Quddus A R, Islam M N, Uddin M B, Mahmud A A, Badruzzaman M, Saha S K, Sattar S, Afreen K F
Dr ASM Ruhul Quddush, Associate Professor, Department of Pediatrics, Community Based Medical College, Mymensingh, Bangladesh.
Mymensingh Med J. 2019 Oct;28(4):839-848.
Neonatal sepsis is one of the most common reasons for admission to neonatal units in developing countries. It is also a major cause of mortality in both developed and developing countries. The type and pattern of organisms that cause neonatal sepsis changes over time and vary from one hospital to another hospital, even in the same country. In addition the causative organisms have developed increased drug resistance for the last two decades. Maternal, neonatal and environmental risk factors have contributed for the development of sepsis. To study the risk factors, causative organism and bacterial sensitivity pattern in cases of neonatal sepsis. This cross-sectional study was conducted over a period of six months. The study included 100 patients admitted at the neonatal ward of Department of Pediatrics, Community Based Medical College Bangladesh, Mymensingh, Bangladesh. Blood samples for culture were taken aseptically before starting antibiotic therapy. Microorganisms were isolated and identified by standard microbiological processes and antimicrobial sensitivity patterns were performed against amikacin, gentamicin, ceftriaxone, ciprofloxacin and ceftazidime. The factors which carried a significant risk for development of neonatal sepsis were low birth weight, preterm neonates, meconium stained liquor and prolonged rupture of membrane (>18 hours). Gram negative organisms predominated (68.8%) with Escherichia coli (33.3%) being the commonest. The gram negative bacteria which were isolated sensitive to amikacin, gentamicin and ceftriaxone. The organisms also relatively more sensitive to ciprofloxacin and highly sensitive to ceftazidime. The Gram positive bacteria showed sensitivity against only the antibiotic Ceftriaxone and Ciprofloxacin. The overall mortality was 9%. The outcome of the study will contribute to preventing and treating neonatal sepsis in the hospital.
新生儿败血症是发展中国家新生儿入住新生儿病房最常见的原因之一。它也是发达国家和发展中国家死亡的主要原因。导致新生儿败血症的微生物类型和模式会随着时间变化，并且即使在同一个国家，不同医院之间也存在差异。此外，在过去二十年中，致病微生物的耐药性有所增加。母体、新生儿和环境风险因素都与败血症的发生有关。为了研究新生儿败血症病例中的风险因素、致病微生物及细菌敏感性模式。这项横断面研究历时六个月。该研究纳入了孟加拉国迈门辛社区医学院儿科学系新生儿病房收治的100例患者。在开始抗生素治疗前无菌采集血样进行培养。通过标准微生物学方法分离和鉴定微生物，并对阿米卡星、庆大霉素、头孢曲松、环丙沙星和头孢他啶进行抗菌敏感性检测。导致新生儿败血症发生风险显著增加的因素包括低出生体重、早产儿、羊水胎粪污染和胎膜早破（>18小时）。革兰氏阴性菌占主导（68.8%），其中大肠杆菌最为常见（33.3%）。分离出的革兰氏阴性菌对阿米卡星、庆大霉素和头孢曲松敏感。这些微生物对环丙沙星也相对更敏感，对头孢他啶高度敏感。革兰氏阳性菌仅对头孢曲松和环丙沙星敏感。总体死亡率为9%。该研究结果将有助于医院预防和治疗新生儿败血症。
