Akindolire Abimbola Ellen, Tongo Olukemi, Dada-Adegbola Hannah, Akinyinka Olusegun
University College Hospital, Ibadan, Nigeria.
J Infect Dev Ctries. 2016 Dec 30;10(12):1338-1344. doi: 10.3855/jidc.7830.
Neonatal septicemia remains a major cause of newborn deaths in developing countries. Its burden is further compounded by the emergence of multidrug-resistant pathogens, which is related to a lack of antibiotic protocols resulting in unrestricted use of antibiotics. The absence of reliable antibiotic sensitivity testing makes the formulation of antibiotic guidelines and judicious use of antibiotics difficult. This study sought to identify the current bacterial agents associated with early onset septicemia (EOS; age <72 hours) and their antibiotic susceptibility patterns among neonates at the University College Hospital, Ibadan, Nigeria.
A total of 202 inborn and outborn neonates with risk factors for or clinical features of septicemia in the first 72 hours of life had samples for blood cultures and antibiotic sensitivity patterns taken prior to treatment.
Of the subjects, 95 (47.0%) were inborn and 107 (53.0%) outborn, with a M:F ratio of 1.3:1; 12.5% were culture positive, and the prevalence of EOS was 8.8/1,000 live births. The isolates were Staphylococcus aureus (52%), 30.7% of which were methicillin-resistant Staphylococcus aureus (MRSA), Klebsiella pneumoniae (12%), Enterobacter aerogenes (8%), Enterococcus spp. (8%), Eschericia coli (4%), and other Gram-negatives (12%). All the isolates except Staphylococcus aureus were susceptible to ampicillin, ampicillin/sulbactam, amikacin, gentamicin, and third-generation cephalosporins. All MRSA were sensitive to amikacin, ciprofloxacin, and chloramphenicol, while all methicillin-sensitive Staphylococcus aureus were sensitive to ampicillin/sulbactam.
Staphylococcus aureus was the commonest cause of EOS in our setting, with 30.7% of the Staphylococcus aureus isolates being MRSA. Only MRSA demonstrated multidrug resistance.
在发展中国家，新生儿败血症仍然是新生儿死亡的主要原因。多重耐药病原体的出现使这一负担更加沉重，这与缺乏抗生素使用规范导致抗生素的无节制使用有关。缺乏可靠的抗生素敏感性检测使得制定抗生素指南和合理使用抗生素变得困难。本研究旨在确定尼日利亚伊巴丹大学学院医院新生儿中与早发型败血症（EOS；年龄<72小时）相关的当前细菌病原体及其抗生素敏感性模式。
共有202例在出生后72小时内具有败血症危险因素或临床特征的住院和院外新生儿在治疗前采集血培养样本和抗生素敏感性模式样本。
在这些受试者中，95例（47.0%）为住院新生儿，107例（53.0%）为院外新生儿，男女比例为1.3:1；12.5%的血培养呈阳性，EOS的患病率为8.8/1000活产。分离出的病原体为金黄色葡萄球菌（52%），其中30.7%为耐甲氧西林金黄色葡萄球菌（MRSA）、肺炎克雷伯菌（12%）、产气肠杆菌（8%）、肠球菌属（8%）、大肠杆菌（4%）和其他革兰氏阴性菌（12%）。除金黄色葡萄球菌外，所有分离出的病原体对氨苄西林、氨苄西林/舒巴坦、阿米卡星、庆大霉素和第三代头孢菌素敏感。所有MRSA对阿米卡星、环丙沙星和氯霉素敏感，而所有甲氧西林敏感金黄色葡萄球菌对氨苄西林/舒巴坦敏感。
在我们的研究环境中，金黄色葡萄球菌是EOS最常见的病因，30.7%的金黄色葡萄球菌分离株为MRSA。只有MRSA表现出多重耐药性。
