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 |
Externí odkaz: |