Clinical and bacteriological profiles of neonatal sepsis in a tertiary hospital, south-western Nigeria.

Autor: Obadare TO; MBBS, MPH, FMCpath, Department of Medical Microbiology and Parasitology, Obafemi Awolowo University Teaching Hospitals Complex, P.M.B. 5538, 220222, Ilesha-road, Ile-Ife, Nigeria., Adejuyigbe EA; BSc, MBChB, FMCPaed, MD, Neonatal Unit, Department of Paediatrics and Child Health, Obafemi Awolowo University & Obafemi Awolowo University Teaching Hospitals Complex, P.M.B 5538, 220222, Ilesha-road, Ile-Ife, Nigeria., Adeyemo AT; MBBS, FMCpath, Department of Medical Microbiology and Parasitology, Obafemi Awolowo University Teaching Hospitals Complex, P.M.B. 5538, 220222, Ilesha-road, Ile-Ife, Nigeria., Amupitan AA; BSc, MBBS, MWACP, FMCpath, Department of Medical Microbiology and Parasitology, Obafemi Awolowo University Teaching Hospitals Complex, P.M.B. 5538, 220222, Ilesha-road, Ile-Ife, Nigeria., Ugowe OJ; MBBS, FWACP, FMCpead, Neonatal Unit, Department of Paediatrics and Child Health, Obafemi Awolowo University Teaching Hospitals Complex, P.M.B 5538, 220222, Ilesha-road, Ile-Ife, Nigeria., Anyabolu CH; MBBS, WACP, FMCPead, Department of Paediatrics and Child Health, Obafemi Awolowo University & Obafemi Awolowo University Teaching Hospitals Complex, P.M.B 5538, 220222, Ilesha-road, Ile-Ife, Nigeria., Aboderin AO; MBChB, MSc, FMCPath, FRCPath, Department of Medical Microbiology and Parasitology, Obafemi Awolowo University & Obafemi Awolowo University Teaching Hospitals Complex, P.M.B. 5538, 220222, Ilesha-road, Ile-Ife, Nigeria.
Jazyk: angličtina
Zdroj: Germs [Germs] 2023 Jun 30; Vol. 13 (2), pp. 137-150. Date of Electronic Publication: 2023 Jun 30 (Print Publication: 2023).
DOI: 10.18683/germs.2023.1377
Abstrakt: Introduction: Antibiotic-resistant bacteria complicate treatment options in neonatal sepsis, especially in developing countries. This study determined the epidemiology and bacteriological characteristics of neonatal sepsis at a tertiary hospital, in southwest Nigeria.
Methods: This was a cross-sectional study from December 2017 to April 2019 among admitted babies with clinical neonatal sepsis. Blood culture was performed by semi-automated system, sepsis biomarker assay (serum procalcitonin) by a semi-quantitative kit while proforma was used to capture clinico-demographic data. Bacterial identification, antibiotic susceptibility patterns, determination of genetic elements mediating resistance, were performed by standard methods and polymerase chain reaction protocols, respectively. Quantitative data were expressed as frequencies, mean; bivariate and multivariate analyses were performed by Chi-square or Fishers' exact test and logistic regression.
Results: Of the 192 cases of neonatal sepsis enrolled, 42.7% (82/192) were blood culture positive. Factors associated with blood culture positivity included respiratory rate ≥60 bpm (60/82; p<0.03), lethargy/unconsciousness (59/82; FE=7.76; p<0.001), grunting respiration (54/82; p=0.04), meconium passage before birth (17/82; p=0.03) and prolonged rupture of membranes ≥24 hours (50/82; FE=6.90; p=0.01). On the other hand, mortality in the neonates was associated with elevated serum procalcitonin assay (>0.5 ng/mL) χ 2 =13.58; p=0.03] and Gram-negative bacteremia (χ 2 =24.64; p<0.001). The most common bacterial isolates were Staphylococcus aureus (42/82), coagulase-negative Staphylococcus spp. (17/82), Enterobacter spp. (8/82), and Acinetobacter spp. (6/82). Methicillin resistance was present in 85.7% (36/42) of Staphylococcus aureus and 52.9% (9/17) of coagulase-negative Staphylococcus , while extended-spectrum beta-lactamase (ESBL) and AmpC enzymes were present in (21.1%; 4/19) of the Gram-negative bacilli.
Conclusions: Almost half of the cases of clinically diagnosed neonatal sepsis have bacterial etiologic confirmation of sepsis. Gram-negative bacteremia and high serum procalcitonin predict mortality in neonatal sepsis. There was high resistance to common antibiotics for the treatment of neonatal sepsis in our settings.
Competing Interests: Conflicts of interest: All authors – none to declare.
(GERMS.)
Databáze: MEDLINE
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