埃塞俄比亚提格雷州 Ayder 综合专科医院重症监护病房新生儿败血症：细菌学特征、药敏模式及相关因素。
Neonatal septicemia at intensive care unit, Ayder Comprehensive Specialized Hospital, Tigray, North Ethiopia: Bacteriological profile, drug susceptibility pattern, and associated factors.
机构信息
Department of Medical Microbiology and Immunology, Division of Biomedical Sciences, College of Health Sciences, Mekelle University, Mekelle, Tigray Region, Ethiopia.
Department of Paediatric & Child Health, School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Tigray Region, Ethiopia.
出版信息
PLoS One. 2020 Jun 30;15(6):e0235391. doi: 10.1371/journal.pone.0235391. eCollection 2020.
BACKGROUND
Neonatal septicemia is a life threatening medical emergency that requires timely detection of pathogens with urgent rational antibiotics therapy.
METHODS
A cross-sectional study was conducted between March 2017 to September 2018 among 317 septicemia suspected neonates at neonatal intensive care unit, Ayder Comprehensive Specialized Hospital, Mekelle, Tigray, North Ethiopia. A 3 mL of blood was collected from each participant. Identification of bacterial species was done using the standard microbiological techniques. Antibiotic sensitivity test was done using disk diffusion method. Data were entered and analyzed using computer software SPSS version 22. Bivariate and multivariate regression analysis was applied to determine the association between variables.
RESULTS
Of the 317 (190 male and 127 female) neonates, 116 (36.6%) were found to be with culture proven septicemia. Klebsiella species were the predominant etiologic agents. Length of hospital stay (AOR (adjusted odds ratio) = 3.65 (2.17-6.13), p < 0.001) and low birth weight (AOR = 1.64 (1.13-2.78), p = 0.04) were the factors associated with neonatalsepticemia. Most isolates showeda frightening drug resistance rate to the commonly used antimicrobial drugs. K. pneumoniae, E. coli, Enterobacter and Citrobacter species were 57% to100% resistant to ceftazidime, ceftriaxone, gentamycin, amoxacillin-clavulunic acid and ampicillin. All, 9 (100%) isolates of S. aureus were resistant to oxacilline, ampicillin,erythromycin and gentamycin. Furthermore, 55.6% S. aureus isolates were Methicillin Resistant Staphylococcus aureus.
CONCLUSION
Neonaltal septicemia is found to be significantly high in the present study. As most of the isolates are potentially related to hospital acquired infections, prevention and control policy should have to be more strengthening in the neonatal intensive care unit.
背景
新生儿败血症是一种危及生命的医疗紧急情况，需要及时检测病原体，并进行紧急合理的抗生素治疗。
方法
本研究为 2017 年 3 月至 2018 年 9 月在埃塞俄比亚提格雷州默克莱的阿耶德综合专科医院新生儿重症监护病房进行的一项横断面研究，共纳入 317 例疑似败血症的新生儿。从每个参与者身上采集 3 毫升血液。使用标准微生物学技术鉴定细菌种类。使用圆盘扩散法进行抗生素敏感性试验。使用计算机软件 SPSS 版本 22 输入和分析数据。应用双变量和多变量回归分析来确定变量之间的关系。
结果
在 317 例（190 例男性和 127 例女性）新生儿中，有 116 例（36.6%）被证实为培养阳性败血症。克雷伯菌属是主要的病原体。住院时间长（调整后的优势比（AOR）= 3.65（2.17-6.13），p < 0.001）和低出生体重（AOR = 1.64（1.13-2.78），p = 0.04）是与新生儿败血症相关的因素。大多数分离株对常用抗菌药物表现出令人担忧的耐药率。K. pneumoniae、E. coli、Enterobacter 和 Citrobacter 对头孢他啶、头孢曲松、庆大霉素、氨芐西林-克拉维酸和氨苄西林的耐药率分别为 57%至 100%。金黄色葡萄球菌对苯唑西林、氨苄西林、红霉素和庆大霉素的耐药率均为 100%。此外，55.6%的金黄色葡萄球菌分离株为耐甲氧西林金黄色葡萄球菌。
结论
本研究发现新生儿败血症发生率较高。由于大多数分离株可能与医院获得性感染有关，因此需要在新生儿重症监护病房加强预防和控制政策。
Zotero 插件