Arsi University Asella College of Health Science, Asella, Ethiopia.
Hirsch-Institute of Tropical Medicine, Asella, Ethiopia.
Antimicrob Resist Infect Control. 2019 Feb 20;8:42. doi: 10.1186/s13756-019-0486-6. eCollection 2019.
Antimicrobial resistance is one of the major public health emergencies worldwide, and this trend didn't spare developing countries like Ethiopia. The objective of this study was to evaluate patterns of bacterial isolates and local antimicrobial susceptibility patterns in neonatal sepsis.
A hospital based observational study was conducted from April 2016 to May 2017 in Asella teaching and referral hospital (ATRH). A total of 303 neonates with clinical sepsis were included. Collected data were entered into EPI-INFO version 3.5.1 for cleanup; and then exported to SPSS version 21 for further analysis. Frequencies and proportion were used to describe the study population in relation to relevant variables.
Bacterial growth was detected in 88 (29.4%) of blood cultures. Predominantly isolated bacteria were coagulase negative (CoNS) 22 (25%), (E.Coli) 18 (20.5%) and aureus 16 (18%). Resistance rates of S. aureus and CoNS against Ampicillin were 11 (69%) and 20 (91%) respectively. The resistance rate of against Ampicillin and Gentamycin were 12 (66.7%) and 10 (55.6%) while resistance rate gets much higher against these two first line antibiotics [10 (91%) and 9 (82%) respectively]. Similarly, both Gram-positive and Gram-negative bacteria isolates were also highly resistant to third generation Cephalosporins, and 63 (72%) isolated bacteria showed multidrug-resistance. However; Gram-positive bacteria isolates had better susceptibility patterns to third line antibiotics like Clindamycin, Vancomycin and Ciprofloxacin while Gram-negative isolates had a higher susceptibility to Ciprofloxacin and Amikacin.
CoNS, , and were the leading bacterial causes of neonatal sepsis in our study. They were highly resistant to first- and second-line empiric antimicrobial treatment used at NICU (Neonatal intensive care unit), reducing the antimicrobial choices for management of neonatal sepsis. Fortunately, the mentioned isolated bacteria remained susceptible to third line antibiotics used to treat neonatal sepsis.
抗菌药物耐药性是全球主要的公共卫生紧急事件之一，这种趋势并没有放过埃塞俄比亚等发展中国家。本研究的目的是评估新生儿败血症中细菌分离株的模式和本地抗菌药物敏感性模式。
这是一项 2016 年 4 月至 2017 年 5 月在阿塞拉教学和转诊医院（ATRH）进行的基于医院的观察性研究。共纳入 303 例临床败血症新生儿。收集的数据输入 EPI-INFO 版本 3.5.1 进行清理；然后导出到 SPSS 版本 21 进行进一步分析。频率和比例用于描述与相关变量相关的研究人群。
在 88 份（29.4%）血培养物中检测到细菌生长。分离出的主要细菌为凝固酶阴性（CoNS）22 株（25%）、大肠埃希菌 18 株（20.5%）和金黄色葡萄球菌 16 株（18%）。金黄色葡萄球菌和 CoNS 对氨苄西林的耐药率分别为 11（69%）和 20（91%）。对氨苄西林和庆大霉素的耐药率分别为 12（66.7%）和 10（55.6%），而这两种一线抗生素的耐药率更高[10（91%）和 9（82%）]。同样，革兰氏阳性和革兰氏阴性细菌分离株对第三代头孢菌素也高度耐药，63 株（72%）分离菌表现出多药耐药性。然而，革兰氏阳性细菌分离株对克林霉素、万古霉素和环丙沙星等三线抗生素具有更好的敏感性模式，而革兰氏阴性分离株对环丙沙星和阿米卡星具有更高的敏感性。
在本研究中，凝固酶阴性葡萄球菌、大肠埃希菌、金黄色葡萄球菌和 是导致新生儿败血症的主要细菌病原体。它们对新生儿重症监护病房（NICU）使用的一线和二线经验性抗菌治疗药物高度耐药，减少了新生儿败血症管理的抗菌药物选择。幸运的是，上述分离细菌对用于治疗新生儿败血症的三线抗生素仍保持敏感性。
