Mshana Happyness J, Kovacs Dorottya, Muro Florida, Zadoks Ruth, Oravcova Katarina, Matthews Louise, Mmbaga Blandina T
Department of Research and Clinical Trial, Kilimanjaro Clinical Research Institute, Moshi, Tanzania.
Boyd Orr Centre for Population and Ecosystem Health, School of Biodiversity, One Health and Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom.
Front Antibiot. 2025 May 21;4:1556842. doi: 10.3389/frabi.2025.1556842. eCollection 2025.
Infections are a major driver of broad-spectrum antibiotic use. This wide use of antibiotics contributes to the emergence of antimicrobial resistance globally that poses a threat to human and animal health. Infections continue to be a major cause of death among pregnant women and neonates. Therefore, this study aimed to assess the burden of extended-spectrum beta-lactamase (ESBL)-producing and carriage among neonates and their surroundings admitted to a referral hospital in Northeast Tanzania.
The burden of ESBL-producing and in a neonatal ward was assessed by screening neonates' rectums, maternal and healthcare workers' hands, and neonatal cots. Isolates were cultured, identified, and tested for antimicrobial resistance, while generalized linear models identified risk factors for carriage.
A total of 437 neonates were screened for ESBL-producing and , with 235 (54%) being male. In addition, 77 maternal hand swabs, 118 neonatal cots, and 45 healthcare workers' hand swabs were collected. ESBL-producing was isolated from 198 neonates (45%), and from 96 (23%). Additionally, 5% of maternal hands and 22% of neonatal cots were contaminated with these resistant bacteria. Overall ampicillin resistance was frequent in ESBL-producing and ESBL neonatal colonization (n=261,100%), as was resistance to trimethoprim-sulfamethoxazole ( = 233,89%), gentamicin ( = 169, 66%), and tetracycline ( = 140,54%). Only three (1%) of the ESBL-producing and ESBL isolates were resistant to meropenem. Risk factors significantly associated with carriage of either ESBL-producing or were being born in an admission room [odds ratio (OR)=1.95, confidence interval (CI)=1.31-3.13, p=0.006] and delivery mode, with vaginal delivery associated with a reduced risk of carriage (OR=0.57, CI=0.35-0.92, p=0.023).
The study reveals a high burden of ESBL-producing and in neonates and their environment, with frequent resistance to ampicillin and gentamicin. Hospital admission and cesarean delivery increase the risk of carriage, while vaginal delivery lowers it. Active screening upon admission and advanced diagnostic methods can help reduce transmission and guide effective antimicrobial treatment.
感染是广谱抗生素使用的主要驱动因素。抗生素的广泛使用促使全球抗菌药物耐药性的出现，这对人类和动物健康构成威胁。感染仍然是孕妇和新生儿死亡的主要原因。因此，本研究旨在评估坦桑尼亚东北部一家转诊医院收治的新生儿及其周围环境中产超广谱β-内酰胺酶（ESBL）细菌的携带情况及负担。
通过筛查新生儿直肠、母亲及医护人员的手部以及新生儿床，评估新生儿病房中产ESBL细菌的携带情况及负担。对分离菌株进行培养、鉴定及抗菌药物耐药性检测，同时采用广义线性模型确定携带的危险因素。
共对437名新生儿进行了产ESBL细菌的筛查，其中235名（54%）为男性。此外，还收集了77份母亲手部拭子、118份新生儿床拭子和45份医护人员手部拭子。从198名新生儿（45%）中分离出产ESBL细菌，96名（23%）分离出其他细菌。此外，5%的母亲手部和22%的新生儿床被这些耐药菌污染。总体而言，产ESBL细菌和ESBL阴性细菌的新生儿定植中氨苄西林耐药很常见（n = 261，100%），对甲氧苄啶-磺胺甲恶唑（n = 233，89%）、庆大霉素（n = 169，66%）和四环素（n = 140，54%）的耐药情况也很常见。产ESBL细菌和ESBL阴性细菌的分离株中只有三株（1%）对美罗培南耐药。与产ESBL细菌或其他细菌携带显著相关的危险因素包括在入院室出生[比值比（OR）=1.95，置信区间（CI）=1.31 - 3.13，p = 0.006]和分娩方式，阴道分娩与携带风险降低相关（OR = 0.57，CI = 0.35 - 0.92，p = 0.023）。
该研究揭示了新生儿及其环境中产ESBL细菌和其他细菌的负担较重，对氨苄西林和庆大霉素耐药情况常见。入院和剖宫产会增加携带风险，而阴道分娩会降低风险。入院时进行主动筛查和先进的诊断方法有助于减少传播并指导有效的抗菌治疗。
