Deress Teshiwal, Belay Gizeaddis, Ayenew Getahun, Ferede Worku, Worku Minichile, Feleke Tigist, Mulu Meseret, Belay Solomon, Getie Michael
Department of Quality Assurance and Laboratory Management, School of Biomedical and Laboratory Science, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Medical Microbiology, Amhara National Regional State Public Health Institute, Bahir Dar, Ethiopia.
Front Microbiol. 2024 Oct 21;15:1461689. doi: 10.3389/fmicb.2024.1461689. eCollection 2024.
Neonatal sepsis is a major cause of morbidity and mortality worldwide. Understanding the bacterial profiles and antibiotic susceptibility patterns causing neonatal sepsis is crucial for guiding appropriate treatment, improving patient outcomes, and combating the emergence of antibiotic resistance. Despite its importance, data regarding neonatal sepsis in the study area is limited. Therefore, this study aimed to characterize the bacterial pathogens and identify associated factors among neonates with suspected sepsis at the University of Gondar Comprehensive Specialized Hospital, Ethiopia.
A cross-sectional study was conducted by reviewing laboratory records of neonates admitted for suspected sepsis from January 2019 to December 2021. Data were checked for completeness and encoded in a spreadsheet program. Then, data were exported to STATA version 17 for analysis. Descriptive statistics such as frequency and percentage were computed. The association between neonatal sepsis and potential risk factors was assessed using Pearson's chi-square test. A -value of < 0.05, was considered statistically significant.
A total of 1,236 neonates were included. Of these, 96.2% (1,190/1,236) had a fever before admission. The prevalence of culture-confirmed sepsis was 25.4% (314/1,236). Bacterial pathogens accounted for 23% (284/1,236) of these isolates, with Gram-negative bacteria being more prevalent at 75.3% (214/284) than Gram-positive bacteria at 24.7% (70/284). The most frequently isolated bacterial pathogens were 38.7% (110/284) and 13% (37/284). The isolates demonstrated a high resistance level to commonly used antibiotics, with 61.6% exhibiting multidrug resistance. showed the highest rate of multidrug resistance (90.9%). Neonatal sepsis was associated with several factors, including fever before and after admission, hypothermia, increased respiration, suspected pneumonia, and suspected meningitis.
This study identified a high prevalence of culture-confirmed sepsis in neonates at UoGCSH, with Gram-negative bacteria, especially , dominating the isolated pathogens. The isolated bacteria exhibited alarming resistance to commonly used antibiotics, with a high proportion demonstrating multidrug resistance. Implementing effective antibiotic stewardship programs is crucial to optimize antibiotic use, reduce unnecessary prescriptions, and curb the spread of resistant strains.
新生儿败血症是全球发病和死亡的主要原因。了解导致新生儿败血症的细菌谱和抗生素敏感性模式对于指导适当治疗、改善患者预后以及对抗抗生素耐药性的出现至关重要。尽管其很重要，但研究区域内关于新生儿败血症的数据有限。因此，本研究旨在对埃塞俄比亚贡德尔大学综合专科医院疑似败血症新生儿中的细菌病原体进行特征描述并确定相关因素。
通过回顾2019年1月至2021年12月因疑似败血症入院的新生儿的实验室记录进行横断面研究。检查数据的完整性并在电子表格程序中编码。然后，将数据导出到STATA 17版本进行分析。计算频率和百分比等描述性统计数据。使用Pearson卡方检验评估新生儿败血症与潜在危险因素之间的关联。P值<0.05被认为具有统计学意义。
共纳入1236名新生儿。其中，96.2%（1190/1236）在入院前有发热症状。血培养确诊的败血症患病率为25.4%（314/1236）。细菌病原体占这些分离株的23%（284/1236），革兰氏阴性菌更为常见，占75.3%（214/284），而革兰氏阳性菌占24.7%（70/284）。最常分离出的细菌病原体是[具体细菌1]，占38.7%（110/284）和[具体细菌2]，占13%（37/284）。分离株对常用抗生素表现出较高的耐药水平，61.6%表现出多重耐药性。[具体细菌]表现出最高的多重耐药率（90.9%）。新生儿败血症与多种因素有关，包括入院前后发热、体温过低、呼吸加快、疑似肺炎和疑似脑膜炎。
本研究发现贡德尔大学综合专科医院新生儿血培养确诊的败血症患病率较高，革兰氏阴性菌，尤其是[具体细菌]，在分离出的病原体中占主导地位。分离出的细菌对常用抗生素表现出惊人的耐药性，很大一部分表现出多重耐药性。实施有效的抗生素管理计划对于优化抗生素使用、减少不必要的处方以及遏制耐药菌株的传播至关重要。
