ISSN: 0973-7510

E-ISSN: 2581-690X

Research Article | Open Access
Dina M. Hassan1 , Lamiaa A. Madkour2 and Walaa A. Abuelhamd3
1Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Egypt.
2Medical Microbiology and Immunology Department, Faculty of Medicine, Cairo University, Egypt.
3Pediatrics and Neonatology Department, Faculty of Medicine, Cairo University, Egypt.
J Pure Appl Microbiol. 2020;14(3):2189-2202 | Article Number: 6616
https://doi.org/10.22207/JPAM.14.3.60 | © The Author(s). 2020
Received: 29/08/2020 | Accepted: 21/09/2020 | Published: 29/09/2020
Abstract

A surge of extended spectrum beta lactamase (ESBL)-producers is being witnessed in the neonatal intensive care units (NICUs). Hence, the present study was conducted to analyze both the bacteriological profile and clinical outcome of neonatal septicemia, and to identify the prevalence and sensitivity of the incriminated pathogens with emphasis on ESBL producers. We conducted this study in the NICU of a tertiary referral hospital over a one-year-period. All neonates with a clinical diagnosis of sepsis (371 participants) were enrolled. Blood cultures were performed, and subsequent cultures of various specimens were done according to clinical suspicion. Antibiotic susceptibility tests were carried out and the neonates were followed up until discharge. Out of the 371 neonates, 137 (37%) had positive blood culture results, of whom 49% died versus only 7.7% of neonates with a negative blood culture (P-value< 0.0001). Low birth weight, prematurity, and the duration of hospital stay were considered as positive blood culture risk factors. Meanwhile, among 85 cultures that yielded Gram-negative pathogens, 16 isolates were identified as ESBL producers with Klebsiella pneumoniae being the most frequently encountered isolate (19.7%). Of the neonates inflicted with ESBL-sepsis, 62.5% died versus 11.6% with non-ESBL sepsis. Judicious antibiotic stewardship together with infection control practices can hinder the spread of drug-resistant pathogens. This is especially compelling among the vulnerable population of the NICUs. Meanwhile, rapid diagnostic modalities and timely antibiotic susceptibility tests are of paramount importance to initiate appropriate therapy which can hugely impact the clinical prognosis.

Keywords

Acinetobacter, ESBL, Klebsiella, MDR, Neonatal septicemia, NICU

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© The Author(s) 2020. Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License which permits unrestricted use, sharing, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.