Intestinal carriage of multidrug-resistant gram-negative bacteria in preterm-infants during hospitalization in neonatal intensive care unit (NICU)

Autor: Mohd Yasim Md Yusof, Ivan K. S. Yap, Chun Wie Chong, Azanna Ahmad Kamar, Yao Mun Choo, Polly Soo Xi Yap, Cindy Shuan Ju Teh, Kwai Lin Thong
Rok vydání: 2016
Předmět:
Male
0301 basic medicine
Neonatal intensive care unit
Klebsiella pneumoniae
030106 microbiology
Ceftazidime
Microbial Sensitivity Tests
Aztreonam
Risk Assessment
Microbiology
Specimen Handling
Tertiary Care Centers
Feces
03 medical and health sciences
chemistry.chemical_compound
Drug Resistance
Multiple
Bacterial
Intensive Care Units
Neonatal
Gram-Negative Bacteria
Escherichia coli
medicine
Humans
Prospective Studies
Cefoxitin
biology
business.industry
Infant
Newborn
Malaysia
Public Health
Environmental and Occupational Health
Original Articles
General Medicine
Amoxicillin
biology.organism_classification
Anti-Bacterial Agents
Electrophoresis
Gel
Pulsed-Field
Hospitalization
Intestines
Infectious Diseases
chemistry
Carrier State
Ceftriaxone
Colistin
Female
Parasitology
business
Infant
Premature
medicine.drug
Zdroj: Pathogens and Global Health. 110:238-246
ISSN: 2047-7732
2047-7724
Popis: The prevalence and antibiotic susceptibility of intestinal carriage of Gram-negative bacteria among preterm infants admitted to the neonatal intensive care unit (NICU) in a tertiary teaching hospital in Malaysia were determined. A total of 34 stool specimens were obtained from preterm infants upon admission and once weekly up to two weeks during hospitalization. The presumptive colonies of Escherichia coli and Klebsiella pneumoniae were selected for identification, antibiotic susceptibility testing, and subtyping by using pulsed-field gel electrophoresis (PFGE). Out of 76 Gram-negative isolates, highest resistance was detected for amoxicillin/clavulanate (30.8%, n = 16), ceftriaxone (42.3%, n = 22), ceftazidime (28.8%, n = 15), cefoxitin (28.8%, n = 15), aztreonam (36.5%, n = 19), and polymyxin B (23.1%, n = 12). Three colistin resistant K. pneumoniae have also been detected based on E-test analysis. Thirty-nine isolates of K. pneumoniae and 20 isolates of E. coli were resistant to more than three antimicrobial classes and were categorized as multidrug resistant (MDR). PFGE analysis revealed a higher diversity in pulsotypes for K. pneumoniae (18 pulsotypes) in comparison to E. coli (four pulsotypes). In addition, a total of fifteen pulsotypes was observed from 39 MDR K. pneumoniae. The risk factors for antibiotic resistance were assessed using random forest analysis. Gender was found to be the most important predictor for colistin resistant while length, OFC, and delivery mode were showing greater predictive power in the polymyxin B resistance. This study revealed worrying prevalence rates of intestinal carriage of multidrug-resistant K. pneumoniae and E. coli of hospitalized preterm infants in Malaysia, particularly high resistance to polymyxins.
Databáze: OpenAIRE
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