Neonatal Intensive Care Unit, King Fahad Medical City, Critical Care Services Administration, Riyadh, Saudi Arabia.
Research Center, King Fahad Medical City, Riyadh, Saudi Arabia.
J Infect Public Health. 2019 Sep-Oct;12(5):666-672. doi: 10.1016/j.jiph.2019.03.007. Epub 2019 Apr 13.
To identify the risk factors, laboratory profile, microbial profile, mortality and complications, mortality causing organisms and antimicrobial susceptibility patterns of neonatal sepsis at a tertiary care hospital.
A retrospective study was conducted using the neonatal intensive care unit (NICU) database in King Fahad Medical City (KFMC), Riyadh, Saudi Arabia. All neonates born in KFMC with clinically diagnosed sepsis in the NICU were included in this study.
During the study period, a total of 245 neonates with a culture-proven diagnosis of neonatal sepsis were included in this study and 298 episodes of sepsis were observed. Out of the 298 episodes, EOS occurred 33 (11.1%) times, and LOS occurred 265 (88.9%) times. For both neonates with EOS and LOS prematurity was the major neonatal risk factors for sepsis 16 (48.5%), 214 (80.8%); respectively. Multiparty and delivery by caesarean section were the top maternal risk factors of both EOS and LOS. Nneonates with LOS had high CRP, Total WBC count and thrombocytopenia compared to EOS neonates. Our results showed that in the EOS neonates, GBS was the most common pathogen followed by Escherichia Coli. In LOS neonates, the common organisms were Staphylococcus spp., Klebsiella and Pseudomonas aeruginosa. Mortality rate of neonatal sepsis is higher in EOS 5 (15.2%) from total EOS compared to LOS 24 (11.3%) from total LOS. All Gram-negative bacteria were sensitive to Amikacin. Gram-negative non-fermenting bacteria, such as P. aeruginosa and Acinetobacter were sensitive to amikacin and gentamycin. All Gram-positive bacteria were sensitive to gentamycin. Among thirteen Candida albicans isolates, 85% were sensitive to fluconazole.
Concerted efforts are needed to determine the spectrum of risk factors and the clinical characteristics of EOS and LOS in order to implement appropriate treatment strategies as sepsis remains to be a serious danger to neonatal wellbeing. Moreover, our study emphasizes that use of aminoglycosides is much agreeable as compared to the broad spectrum antibiotics which are more rampantly used nowadays.
在沙特阿拉伯利雅得法赫德国王医疗城（KFMC）的新生儿重症监护病房（NICU）数据库中，确定新生儿败血症的危险因素、实验室特征、微生物特征、死亡率和并发症、导致死亡的病原体以及抗菌药物敏感性模式。
本研究采用回顾性研究方法，对在 KFMC 出生并在 NICU 中临床诊断为败血症的所有新生儿进行了研究。
在研究期间，共有 245 例培养证实为新生儿败血症的新生儿纳入本研究，共观察到 298 例败血症发作。在 298 例中，EOS 发生 33 次（11.1%），LOS 发生 265 次（88.9%）。对于 EOS 和 LOS 新生儿，早产是败血症的主要新生儿危险因素，分别为 16（48.5%）和 214（80.8%）。产妇的多胎分娩和剖宫产是 EOS 和 LOS 的主要危险因素。与 EOS 新生儿相比，LOS 新生儿的 CRP、总白细胞计数和血小板减少症更高。我们的结果表明，在 EOS 新生儿中，GBS 是最常见的病原体，其次是大肠杆菌。在 LOS 新生儿中，常见的病原体是葡萄球菌、克雷伯菌和铜绿假单胞菌。EOS 新生儿的败血症死亡率为 5（15.2%），高于 LOS 新生儿的 24（11.3%）。所有革兰氏阴性菌均对阿米卡星敏感。革兰氏阴性非发酵菌，如铜绿假单胞菌和不动杆菌，对阿米卡星和庆大霉素敏感。所有革兰氏阳性菌均对庆大霉素敏感。在 13 株白色念珠菌分离株中，85%对氟康唑敏感。
需要共同努力，确定 EOS 和 LOS 的危险因素和临床特征，以便实施适当的治疗策略，因为败血症仍然是新生儿健康的严重威胁。此外，我们的研究强调，与现在更广泛使用的广谱抗生素相比，使用氨基糖苷类药物更为合理。
