Institute of Microbiology, University of Agriculture, Faisalabad, Pakistan (Ms Asghar and Drs Mahmood and Arshad); and Institute of Pharmacy, Physiology and Pharmacology, University of Agriculture, Faisalabad, Pakistan (Dr Khan).
Adv Neonatal Care. 2020 Aug;20(4):E59-E69. doi: 10.1097/ANC.0000000000000701.
Neonatal sepsis is a leading cause of morbidity and early-life mortality worldwide, and previous data have reported the highest neonatal mortality rate in Pakistan.
The present study aimed to decipher the prevalence of group B Streptococcus (GBS)-associated sepsis, coinfections, and antibiotic susceptibility of isolated microbes in neonates.
Blood samples of 100 cases of neonatal sepsis were subcultured on blood agar, GBS agar, and MacConkey agar for isolation of GBS and suspected microbes.
Of 100 neonatal blood samples, 85 blood samples were culture-positive, including mixed culture growth (n = 18), 25 samples as early-onset neonatal sepsis (EONS) and 60 as late-onset neonatal sepsis (LONS). Staphylococcus aureus showed high percent positivity (31.4%), followed by Candida sp (16.5%), GBS (14.1%), Klebsiella (14.1%), Staphylococcus epidermidis (11.8%), Pseudomonas (9.4%), Acinetobacter (9.4%), Esherichia coli (8.2%), and Enterococcus (5.9%). GBS was isolated more frequently from EONS than from LONS with 50% coinfections. Mode of delivery, gender, and respiratory distress in neonates were significantly associated with culture-positive sepsis. GBS isolates were highly (91.7%) susceptible to vancomycin, cefotaxime, and chloramphenicol, followed by penicillin (83.3%), ampicillin, and tetracycline (75%). GBS isolates were resistant to erythromycin, clindamycin, ciprofloxacin, and linezolid.
Our findings evidenced GBS-associated risk factors and antibiotic susceptibility pattern of neonatal sepsis, which will help clinicians in management, control, and treatment of neonatal sepsis.
The epidemiological evidence of GBS-associated neonatal sepsis, demographic characteristics, risk factor data analysis, and drug resistance pattern has disease prevention implications in neonates in low-income countries including Pakistan.
新生儿败血症是全球发病率和早期死亡率的主要原因，此前的数据报告显示，巴基斯坦的新生儿死亡率最高。
本研究旨在阐明 B 群链球菌（GBS）相关性败血症、合并感染以及分离微生物的抗生素敏感性在新生儿中的流行情况。
将 100 例新生儿败血症的血样接种于血琼脂、GBS 琼脂和麦康凯琼脂上，以分离 GBS 和可疑微生物。
100 例新生儿血样中，85 例血样培养阳性，包括混合培养生长（n=18），25 例为早发型新生儿败血症（EONS），60 例为晚发型新生儿败血症（LONS）。金黄色葡萄球菌的阳性率最高（31.4%），其次是念珠菌（16.5%）、GBS（14.1%）、克雷伯菌（14.1%）、表皮葡萄球菌（11.8%）、假单胞菌（9.4%）、不动杆菌（9.4%）、大肠杆菌（8.2%）和肠球菌（5.9%）。GBS 从 EONS 中分离出来的频率高于 LONS，且有 50%的合并感染。分娩方式、性别和新生儿呼吸窘迫与培养阳性败血症显著相关。GBS 分离株对万古霉素、头孢噻肟和氯霉素高度敏感（91.7%），其次是青霉素（83.3%）、氨苄西林和四环素（75%）。GBS 分离株对红霉素、克林霉素、环丙沙星和利奈唑胺耐药。
我们的研究结果为新生儿败血症与 GBS 相关的危险因素和抗生素敏感性模式提供了证据，这将有助于临床医生对新生儿败血症的管理、控制和治疗。
GBS 相关性新生儿败血症的流行病学证据、人口统计学特征、危险因素数据分析和耐药模式，对包括巴基斯坦在内的低收入国家的新生儿疾病预防具有重要意义。
