加纳三级医疗机构新生儿重症监护室败血症致病细菌的细菌学特征和抗生素敏感性模式

Kwame Opare-Asamoah, E. K. Vicar, Samuel E Acquah, Lawrence Quaye, Abdul-Mumin Alhassan, Saeed F Majeed, Abigail Asantewaa Sakyi, Endorah Fotwe Blankson, Kwasi Boadu Mensah
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Methods: Neonatal biodata were collected from patient folders, after which identification, isolation, and susceptibility of isolated bacteria to prescribed anti-bacterial (Kirby-Bauer disk diffusion method) were carried out on single venipuncture blood samples aseptically drawn from 275 neonates clinically diagnosed with sepsis. Results: 275 neonates took part in the study, of which 218 (79.3%) presented with early-onset sepsis (EOS) and 57 (20.7%) with late-onset sepsis (LOS). The laboratory results confirmed a septicemia prevalence of 70.3% among neonates clinically diagnosed with sepsis. Preterm delivery (P = .01), hypothermia (P = .001), and delivery at the tertiary healthcare facility were significantly associated with EOS (P < .000), while low birth weight (P = .012), duration of hospital stay (P = .001), and delivery at the tertiary healthcare facility (P < .000) were found to be significantly associated with LOS. 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引用次数: 0

摘要

背景:新生儿脓毒症是一种临床急症,需要通过准确的实验室分析和及时的临床干预来进行合理的评估。因此,本研究是在加纳北部地区一家三级卫生保健机构的新生儿重症监护病房进行的,目的是确定导致新生儿败血症的细菌及其对常用抗生素的易感性。方法:从患者文件夹中收集新生儿生物资料,对临床诊断为败血症的275例新生儿无菌单次静脉穿刺采血标本进行鉴定、分离及分离菌对处方抗菌药物(Kirby-Bauer圆盘扩散法)的药敏试验。结果:275例新生儿参与研究,其中218例(79.3%)出现早发型脓毒症(EOS), 57例(20.7%)出现晚发型脓毒症(LOS)。实验室结果证实,在临床诊断为败血症的新生儿中,败血症患病率为70.3%。早产(P = 0.01)、体温过低(P = 0.001)和在三级医疗机构分娩与EOS显著相关(P < .000),而低出生体重(P = .012)、住院时间(P = .001)和在三级医疗机构分娩(P < .000)被发现与LOS显著相关。革兰氏阳性球菌107株占54.9%,革兰氏阴性球菌88株占45.1%。革兰氏阳性和革兰氏阴性菌株分别占70.1%(75株)和39.8%(35株)。对氨苄西林和阿莫西林/克拉维酸敏感者分别占57.8%和55.8%。93.5%的con及所有分离的金黄色葡萄球菌和克雷伯菌对阿米卡星敏感。结论:凝血酶阴性葡萄球菌(con)和克雷伯菌(Klebsiella)分别是新生儿重症监护病房主要的革兰氏阳性和阴性败血症致病菌。阿米卡星对革兰氏阳性和阴性病原体表现出最高的敏感性,使其成为该机构经验治疗新生儿败血症的有力候选。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Bacteriological Profile and Antibiotic Susceptibility Patterns of Sepsis-Causing Bacteria at the Neonatal Intensive Care Unit of a Tertiary Health Care Facility in Ghana
Background: Neonatal sepsis is a clinical emergency that requires sound evaluation supported by accurate laboratory analysis and timely clinical intervention for its management. This study, therefore, was conducted to identify bacteria causing neonatal sepsis and their susceptibility to the commonly prescribed antibiotic at the Neonatal Intensive Care Unit of a tertiary health care facility in the Northern Region of Ghana. Methods: Neonatal biodata were collected from patient folders, after which identification, isolation, and susceptibility of isolated bacteria to prescribed anti-bacterial (Kirby-Bauer disk diffusion method) were carried out on single venipuncture blood samples aseptically drawn from 275 neonates clinically diagnosed with sepsis. Results: 275 neonates took part in the study, of which 218 (79.3%) presented with early-onset sepsis (EOS) and 57 (20.7%) with late-onset sepsis (LOS). The laboratory results confirmed a septicemia prevalence of 70.3% among neonates clinically diagnosed with sepsis. Preterm delivery (P = .01), hypothermia (P = .001), and delivery at the tertiary healthcare facility were significantly associated with EOS (P < .000), while low birth weight (P = .012), duration of hospital stay (P = .001), and delivery at the tertiary healthcare facility (P < .000) were found to be significantly associated with LOS. Gram-positive cocci constituted 54.9% (107), with Gram-negative constituting 45.1% (88) of all the bacteria isolates. Coagulase-negative staphylococcus (CoNS) 70.1% (75) and Klebsiella species 39.8% (35) were the dominant Gram-positive and Gram-negative isolates, respectively. 57.8% and 55.8% of CoNS isolates were susceptible to ampicillin and amoxicillin/clavulanic acid, respectively. 93.5% of CoNS and all the isolated Staphylococcus aureus and Klebsiella species were susceptible to amikacin. Conclusions: Coagulase-negative staphylococcus (CoNS) and Klebsiella species were the predominant Gram-positive and negative sepsis-causing agents at the NICU, respectively. Amikacin exhibited the highest sensitivity to Gram-positive and negative causative agents, making it a strong candidate for consideration in the facility’s empirical treatment of neonatal sepsis.
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