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High rates of admission in lower middle-income countries’ neonatal units suggest an enhanced focus on infection prevention and control measures is required
  1. Aislinn Cook1,
  2. Rebecca Lundin2,
  3. Julia Bielicki1,
  4. Mike Sharland1,
  5. Yingfen Hsia1
  1. 1 Paediatric Infectious Diseases Research Group, St George’s University of London, London, UK
  2. 2 Data Area, Fondazione PENTA Onlus, Padua, Italy
  1. Correspondence to Aislinn Cook, Paediatric Infectious Diseases Research Group, St George's University of London, London SW17 0RE, UK; aicook{at}

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The recent publication of key findings from a WHO/UNICEF report on care for sick and small newborns, Survive and Thrive: Transforming Care for Every Small and Sick Newborn,1 recommends the expansion of NICU services globally for small/sick babies, but does not include the need to enhance infection prevention and control (IPC) in parallel with expansion of NICU services. There is evidence that incidence of healthcare-associated infections in NICUs in lower middle–income countries (LMICs) is higher than in high-income countries (HICs), and a high proportion of these neonatal infections are resistant to WHO-recommended ampicillin and gentamicin.2 3 Culture-positive neonatal infections in LMIC settings are predominantly caused by Gram-negative pathogens and Staphylococcus aureus whereas Group B streptococci and coagulase-negative staphylococci …

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  • Contributors YH, JB and MS conceived the idea and contributed to the design of data collection tools for GARPEC project. AC and YH contributed to data management and analyses. AC, RL and YH contributed to interpretation of data and writing of the letter.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.