Prevalence and antibiotic resistance profiles of ESKAPE pathogens in the neonatal intensive care unit of the women and newborn hospital in Lusaka, Zambia.

Background: Bacterial contamination of the Neonatal Intensive Care Unit (NICU) poses a significant risk for cross-transmission, potentially leading to infections in vulnerable neonates. Key pathogens involved in NICU-acquired infections such as Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp. are collectively known as ESKAPE pathogens. They are known for their antibiotic resistance, posing challenges for treatment. This study aimed to investigate the prevalence and antibiotic resistance profiles of ESKAPE pathogens in the NICU at the Women and Newborn Hospital (WNH).

Methods: A total of 344 Samples were collected from different medical equipment, inanimate, animate surfaces and indoor air using standard microbiological methods. Antimicrobial susceptibility testing was then performed using the Kirby-Bauer method.

Results: Bacterial contamination rate was 323/344 (93.9%), with 83/323 (25.7%) of samples containing ESKAPE pathogens. Antimicrobial susceptibility varied among ESKAPE pathogens with a total of 75/83 (90%) of the ESKAPE isolates being multi-drug resistant (MDR). Gram-negative isolates exhibited high resistance to β-lactams, carbapenems, and fluoroquinolones, with susceptibility to aminoglycosides, while Gram-positive isolates showed resistance to β-lactams and macrolides but remained largely susceptible to linezolid, clindamycin, and vancomycin.

Conclusion: There was a high level of contamination with MDR ESKAPE pathogens in the NICU. This highlights the need for improved infection prevention and control measures as well as antimicrobial stewardship to prevent further resistance.