Improving Diagnosis of Sepsis in Young Infants in Africa: Are We Using Antibiotics Appropriately?

Tisungane Mvalo and Gerald Tegha of Lilongwe Medical Relief Fund Trust along with Msandeni Chiume at Kamuzu Central Hospital both in Malawi, Emily Ciccone from the University of North Carolina in the US and Pascal Lavoie of the University of British Columbia in Canada will establish metagenomic next generation sequencing at a research laboratory in Malawi to identify pathogens causing infections in young infants to ensure rapid treatment with appropriate therapy and limit unnecessary antibiotic use. It is estimated that over a quarter of the 2.9 million neonatal deaths that occur each year are caused by infections. Given these high numbers, antibiotic treatment has become the standard practice for all young infants that have a suspected serious bacterial infection. However, a recent study using clinical microbiology approaches only identified an infectious agent in half of suspected cases, suggesting that antibiotics are often being used unnecessarily. They will sequence blood samples taken from infants under three months of age with suspected infections and vaginal swabs from mothers enrolled in an existing study in an urban hospital to identify infectious agents. They will also evaluate the presence of antimicrobial resistance genes and see if they can be linked with maternal vaginal flora. Overall, they aim to characterize the pathogen landscape associated with suspected infectious diseases in young infants.