Baby GERMS Surveillance:

Neonatal deaths account for almost half of deaths in children under 5 years, with infections being the third largest contributor after prematurity and intrapartum complications.

Baby GERMS is the first population-based surveillance programme on neonatal infections in Africa and was set up in the latter half of 2019 with funding from the Bill and Melinda Gates Foundation (BMGF). The aim was to provide a baseline description of the aetiology, antimicrobial susceptibility and clinical characteristics of culture-confirmed neonatal bloodstream infections and meningitis in South Africa.

Through this surveillance programme, we aimed to identify modifiable risk factors which could be targeted to reduce neonatal morbidity and mortality. Baby GERMS has been acknowledged as a major new source of strategic data by the National Neonatal Task Force, which was launched in September 2019 to provide technical advice and guidance on surveillance for neonatal sepsis, infection prevention and control, neonatal infection case management, antimicrobialstewardship and containment of neonatal unit outbreaks.

In 2021, data from approximately 45 000 laboratory-confirmed cases of neonatal meningitis and blood stream infections were collated and analysed and a publication was submitted to Lancet Global Health. This analysis was shared with stakeholders from the National Department of Health to inform neonatal sepsis prevention guidelines.

Isolates collected from 933 episodes of laboratory-confirmed neonatal meningitis and blood stream infections occurring at 6 provincial/regional hospitals between October 2019 and September 2020 underwent further genotypic and phenotypic analysis and results on the numerous Klebsiella pneumoniae infections have been shared with KlebNET, an international group looking at global genomics of Klebsiella K-loci.

Aspects of the sentinel surveillance data were shared at the International Symposium on Streptococcus Agalactiae Disease (ISSAD) and the World Symposium on Paediatric Infectious Diseases (WSPID).