{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T22:27:46Z","timestamp":1791412066254,"version":"4.3.3"},"reference-count":30,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2022,9,16]],"date-time":"2022-09-16T00:00:00Z","timestamp":1663286400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"UK Department of Health and Social Care"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>In this study, we described the bacterial profile, antibiotic resistance pattern, and laboratory result turnaround time (TAT) in neonates with suspected sepsis from a tertiary-level, military hospital in Accra, Ghana (2017\u20132020). This was a cross-sectional study using secondary data from electronic medical records. Of 471 neonates clinically diagnosed with suspected sepsis in whom blood samples were collected, the median TAT from culture request to report was three days for neonates who were culture-positive and five days for neonates who were culture-negative. There were 241 (51%) neonates discharged before the receipt of culture reports, and of them, 37 (15%) were culture-positive. Of 471 neonates, twenty-nine percent (n = 139) were bacteriologically confirmed, of whom 61% (n = 85) had late-onset sepsis. Gram-positive bacterial infection (89%, n = 124) was the most common cause of culture-positive neonatal sepsis. The most frequent Gram-positive pathogen was coagulase-negative Staphylococcus (55%, n = 68) followed by Staphylococcus aureus (36%, n = 45), of which one in two were multidrug resistant. The reasons for large numbers being discharged before the receipt of culture reports need to be further explored. There is a need for improved infection prevention and control, along with ongoing local antimicrobial resistance surveillance and antibiotic stewardship to guide future empirical treatment.<\/jats:p>","DOI":"10.3390\/ijerph191811659","type":"journal-article","created":{"date-parts":[[2022,9,16]],"date-time":"2022-09-16T03:48:04Z","timestamp":1663300084000},"page":"11659","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Sepsis among Neonates in a Ghanaian Tertiary Military Hospital: Culture Results and Turnaround Times"],"prefix":"10.3390","volume":"19","author":[{"given":"Francis Kwame Morgan","family":"Tetteh","sequence":"first","affiliation":[{"name":"Pathology Division, 37 Military Hospital, Neghelli Barracks, Accra GA 01, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond","family":"Fatchu","sequence":"additional","affiliation":[{"name":"Pathology Division, 37 Military Hospital, Neghelli Barracks, Accra GA 01, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kingsley","family":"Ackah","sequence":"additional","affiliation":[{"name":"Pathology Division, 37 Military Hospital, Neghelli Barracks, Accra GA 01, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3279-6333","authenticated-orcid":false,"given":"Trudy Janice","family":"Philips","sequence":"additional","affiliation":[{"name":"Clinical Pathology Department, Noguchi Memorial Institute for Medical Research, P.O. Box LG 581, Accra GA 01, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8242-1911","authenticated-orcid":false,"given":"Hemant Deepak","family":"Shewade","sequence":"additional","affiliation":[{"name":"Division of Health System Research, ICMR-National Institute of Epidemiology (ICMR-NIE), Chennai 600077, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9367-1265","authenticated-orcid":false,"given":"Ama Pokuaa","family":"Fenny","sequence":"additional","affiliation":[{"name":"Institute of Statistical, Social and Economic Research, University of Ghana, P.O. Box LG 1181, Accra GA 01, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0997-9799","authenticated-orcid":false,"given":"Collins","family":"Timire","sequence":"additional","affiliation":[{"name":"International Union against Tuberculosis and Lung Disease (The Union), 75006 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey Karl","family":"Edwards","sequence":"additional","affiliation":[{"name":"Department of Global Health, University of Washington, Seattle, WA 98195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5332-125X","authenticated-orcid":false,"given":"Emmanuel Abbeyquaye","family":"Parbie","sequence":"additional","affiliation":[{"name":"Paedriatric Division, 37 Military Hospital, Neghelli Barracks, Accra GA 01, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,16]]},"reference":[{"key":"ref_1","first-page":"977","article-title":"Bacteriological Profile and Antibiotic Susceptibility Pattern of Neonatal Septicaemia in a Tertiary Care Hospital","volume":"4","author":"Sawhney","year":"2015","journal-title":"Int. J. Curr. Microbiol. Appl. Sci."},{"key":"ref_2","first-page":"1","article-title":"Perinatal & Neonatal Mortality in a Hospital","volume":"94","author":"Singh","year":"1991","journal-title":"Indian J. Med. Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1770","DOI":"10.1016\/S0140-6736(17)31002-4","article-title":"Neonatal Sepsis","volume":"390","author":"Shane","year":"2017","journal-title":"Lancet Lond. Engl."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.1016\/S0140-6736(05)71881-X","article-title":"Hospital-Acquired Neonatal Infections in Developing Countries","volume":"365","author":"Zaidi","year":"2005","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Labi, A.-K., Obeng-Nkrumah, N., Bjerrum, S., Enweronu-Laryea, C., and Newman, M.J. (2016). Neonatal Bloodstream Infections in a Ghanaian Tertiary Hospital: Are the Current Antibiotic Recommendations Adequate?. BMC Infect. Dis., 16.","DOI":"10.1186\/s12879-016-1913-4"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1136\/archdischild-2020-320217","article-title":"Global Incidence and Mortality of Neonatal Sepsis: A Systematic Review and Meta-Analysis","volume":"106","author":"Fleischmann","year":"2021","journal-title":"Arch. Dis. Child."},{"key":"ref_7","unstructured":"(2018). GBD 2017 Causes of Death Collaborators Global, Regional, and National Age-Sex-Specific Mortality for 282 Causes of Death in 195 Countries and Territories, 1980\u20132017: A Systematic Analysis for the Global Burden of Disease Study 2017. Lancet Lond. Engl., 392, 1736\u20131788."},{"key":"ref_8","unstructured":"(2018). GBD 2017 Disease and Injury Incidence and Prevalence Collaborators Global, Regional, and National Incidence, Prevalence, and Years Lived with Disability for 354 Diseases and Injuries for 195 Countries and Territories, 1990\u20132017: A Systematic Analysis for the Global Burden of Disease Study 2017. Lancet Lond. Engl., 392, 1789\u20131858."},{"key":"ref_9","unstructured":"UNICEF (2015). Levels & Trends in Child Mortality, WHO, World Bank Group. Available online: https:\/\/www.unicef.org\/media\/files\/IGME_Report_Final2.pdf."},{"key":"ref_10","unstructured":"WHO (2019). Newborns: Reducing Mortality, WHO, World Health Organization. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/newborns-reducing-mortality."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e000347","DOI":"10.1136\/bmjgh-2017-000347","article-title":"Economic Burden of Neonatal Sepsis in Sub-Saharan Africa","volume":"3","author":"Ranjeva","year":"2018","journal-title":"BMJ Glob. Health"},{"key":"ref_12","first-page":"499","article-title":"Etiology of Neonatal Blood Stream Infections in Tbilisi, Republic of Georgia","volume":"13","author":"Macharashvili","year":"2009","journal-title":"Int. J. Infect. Dis. IJID Off. Publ. Int. Soc. Infect. Dis."},{"key":"ref_13","unstructured":"WHO (2019). WHO Releases the 2019 AWaRe Classification Antibiotics, WHO. Available online: https:\/\/www.who.int\/news\/item\/01-10-2019-who-releases-the-2019-aware-classification-antibiotics."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"850","DOI":"10.4269\/ajtmh.15-0083","article-title":"Cost-Effectiveness of Surveillance for Bloodstream Infections for Sepsis Management in Low-Resource Settings","volume":"93","author":"Penno","year":"2015","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Adjei, G., Darteh, E.K.M., Nettey, O.E.A., and Doku, D.T. (2021). Neonatal Mortality in the Central Districts of Ghana: Analysis of Community and Composition Factors. BMC Public Health, 21.","DOI":"10.1186\/s12889-021-10156-6"},{"key":"ref_16","unstructured":"Ghana Statistical Service, Ghana Health Service, and ICF International (2015). Ghana Demographic and Health Survey 2014, GSS, GHS, ICF International. Available online: https:\/\/dhsprogram.com\/pubs\/pdf\/fr307\/fr307.pdf."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s40748-017-0071-z","article-title":"Bacteriological Profile and Antibiotic Susceptibility Pattern of Common Isolates of Neonatal Sepsis, Ho Municipality, Ghana-2016","volume":"4","author":"Aku","year":"2018","journal-title":"Matern. Health Neonatol. Perinatol."},{"key":"ref_18","unstructured":"(2022, July 08). Ghana|History, Flag, Map, Population, Language, Currency, & Facts|Britannica. Available online: https:\/\/www.britannica.com\/place\/Ghana."},{"key":"ref_19","unstructured":"(2022, July 08). Ghana Population (2022)\u2014Worldometer. Available online: https:\/\/www.worldometers.info\/world-population\/ghana-population\/."},{"key":"ref_20","first-page":"321","article-title":"The Medical System in Ghana","volume":"87","author":"Drislane","year":"2014","journal-title":"Yale J. Biol. Med."},{"key":"ref_21","unstructured":"(2022, July 08). M100Ed32|Performance Standards for Antimicrobial Susceptibility Testing, 32nd ed. Available online: https:\/\/clsi.org\/standards\/products\/microbiology\/documents\/m100\/."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1111\/j.1469-0691.2011.03570.x","article-title":"Multidrug-Resistant, Extensively Drug-Resistant and Pandrug-Resistant Bacteria: An International Expert Proposal for Interim Standard Definitions for Acquired Resistance","volume":"18","author":"Magiorakos","year":"2012","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Tsai, Y.-W., Lin, T.-C., Chou, H.-Y., Hung, H.-Y., Tan, C.-K., Wu, L.-C., Feng, I.-J., and Shiue, Y.-L. (2021). Shortening the Time of the Identification and Antimicrobial Susceptibility Testing on Positive Blood Cultures with MALDI-TOF MS. Diagnostics, 11.","DOI":"10.3390\/diagnostics11081514"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"131","DOI":"10.3389\/fmed.2019.00131","article-title":"Best Practices of Blood Cultures in Low- and Middle-Income Countries","volume":"6","author":"Ombelet","year":"2019","journal-title":"Front. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"6","DOI":"10.5588\/pha.21.0038","article-title":"Antimicrobial Resistance in Neonates with Suspected Sepsis","volume":"11","author":"Yadav","year":"2021","journal-title":"Public Health Action"},{"key":"ref_26","first-page":"e21107","article-title":"Common Bacterial Isolates Associated with Neonatal Sepsis and Their Antimicrobial Profile: A Retrospective Study at King Abdulaziz University Hospital, Jeddah, Saudi Arabia","volume":"14","author":"Alharbi","year":"2022","journal-title":"Cureus"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Oo, N.A.T., Edwards, J.K., Pyakurel, P., Thekkur, P., Maung, T.M., Aye, N.S.S., and Nwe, H.M. (2021). Neonatal Sepsis, Antibiotic Susceptibility Pattern, and Treatment Outcomes among Neonates Treated in Two Tertiary Care Hospitals of Yangon, Myanmar from 2017 to 2019. Trop. Med. Infect. Dis., 6.","DOI":"10.3390\/tropicalmed6020062"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"285","DOI":"10.3389\/fped.2018.00285","article-title":"Culture-Negative Early-Onset Neonatal Sepsis\u2014At the Crossroad Between Efficient Sepsis Care and Antimicrobial Stewardship","volume":"6","author":"Klingenberg","year":"2018","journal-title":"Front. Pediatr."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"586076","DOI":"10.1155\/2013\/586076","article-title":"Neonatal Sepsis Due to Coagulase-Negative Staphylococci","volume":"2013","author":"Marchant","year":"2013","journal-title":"Clin. Dev. Immunol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1186\/cc9013","article-title":"Gram-Negative versus Gram-Positive Bacteremia: What Is More Alarmin(g)?","volume":"14","author":"Alexandraki","year":"2010","journal-title":"Crit. Care Lond. Engl."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/18\/11659\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:32:34Z","timestamp":1760142754000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/18\/11659"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,16]]},"references-count":30,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2022,9]]}},"alternative-id":["ijerph191811659"],"URL":"https:\/\/doi.org\/10.3390\/ijerph191811659","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,16]]}}}