Department of Obstetrics and Gynecology, Hôpital Provincial Général de Référence de Bukavu, Bukavu, Democratic Republic of the Congo.
Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of the Congo.
Clin Infect Dis. 2021 Aug 16;73(4):e976-e980. doi: 10.1093/cid/ciab114.
The Democratic Republic of the Congo (DRC) has one of the highest neonatal death rates (between 14% and 28%) in the world. In the DRC, neonatal sepsis causes 15.6% of this mortality, but data on the bacterial etiology and associated drug susceptibility are lacking.
Hemocultures of 150 neonates with possible early-onset neonatal sepsis (pEOS) were obtained at the Hôpital Provincial Général de Référence de Bukavu (Bukavu, DRC). The newborns with pEOS received an empirical first-line antimicrobial treatment (ampicillin, cefotaxime, and gentamicin) based on the synopsis of international guidelines for the management of EOS that are in line with World Health Organization (WHO) recommendations. Isolates were identified using matrix-assisted laser desorption/ ionization time-of-flight mass spectrophotometry. Antibiotic resistance was assessed using the disk diffusion method.
Fifty strains were obtained from 48 patients and identified. The 3 most prevalent species were Enterobacter cloacae complex (42%), Klebsiella pneumoniae (18%), and Serratia marcescens (12%). Enterobacter cloacae isolates were resistant to all first-line antibiotics. All K. pneumoniae and S. marcescens isolates were resistant to ampicillin, and the majority of the K. pneumoniae and half of the S. marcescens isolates were resistant to both cefotaxime and gentamicin. All E. cloacae complex strains, 89% of K. pneumoniae, and half of S. marcescens had an extended-spectrum ß-lactamase phenotype.
The most prevalent pathogens causing EOS in Bukavu were E. cloacae complex, K. pneumoniae, and S. marcescens. Most of these isolates were resistant to the WHO-recommended antibiotics.
刚果民主共和国（DRC）是世界上新生儿死亡率最高的国家之一（在 14%至 28%之间）。在 DRC，新生儿败血症导致 15.6%的死亡率，但关于细菌病因和相关药物敏感性的数据尚缺乏。
在布卡武省总医院（Bukavu，DRC），对 150 名患有早期新生儿败血症（pEOS）的新生儿进行了血培养。患有 pEOS 的新生儿根据与世界卫生组织（WHO）建议一致的 EOS 管理国际指南概要接受了经验性一线抗菌治疗（氨苄西林、头孢噻肟和庆大霉素）。使用基质辅助激光解吸/电离飞行时间质谱法鉴定分离株。使用圆盘扩散法评估抗生素耐药性。
从 48 名患者中获得了 50 株并进行了鉴定。最常见的 3 个物种是阴沟肠杆菌复合体（42%）、肺炎克雷伯菌（18%）和粘质沙雷氏菌（12%）。阴沟肠杆菌分离株对所有一线抗生素均耐药。所有肺炎克雷伯菌和粘质沙雷氏菌分离株均对氨苄西林耐药，大多数肺炎克雷伯菌和一半的粘质沙雷氏菌分离株对头孢噻肟和庆大霉素均耐药。所有阴沟肠杆菌复合体菌株、89%的肺炎克雷伯菌和一半的粘质沙雷氏菌均具有超广谱β-内酰胺酶表型。
在布卡武引起 EOS 的最常见病原体是阴沟肠杆菌复合体、肺炎克雷伯菌和粘质沙雷氏菌。这些分离株大多数对世界卫生组织推荐的抗生素耐药。
