Introduction: Healthcare-associated bloodstream infections (HA-BSIs) represent a major cause of morbidity and mortality in neonatal intensive care units, particularly in low- and middle-income countries (LMICs). In Senegal, few data exist regarding the incidence, bacterial spectrum, and antimicrobial resistance patterns of HA-BSIs in neonates. This study aimed to describe the epidemiological and microbiological profile of healthcare-associated bloodstream infections in the neonatal unit of Dalal Jamm National Hospital in Senegal. Methods: We conducted a retrospective longitudinal study from October 2022 to July 2023 in the neonatal unit of Dalal Jamm National Hospital. All neonates with at least one positive blood culture obtained ≥48 hours after admission were included. Data were extracted from medical records and bacteriology registers and analyzed using R software v4.1.3. Categorical variables were expressed as frequencies, and the time to infection onset was described by the median and interquartile range. Results: Among 288 admitted neonates, 36 cases of HA-BSIs were recorded, yielding a cumulative incidence of 12.5% and an incidence density of 15.5 cases per 1 000 patient-days. The median time to infection was 6 days IQR 2–13. Prematurity and low birth weight ( 2 500 g) were observed in 53% of cases. A total of 38 pathogens were isolated, predominantly Gram-negative bacilli (65.8%), mainly Enterobacter cloacae (18.4%), Klebsiella pneumoniae (15.8%), and Escherichia coli (13.1%). Gram-positive cocci accounted for 31.6% of isolates, primarily coagulase-negative staphylococci (21%). Among 28 strains tested for resistance, 57% were multidrug-resistant, including 61% ESBL- or carbapenemase-producing Enterobacterales. The case-fatality rate was 36%. Conclusion: The incidence of healthcare-associated bloodstream infections in the neonatal unit of Dalal Jamm Hospital is high, with a predominance of multidrug-resistant Gram-negative bacteria. Strengthening infection prevention and control programs, rational antibiotic use, and continuous surveillance are urgently needed to reduce neonatal morbidity and mortality in resource-limited settings.
Sow et al. (Fri,) studied this question.