Mustapha Samaha Saleh, Zaidu Musa Aishatu, Yusuf Muhammad Shamsuddeen, Aliyu Shamsudin, Abdulkadir Isa
Department of Paediatrics, Abubakar Tafawa Balewa University, Bauchi, Nigeria.
Department of Medical Microbiology Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
Niger Med J. 2024 Sep 26;65(4):503-511. doi: 10.60787/nmj-v65i3-496. eCollection 2024 Jul-Aug.
Methicillin-Resistant (MRSA) is both a human commensal and a pathogen that causes neonatal infection which is associated with significant morbidity and mortality. Its genetic flexibility and versatility have equipped it with the ability to develop resistance to numerous antibiotics. Outbreaks of infections in neonatal intensive care units as well as community infections have been reported mostly in developed countries. However, there is a paucity of data on neonatal MRSA infection in developing countries. The study aims to highlight cases of MRSA infection, describe the clinical presentation, and outline the antibiotic susceptibility pattern among term neonates in our facility.
It was a prospective cross-sectional hospital-based study carried out from October 2018 to July 2019. A total of 248 term neonates with suspected sepsis were enrolled in the study and had their blood samples taken for investigations including blood culture. Bacterial identification and antibiotic susceptibility patterns were carried out using MicrobactTM24E (Oxiod UK) and Staph ID and modified Kirby-Bauer disk diffusion technique respectively.
Out of the 248 subjects enrolled in the study, 34.2% had proven sepsis, with Staphylococcus species accounting for 56.4% of these cases. Among those with staphylococcal sepsis, 56.3% were found to have MRSA infection. Notably, the majority (94.4%) of cases originated from outside the hospital, presenting as neonatal sepsis with non-specific clinical features. Sensitivity testing revealed that ciprofloxacin and chloramphenicol were the most effective antibiotics against the identified pathogens.
The presence of MRSA infections in neonates poses a critical public health threat. This trend underscores the emergence of antimicrobial resistance, potentially compromising treatment efficacy and jeopardizing neonatal well-being. Urgent and decisive measures are necessary to curb this trajectory.
耐甲氧西林金黄色葡萄球菌（MRSA）既是一种人体共生菌，也是一种可导致新生儿感染的病原体，这种感染与显著的发病率和死亡率相关。其基因的灵活性和多样性使其具备了对多种抗生素产生耐药性的能力。新生儿重症监护病房的感染暴发以及社区感染大多在发达国家有报道。然而，发展中国家关于新生儿MRSA感染的数据匮乏。本研究旨在突出MRSA感染病例，描述临床表现，并概述我们机构足月儿中的抗生素敏感性模式。
这是一项于2018年10月至2019年7月开展的基于医院的前瞻性横断面研究。共有248名疑似败血症的足月儿纳入本研究，并采集他们的血样进行包括血培养在内的检查。分别使用MicrobactTM24E（英国奥克托）和葡萄球菌鉴定及改良的 Kirby-Bauer 纸片扩散技术进行细菌鉴定和抗生素敏感性模式分析。
在纳入研究的248名受试者中，34.2%被证实患有败血症，其中葡萄球菌属占这些病例的56.4%。在患有葡萄球菌败血症的患者中，56.3%被发现患有MRSA感染。值得注意的是，大多数（94.4%）病例来自医院外，表现为具有非特异性临床特征的新生儿败血症。敏感性测试显示，环丙沙星和氯霉素是针对已鉴定病原体最有效的抗生素。
新生儿中MRSA感染的存在构成了严重的公共卫生威胁。这一趋势凸显了抗菌药物耐药性的出现，可能会损害治疗效果并危及新生儿健康。必须采取紧急且果断的措施来遏制这一趋势。
