SRA

The level of antibiotic resistance in neonatal infections and its impact on mortality in low-middle income countries (LMICs) is unacceptably high. The study, entitled the Burden of Antibiotic Resistance in Neonates from Developing Societies (BARNARDS), will provide the means, support, network and tools to understand the impact of antibiotic resistance on neonatal morbidity and mortality in addition to identifying possible solutions to minimize its impact.Antimicrobial resistance (AMR) is now recognised as one of the most serious global threats to human health in the 21st century. There is evidence of political traction through endorsements of statements by the UK and US governments, WHO and CDC describe a global crisis and an impending catastrophe of moving into a post-antibiotic era. These serious concerns have been catalysed by the rapid increase in Multi-Drug Resistant (MDR) Gram-negative bacteria (GNB), particularly Enterobacteriaceae.Developing countries bear the burden of 99% of neonatal mortality worldwide (WHO) with infections such as tetanus, pneumonia and sepsis acting as a leading causes of neonatal mortality. Increased antibiotic resistance in bacteria, including MDR pathogens, render infections increasingly difficult to treat, with resistance arising against last resort treatments.The study will be the first of its kind in the world to blend clinical and molecular epidemiology from low-middle income countries with respect to neonatal Gram-negative infections. The data generated will be used to inform local, national and international health bodies. The BARNARDS group will focus on monitoring and improving mother and infant wellbeing by exploring the impact of infection control interventions. In addition to assessing the burden of antibiotic resistance, we will also determine the prevalence of multi-drug resistant Gram-negative bacteria (MDR_GNB) carried as normal flora that causes neonatal sepsis and identify contributing demographic indices such as population size, overcrowding, access to clean water, sanitation conditions, family size, poverty level and antibiotic usage impact on MDR_GNB.BARNARDS is currently active in 12 different sites, across seven different countries; Bangladesh (Chittagong and Dhaka), Ethiopia (Addis Ababa), India (Kolkata), Nigeria (Kano, Abuja (National Hospital) and Abuja (Wuse), Pakistan (Islamabad and Bhara Kahu), Rwanda, (Kigali and Kabgayi) and South Africa (Cape Town). Bangladesh, Nigeria, Pakistan, Rwanda and South Africa joined the study in 2015 and Nigeria (Kano), Ethiopia and India joined in 2016