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加纳霍市2016年新生儿败血症常见分离株的细菌学特征及抗生素敏感性模式

Bacteriological profile and antibiotic susceptibility pattern of common isolates of neonatal sepsis, Ho Municipality, Ghana-2016.

作者信息

Aku Fortress Yayra, Akweongo Patricia, Nyarko Kofi, Sackey Samuel, Wurapa Fredrick, Afari Edwin Andrew, Ameme Donne Kofi, Kenu Ernest

机构信息

1Ghana Field Epidemiology and Laboratory Training Programme and Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana.

2Ghana Health Service, Volta Regional Health Directorate, Ho, Ghana.

出版信息

Matern Health Neonatol Perinatol. 2018 Jan 23;4:2. doi: 10.1186/s40748-017-0071-z. eCollection 2018.

Abstract

BACKGROUND

Globally, 4 million neonates die annually, with one-third of such deaths occurring as a result of infections. In 2011, there were 7.2million deaths in children below 5 years globally, and a proportion of 40% of these deaths occurred in neonates. Sepsis was reported to account for one-third of these deaths. Presently, multidrug antibiotic resistance is rapidly increasing in Neonatal Intensive Care Units (NICUs), particularly in developing countries and poses a threat to public health. The change in these organisms has been reported to vary across regions, between health facilities and even within the same facility. Continuous surveillance is required to inform antibiotic choice for neonatal sepsis management. We identified the common causative organisms of neonatal sepsis and their antibiotic susceptibility pattern in the Ho municipality.

METHOD

A cross sectional study was conducted in the Ho municipality from January to May, 2016. A semi-structured questionnaire was used to collect socio-demographic data from mothers of neonates with clinically suspected of sepsis. Clinical data of both mothers and neonates were extracted from case notes. A 2 ml volume of blood was also taken from neonates and dispensed into a 20 ml mixture of thioglycollate fluid broth and tryptone soy broth for culture and antibiotic susceptibility pattern determined.

RESULTS

Out of the 150 clinically suspected neonatal sepsis cases, 91 (60.7%) were males. The Median gestational week was 38 (IQR: 36-39) and Median birthweight was 3.0 kg (IQR 2.5-3.4). The prevalence of culture positive sepsis was 17.3% of the 150 suspected cases. A total of 26 different pathogens were isolated, of which gram positive organisms had a preponderance of 18 (69%) over gram negative organisms 8 (31%). was the most common 14 (53.8%) isolate identified. There was a single isolate (4%) each of and identified. All the isolates identified showed 100% resistance to ampicillin.

CONCLUSION

The prevalence of culture proven sepsis was 17.3% and was the most common isolate identified. Pathogens isolated were resistant to the first line drugs for management of neonatal sepsis. Hence, the need for a review of first line drug for empirical treatment in neonatal sepsis.

摘要

背景

全球范围内,每年有400万新生儿死亡,其中三分之一的死亡是由感染导致的。2011年,全球5岁以下儿童中有720万死亡,其中40%的死亡发生在新生儿中。据报道,败血症占这些死亡人数的三分之一。目前,新生儿重症监护病房(NICU)中多重耐药抗生素的耐药性正在迅速增加,尤其是在发展中国家,这对公共卫生构成了威胁。据报道,这些微生物的变化在不同地区、不同医疗机构之间甚至同一机构内部都有所不同。需要持续监测以指导新生儿败血症管理中的抗生素选择。我们确定了霍市新生儿败血症的常见致病微生物及其抗生素敏感性模式。

方法

2016年1月至5月在霍市进行了一项横断面研究。使用半结构化问卷从临床疑似败血症的新生儿母亲那里收集社会人口学数据。母亲和新生儿的临床数据从病历中提取。还从新生儿身上采集了2毫升血液,注入20毫升硫乙醇酸盐流体肉汤和胰蛋白胨大豆肉汤的混合物中进行培养,并确定抗生素敏感性模式。

结果

在150例临床疑似新生儿败血症病例中,91例(60.7%)为男性。中位孕周为38周(四分位间距:36 - 39周),中位出生体重为3.0千克(四分位间距2.5 - 3.4千克)。在150例疑似病例中,培养阳性败血症的患病率为17.3%。共分离出26种不同的病原体,其中革兰氏阳性菌占优势,有18种(69%),革兰氏阴性菌有8种(31%)。[此处原文缺失具体细菌名称]是最常见的分离菌株,有14种(53.8%)。分别鉴定出1种[此处原文缺失具体细菌名称]和1种[此处原文缺失具体细菌名称](各占4%)。所有鉴定出的分离菌株对氨苄西林均表现出100%的耐药性。

结论

培养证实的败血症患病率为17.3%,[此处原文缺失具体细菌名称]是最常见的分离菌株。分离出的病原体对新生儿败血症管理的一线药物耐药。因此,需要对新生儿败血症经验性治疗的一线药物进行审查。

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