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资源有限环境下的新生儿败血症:致病微生物及抗菌药物敏感性分析

Neonatal Sepsis in a Resource-Limited Setting: Causative Microorganisms and Antimicrobial Susceptibility Profile.

作者信息

Acheampong Edna Nai, Tsiase Joseph Adjei, Afriyie Daniel Kwame, Amponsah Seth Kwabena

机构信息

Greater Accra Regional Hospital, Accra, Ghana.

Department of Pharmacy, Ghana Police Hospital, Accra, Ghana.

出版信息

Interdiscip Perspect Infect Dis. 2022 May 27;2022:7905727. doi: 10.1155/2022/7905727. eCollection 2022.

Abstract

BACKGROUND

Empiric treatment of suspected neonatal sepsis must be based on data on setting-specific causative pathogens and their respective susceptibilities to antimicrobials, as well as universal treatment guidelines. This approach will ensure better therapeutic outcomes and reduce mortality.

OBJECTIVES

The objectives of this study were to determine the bacteriological profile and antibiotic susceptibility pattern of isolated microorganisms responsible for neonatal sepsis in a regional hospital in Ghana.

METHODS

This was a retrospective study that assessed causative microorganisms and antimicrobial susceptibility profiles of neonates suspected of sepsis at the Greater Accra Regional Hospital from January 2018 to December 2019. Blood culture was done using a fully automated BACTEC 9240 blood culture system. Bacteria isolates were identified by Gram staining and conventional biochemical methods. Antimicrobial susceptibility testing was done by Kirby-Bauer's disc diffusion method, and interpretations were carried out according to clinical and laboratory standards. Culture and antibiotic sensitivity reports were obtained and the data subsequently analyzed.

RESULTS

Of 2514 blood samples collected from neonates suspected of neonatal sepsis, 528 (21.0%) of the samples were found to be culture-positive. The majority of these positive cultures were from male neonates (68.9%). A total of 11 different pathogens were isolated, of which Gram-positive organisms had a preponderance of 72.0% over Gram-negative organisms (28.0%). was the most common pathogen identified, accounting for 60.0% of isolates. The most prevalent Gram-negative bacteria were (13.6%). Most Gram-positive microorganisms showed sensitivity to amikacin, meropenem, vancomycin, and piperacillin/tazobactam. Gram-positive isolates were found to be resistant to ampicillin and penicillin, but moderately susceptible to flucloxacillin. Most Gram-negative isolates were sensitive to meropenem.

CONCLUSION

The prevalence of culture-proven sepsis was 21.0%. The most prevalent Gram-negative bacteria were . As there is some level of antibiotic resistance observed in the current study, it is necessary for routine microbial analysis of samples and their antibiogram.

摘要

背景

对疑似新生儿败血症的经验性治疗必须基于特定环境下致病病原体的数据及其对抗菌药物的敏感性,以及通用治疗指南。这种方法将确保更好的治疗效果并降低死亡率。

目的

本研究的目的是确定加纳一家地区医院中导致新生儿败血症的分离微生物的细菌学特征和抗生素敏感性模式。

方法

这是一项回顾性研究,评估了2018年1月至2019年12月在大阿克拉地区医院疑似败血症的新生儿的致病微生物和抗菌药物敏感性概况。使用全自动BACTEC 9240血培养系统进行血培养。通过革兰氏染色和传统生化方法鉴定细菌分离株。采用 Kirby-Bauer 纸片扩散法进行抗菌药物敏感性试验,并根据临床和实验室标准进行解读。获取培养和抗生素敏感性报告并随后分析数据。

结果

在从疑似新生儿败血症的新生儿中采集的2514份血样中,发现528份(21.0%)样本培养呈阳性。这些阳性培养物中的大多数来自男婴(68.9%)。共分离出11种不同病原体,其中革兰氏阳性菌占比72.0%,高于革兰氏阴性菌(28.0%)。 是鉴定出的最常见病原体,占分离株的60.0%。最常见的革兰氏阴性菌是 (13.6%)。大多数革兰氏阳性微生物对阿米卡星、美罗培南、万古霉素和哌拉西林/他唑巴坦敏感。发现革兰氏阳性分离株对氨苄西林和青霉素耐药,但对氟氯西林中度敏感。大多数革兰氏阴性分离株对美罗培南敏感。

结论

经培养证实的败血症患病率为21.0%。最常见的革兰氏阴性菌是 。由于在本研究中观察到一定程度的抗生素耐药性,因此有必要对样本进行常规微生物分析及其抗菌谱分析。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a9f/9166966/be1b700bfbc4/IPID2022-7905727.001.jpg

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