A global observational study, involving over 3,200 newborn babies diagnosed with sepsis, has highlighted the growing ineffectiveness of antibiotics used for treatment, leading to a significant rise in mortality rates among infants.
The study, published in PLOS Medicine and co-authored by a team of more than 80 researchers, sheds light on the critical issue of antibiotic resistance in at least ten countries, including India. Sepsis, a life-threatening bloodstream infection, affects millions of infants worldwide, with an estimated 3 million cases reported annually. Tragically, 214,000 newborn babies succumb to sepsis every year, primarily in low- and middle-income countries, where the infection has developed resistance to antibiotics.
Conducted from 2018 to 2020, the study aimed to gain a deeper understanding of the infections affecting newborns in hospitals, the causative pathogens, the treatment strategies employed, and the underlying factors contributing to increased mortality rates.
The findings were alarming, highlighting not only the high mortality rate among infants with culture-positive sepsis (nearly 1 in 5 across the hospital sites) but also the significant burden of antibiotic resistance.
Manica Balasegaram, Executive Director of the Global Antibiotic Research and Development Partnership, emphasized the importance of the study in unraveling the complexities surrounding newborn infections and escalating mortality rates.
Newborns are particularly vulnerable to severe infections due to their underdeveloped immune systems. Nishad Plakkal, Additional Professor of Neonatology and Associate Dean (Research) at JIPMER, Puducherry, highlighted the study’s striking finding of the disparity in sepsis-related deaths based on geographical location. Plakkal drew attention to the challenges faced in units where nurses are often overwhelmed with caring for multiple critically ill babies simultaneously, creating an environment conducive to the spread of infections.
The study revealed significant variation in mortality rates among the 19 participating hospitals, ranging from 1.6% to 27.3%. Notably, rates were considerably higher in LMICs, further exposing the harsh reality of antibiotic-resistant infections prevalent in these healthcare settings. Sithembiso Velaphi, Head of Paediatrics at Chris Hani Baragwanath Academic Hospital in Johannesburg, South Africa, emphasized the urgent need for change, pointing out the high risk of infections and the limited effectiveness of antibiotics in saving lives.
The study shed light on the practice of frequently switching antibiotics due to the high levels of resistance observed in treatments. Hospitals employed over 200 different antibiotic combinations, and physicians were often compelled to resort to carbapenems, classified as “Watch” antibiotics by the WHO, due to the escalating resistance to recommended treatments.