简介
Over 25 years of public service, and 15 years as a clinician researcher, I have aspired to reframe healthcare-associated infection (HAI) in newborns and children, from an inevitable consequence of population vulnerability and health system failures, to a condition amenable to diagnostic, treatment and infection prevention intervention. My scientific contributions span epidemiology, diagnostics, clinical trials, implementation science, and data modelling in neonatal sepsis, paediatric HAI and antimicrobial resistance (AMR).
My doctoral research (2014-2016) generated the first large dataset quantifying the burden, spectrum, mortality impact and cost of HAI in hospitalised South African children and established reproducible HAI surveillance models for resource-limited settings. Through the MBIRA study collaboration, I contributed to measuring the impact of AMR Enterobacterales bloodstream infections (BSI) in African hospitals. Through my NIH K43 Emerging Global Leaders award (2018-2021) and the Baby GERMS-SA surveillance network, I characterised neonatal sepsis epidemiology and AMR patterns across South Africa, exposing a critical mismatch between empiric antibiotic recommendations and local AMR profiles. I led the NeoCOLONIZE trial to determine if neonatal skin antisepsis could modify AMR colonization rates. In collaboration with data science colleagues, I pioneered the application of Weighted Incidence Syndromic Combination Antibiograms (WISCAs) to BSI data from South African neonatal units, using innovative data approaches to inform antibiotic regimen selection considering local pathogen-AMR profiles. I participated as site PI, Co-PI or co-investigator in large research trials and consortia including NeoOBS, BARNARDS, MBIRA, NeoCHG, NeoSEP and SNIP-AFRICA. Collectively, these studies and trials have informed guideline development, surveillance methods, infection prevention and control interventions and neonatal sepsis trial designs.
A defining feature of my research is its interdisciplinarity, combining epidemiology, microbiology, pharmacy, and health systems analytics. From 2022 to 2025, I led South Africa's first national multidisciplinary neonatal antimicrobial stewardship programme (NeoAMS), which achieved a 22% reduction in antibiotic use across 14 neonatal units and won the 2023 AMR Industry Alliance Global Stewardship Prize. With one of my doctoral students, we developed and externally validated the NeoHoP bedside infection prediction score for HAI in preterm neonates and demonstrated the potential of point-of-care C-reactive protein testing to reduce neonatal antibiotic use. I have also co-developed and implemented the NeoIPC toolkit, the first global surveillance platform for neonatal HAI. My >150 peer-reviewed publications (H-index 43, 20220 citations) include contributions to landmark multi-country studies published in leading journals. I am passionate about healthcare worker education and have published two free online books on infection prevention and control (IPC) for healthcare workers in resource-limited settings (https://bettercare.co.za).
I am deeply committed to the development of the next generation of clinician and research scientists in neonatal and paediatric infectious diseases, recognising that sustainable change in health outcomes requires continuous investment in people. To date, I have directly supervised or co-supervised 50 undergraduate and postgraduate students, including 3 completed and 4 enrolled PhDs, 3 post-doctoral fellows, 24 Masters/Honours/MPhil graduates, 3 elective research and 13 MBChB research students. My supervisory approach is collaborative and relational, encouraging trainees to develop independent research questions grounded in locally relevant challenges. Several of my graduates have made internationally recognised knowledge contributions, including the development of the NeoHoP prediction score, WISCA antibiogram models, and the characterisation of African AMR epidemiology.
At Stellenbosch University I established the interdisciplinary neonatal infections research group that spans neonatology, infectious diseases, data science, infection prevention, microbiology, pharmacology, pharmacy and nursing. This model has enhanced our research output quality and provided a rich training environment for our trainees. I have extended this multi-disciplinary collaborative model to Sub-Sharan Africa through the NeoNET AFRICA partnership. I co-founded the partnership in 2023, to facilitate collaborative neonatal sepsis diagnosis, treatment and prevention research. We are now developing a NeoNET AFRICA federated data analysis platform to support our vision of collaborative research and capacity-building pathways for clinician-scientist researchers across Africa.
