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尼日利亚一家三级医疗机构中的抗菌药物敏感性与新生儿败血症:趋势是否在变化?

Antimicrobial susceptibility and neonatal sepsis in a tertiary care facility in Nigeria: a changing trend?

作者信息

Uwe Nkoyo O, Ezenwa Beatrice N, Fajolu Iretiola B, Oshun Philip, Chukwuma Stella T, Ezeaka Veronica C

机构信息

Department of Paediatrics, Lagos University Teaching Hospital (LUTH), Lagos, Nigeria.

Department of Paediatrics, College of Medicine University of Lagos, Lagos, Nigeria.

出版信息

JAC Antimicrob Resist. 2022 Sep 30;4(5):dlac100. doi: 10.1093/jacamr/dlac100. eCollection 2022 Oct.

Abstract

BACKGROUND

Neonatal sepsis remains one of the leading causes of morbidity and mortality in neonates, especially in developing countries.

OBJECTIVES

To determine the prevalence, common bacterial pathogens, and the antibiotic susceptibility pattern of neonatal sepsis at the Lagos University Teaching Hospital (LUTH), Lagos, Nigeria.

METHODS

This was a cross-sectional study of neonates who presented at the facility with symptoms and signs of sepsis from January 2017 to October 2017. Demographic and clinical data were extracted using a structured questionnaire. Blood culture, urine and CSF were collected and cultured on blood and MacConkey agar. Bacterial isolates were identified using Microbact 24E system and biochemical tests. Antibacterial susceptibility testing was done using the modified Kirby-Bauer disc diffusion method.

RESULTS

Two hundred and ninety neonates were recruited during the study period. Seventy-three (25.2%) neonates had culture-proven sepsis. One (0.3%) neonate had meningitis and no neonates (0%) had confirmed urinary tract infection. Of the 73 neonates with positive blood cultures, 56 (76.7%) had early-onset sepsis and 17 (23.3%) had late-onset sepsis. Gram-negative bacilli accounted for 60.3% of all isolates. Predominantly isolated pathogens were (20.5%), CoNS (19.2%) and (13.7%). The isolates were most susceptible to levofloxacin and amikacin.

CONCLUSIONS

Neonatal sepsis is still a huge burden in the newborn. , CoNS and are the prevalent pathogens in the local facility, with good susceptibility to levofloxacin and amikacin. Maintaining regular antibiotic surveillance for appropriate empirical antibiotics is important as part of neonatal care.

摘要

背景

新生儿败血症仍然是新生儿发病和死亡的主要原因之一,尤其是在发展中国家。

目的

确定尼日利亚拉各斯大学教学医院(LUTH)新生儿败血症的患病率、常见细菌病原体及抗生素敏感性模式。

方法

这是一项对2017年1月至2017年10月在该机构出现败血症症状和体征的新生儿进行的横断面研究。使用结构化问卷提取人口统计学和临床数据。采集血液、尿液和脑脊液样本,接种于血琼脂和麦康凯琼脂培养基上进行培养。使用Microbact 24E系统和生化试验鉴定细菌分离株。采用改良的 Kirby-Bauer 纸片扩散法进行抗菌药物敏感性试验。

结果

研究期间共招募了290名新生儿。73名(25.2%)新生儿血培养证实患有败血症。1名(0.3%)新生儿患有脑膜炎,无新生儿(0%)确诊尿路感染。在73名血培养阳性的新生儿中,56名(76.7%)为早发型败血症,17名(23.3%)为晚发型败血症。革兰氏阴性杆菌占所有分离株的60.3%。主要分离出的病原体为大肠埃希菌(20.5%)、凝固酶阴性葡萄球菌(CoNS,19.2%)和肺炎克雷伯菌(13.7%)。分离株对左氧氟沙星和阿米卡星最敏感。

结论

新生儿败血症在新生儿中仍然是一个巨大负担。大肠埃希菌、CoNS和肺炎克雷伯菌是当地机构中的常见病原体,对左氧氟沙星和阿米卡星敏感性良好。作为新生儿护理的一部分,定期进行抗生素监测以选择合适的经验性抗生素非常重要。

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