尼日利亚东南部一家三级医疗机构新生儿血培养确诊败血症的细菌分离株、抗菌谱及结果：一项横断面研究

Bacterial isolates, antibiogram and outcomes of blood culture proven sepsis in neonates at a tertiary institution in South East Nigeria: a cross-sectional study.

作者信息

Nnamani Kenechi O, Nnamani Chioma P, Iloh Kenechukwu K, Aghanya Iloduba N, Ushie Simon N, Ofiaeli Ogochukwu C, Ezeudu Chijioke E, Onubogu Chinyere U, Ugochukwu Ebelechukwu F, Akujobi Comfort N, Ezechukwu Clement C

机构信息

Department of Paediatrics, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria.

Department of Family Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi 435101, Nigeria.

出版信息

Ther Adv Infect Dis. 2022 Sep 8;9:20499361221122479. doi: 10.1177/20499361221122479. eCollection 2022 Jan-Dec.

DOI:10.1177/20499361221122479

PMID:36110504

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9468700/

Abstract

BACKGROUND

Neonatal sepsis (NNS) in developing countries continues to be a diagnostic and management challenge due to the delays in identifying the aetiologic pathogens and antibiograms.

AIM

To determine the predominant bacterial isolates, antibiotic susceptibility pattern and outcomes of blood culture proven sepsis in neonates.

METHODOLOGY

A hospital-based cross-sectional study of 120 neonates admitted into the Special Care Baby Unit (SCBU) of Nnamdi Azikiwe University Teaching Hospital Nnewi with clinical features suggestive of sepsis. A semi-structured questionnaire and proforma were used to record neonatal, maternal and laboratory information. Blood specimens were collected for aerobic culture using Bactenecin (BACTEC)-Ped plus culture system. Antibiotic susceptibility testing was performed using the Kirby Bauer disc diffusion method. Data obtained were analysed using SPSS version 23.0. value < 0.05 was considered as significant.

RESULTS

There were 68 males and 52 females giving a male-to-female ratio of 1.3:1. The median age at admission was 48 h. 13 (43.3%) was the most common bacteria isolated. The prevalence of blood culture proven sepsis were 25% and 6.7% of the subjects with positive blood culture died. Gram-positive bacteria isolated were sensitive to gentamicin, vancomycin (VA), linezolid and resistant to penicillin. Gram-negative bacteria isolated were sensitive to meropenem (MEM), imipenem (IPM), ciprofloxacin (CIP) and resistant to ceftazidime, ceftriaxone, ampicillin and amoxicillin-clavulanic acid.

CONCLUSION

The most common bacteria isolated causing NNS using BACTEC automated blood culture system was . The empirical antibiotics considered for use at the study site are gentamycin, VA for Gram-positive organisms and CIP, IPM and MEM for Gram-negative organisms. Some of the participants with positive blood culture died. Therefore, there is a need for regular antibiogram profiles in all hospitals offering neonatal care.

摘要

背景

由于在确定病原病原体和抗菌谱方面存在延迟，发展中国家的新生儿败血症（NNS）仍然是一个诊断和管理方面的挑战。

目的

确定新生儿血培养确诊败血症的主要细菌分离株、抗生素敏感性模式及转归。

方法

对120名入住恩纳姆迪·阿齐克韦大学教学医院纽维分院特殊护理婴儿病房（SCBU）且具有败血症临床特征的新生儿进行一项基于医院的横断面研究。使用半结构化问卷和表格记录新生儿、母亲及实验室信息。采用Bactenecin（BACTEC）-Ped plus培养系统收集血标本进行需氧培养。使用 Kirby Bauer 纸片扩散法进行抗生素敏感性试验。使用SPSS 23.0版对获得的数据进行分析。P值<0.05被认为具有统计学意义。

结果

有68名男性和52名女性，男女比例为1.3:1。入院时的中位年龄为48小时。[未提及具体细菌名称]是分离出的最常见细菌。血培养确诊败血症的患病率为25%，血培养阳性的受试者中有6.7%死亡。分离出的革兰氏阳性菌对庆大霉素、万古霉素（VA）、利奈唑胺敏感，对青霉素耐药。分离出的革兰氏阴性菌对美罗培南（MEM）、亚胺培南（IPM）、环丙沙星（CIP）敏感，对头孢他啶、头孢曲松、氨苄西林和阿莫西林-克拉维酸耐药。