{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T15:09:32Z","timestamp":1791212972685,"version":"4.1.0"},"reference-count":23,"publisher":"BMJ","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2012,3,28]]},"published-print":{"date-parts":[[2012]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To assess the causes of bacteraemia in young infants and susceptibility to first-line antibiotics (benzylpenicillin plus gentamicin) at the Queen Elizabeth Central Hospital (QECH), Malawi during 2002\u20132007.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective analysis of demographic and microbiological data using laboratory records.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>QECH is Malawi's largest hospital with 7000 neonates admitted annually, 9% for septicaemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>All infants aged 60\u2005days or less admitted to QECH that had a blood culture taken over the 6-year period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>6754 blood cultures were taken. 3323 organisms were isolated: one-third were pathogens, two-thirds contaminants. Gram-positive organisms (53%) were more common than gram-negatives (47%). Four organisms made up half of all pathogens:<jats:italic>Staphylococcus aureus<\/jats:italic>(15.3%), group B streptococci (13.5%), non-typhoidal salmonellae (12.6%) and<jats:italic>Escherichia coli<\/jats:italic>(10.5%). Apart from non-typhoidal salmonellae and<jats:italic>Streptococcus pneumoniae<\/jats:italic>, most organisms were more common in the first week of life than later. Overall, 28% of isolates during 2002\u20132007 were resistant to first-line antibiotic, higher than observed during 1996\u20132001 (22%). Penicillin susceptibility fluctuated while gram-negative resistance to gentamicin increased from 17% to 27% over the study period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In the QECH, pathogens causing young infant sepsis are an unusual mix of organisms seen in both developed and developing countries. Resistance to first-line antibiotics is higher than observed in most studies. Ongoing monitoring is needed and clinical outcome data would aid interpretation of findings. A high proportion of blood cultures were contaminated with skin flora\u2014improved training and supervision of phlebotomists are needed to improve the utility of taking blood cultures.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2012-000906","type":"journal-article","created":{"date-parts":[[2012,5,16]],"date-time":"2012-05-16T06:36:20Z","timestamp":1337150180000},"page":"e000906","source":"Crossref","is-referenced-by-count":4,"title":["Bacteraemia in Malawian neonates and young infants 2002\u20132007: a retrospective audit"],"prefix":"10.1136","volume":"2","author":[{"given":"Amanda","family":"Gwee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Coghlan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dean","family":"Everett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Newton","family":"Chagoma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amos","family":"Phiri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorna","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Molyneux","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2012,5,15]]},"reference":[{"key":"2024051503331506000_2.3.e000906.1","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-200004000-00010"},{"key":"2024051503331506000_2.3.e000906.2","doi-asserted-by":"publisher","DOI":"10.1179\/146532805X45692"},{"key":"2024051503331506000_2.3.e000906.3","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkm110"},{"key":"2024051503331506000_2.3.e000906.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)71881-X"},{"key":"2024051503331506000_2.3.e000906.5","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2005-0552"},{"key":"2024051503331506000_2.3.e000906.6","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2002.022863"},{"key":"2024051503331506000_2.3.e000906.7","first-page":"687","article-title":"Neonatal bacterial septicemia in a tropical area. 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