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苏丹喀土穆州疑似社区获得性新生儿败血症的新生儿的细菌学特征及抗生素耐药性

Bacteriological profile and antibiotic resistance in newborn infants with possible community-acquired neonatal sepsis in Khartoum State, Sudan.

作者信息

Braima Osama Ahmed, Ali Manal Abdalaziz, Abdulla Enas Mohammed

机构信息

Department of Paediatrics, University Hospitals of Morecambe, NHS Foundation Trust, United Kingdom.

Microbiology Department, Omdurman Maternity Hospital, Sudan.

出版信息

Sudan J Paediatr. 2021;21(1):13-22. doi: 10.24911/SJP.106-1601909519.

Abstract

Neonatal sepsis is a leading cause of morbidity and mortality, and knowledge of bacterial patterns and susceptibility to antibiotics is essential to design therapeutic guidelines. To determine the bacterial aetiology and antibiotic resistance patterns in neonatal sepsis, a prospective, cross-sectional, hospital-based study was conducted in a large paediatric emergency hospital in Khartoum State, Sudan, over a 6-month period. All newborn infants with a clinical diagnosis of sepsis were included in the study and had a blood sample collected for culture and sensitivity. The World Health Organization case definition of neonatal sepsis in conjunction with the Integrated Management of Childhood Illnesses criteria was used to select patients. A total of 170 newborn infants fulfilled the study inclusion criteria. The median age at presentation was 4-7 days and blood culture was positive in 31%. Early-onset neonatal sepsis was present in 30% of cases, while 70% were late-onset. Gram-positive organisms accounted for 58% of the total isolates, and 38% were Gram-negative organisms. was the most prevalent organism (55% of all isolates) and 72% of these were methicillin-resistant which showed 100% sensitivity to vancomycin and 90% to gentamycin. was the commonest Gram-negative organism in both early and late-onset sepsis and the second commonest isolated organism, accounting for 19% of cases. All Gram-negative organisms were 100% sensitive to imipenem, meropenem and ciprofloxacin. Both Gram-positive and Gram-negative organisms were highly resistant to benzylpenicillin and cefotaxime, the commonly used empiric antibiotics in neonatal sepsis.

摘要

新生儿败血症是发病和死亡的主要原因,了解细菌类型及对抗生素的敏感性对于制定治疗指南至关重要。为确定新生儿败血症的细菌病因及抗生素耐药模式,在苏丹喀土穆州一家大型儿科急诊医院进行了一项为期6个月的前瞻性横断面医院研究。所有临床诊断为败血症的新生儿均纳入研究,并采集血样进行培养和药敏试验。采用世界卫生组织新生儿败血症病例定义并结合儿童疾病综合管理标准来选择患者。共有170名新生儿符合研究纳入标准。就诊时的中位年龄为4至7天,血培养阳性率为31%。30%的病例为早发型新生儿败血症,70%为晚发型。革兰氏阳性菌占分离菌总数的58%,革兰氏阴性菌占38%。 是最常见的细菌(占所有分离菌的55%),其中72%对甲氧西林耐药,对万古霉素的敏感性为100%,对庆大霉素的敏感性为90%。 是早发型和晚发型败血症中最常见的革兰氏阴性菌,也是第二常见的分离菌,占病例的19%。所有革兰氏阴性菌对亚胺培南、美罗培南和环丙沙星均100%敏感。革兰氏阳性菌和革兰氏阴性菌对苄青霉素和头孢噻肟均高度耐药,这两种是新生儿败血症常用的经验性抗生素。

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