in 2001/02 with 1991/92 in the same neonatal unit.Design: We reviewed the hospital records of newborns admitted to the neonatal unit in 2001/02 thathad positive blood cultures and compared the findings with similar work done 1991/92.Setting: Neonatal Unit, Korte Bu Teaching Hospital, Ghana.Results: Gram negative organisms (predominantly Enterobacter, Klebsiella and Acinetobacter)remained the predominant cause of neonatal infection. There was a reduction in the proportionof gram negative bacteraemia [70.9% in 1991/92 vs. 54.2% in 2001/02 (p<0.001)] due to the increasedprevalence of coagulase negative staphylococcus (31.9% in 2001/02 vs. 0% in 1991/92) as a cause ofneonatal bacteraemia ten years later. In 1991/92 as 2001/02 all bacterial isolates showed less than40% susceptibility to ampicillin. The susceptibility of Klebsiella and Enterobacter to commonlyused aminoglycosides and cephalosporins had decreased from over 80% in 1991/92 to less than35% in 2001/02.Conclusion: Bacterial causes of neonatal infections change over time and antimicrobial resistance isa major cause for concern in neonatal units in resource-poor hospitals. Improving infection controlpractices and instituting systems to monitor antimicrobial use and resistance will complimentcommunity efforts to reduce neonatal mortality

METHYLERGOMETRINE POISONING IN THE NEWBORN: REPORT OF TWO CASES

Methylergometrine is probably the most commonly used drug in obstetric care at all levels of the health care system. Many communities in Africa lack skilled birth attendants and adequate health systems; medication errors are more likely to occur and go unreported in these settings. The morbidity and mortality that result from these errors can be reduced if health care workers are better informed. We report two cases of medication error with methylergometrine and suggest guidelines for health care workers at the primary and secondary levels of health care