Etiology of early onset neonatal sepsis in neonatal intensive care unit – Mansoura, Egypt

Seliem, Wael; Sultan, Amira M.

doi:10.3233/npm-17128

Cited by 17 publications

(13 citation statements)

References 27 publications

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“…In the current study, E. coli was the most frequent microorganism isolated from EOS cases (86.2%), which is similar to other studies that found that there is a change in pathogens causing EOS from group B streptococci infections, which have shown a significant decline in recent years due to intrapartum antibiotic prophylaxis to a significant increase in E. coli infections that commonly colonize maternal enteric canal 28. Unlike several studies from Egypt, which found that the most common Gram-negative bacteria causing EOS was Klebsiella , we confirmed our result by detecting the uidA gene encoding the b-glucuronidase enzyme, which is frequently used to identify E. coli 29–31…”

Section: Discussionsupporting

confidence: 84%

Rapid diagnosis of neonatal sepsis by PCR for detection of 16S rRNA gene, while blood culture and PCR results were similar in E.coli-predominant EOS cases

El-Amir¹,

El-Feky²,

Elwafa³

et al. 2019

IDR

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Purpose To determine the bacteriological pattern and antibiotic susceptibility of bacterial isolates causing neonatal sepsis in Qena University Hospitals and compare polymerase chain reaction (PCR) and blood culture results in a trial for rapid diagnosis. Patients and methods Blood samples from 75 clinically suspected cases of neonatal sepsis were subjected to identification of bacteria and determination of their antibiotic sensitivity through blood culture, and rapid detection of 16S rRNA and the uidA gene (to confirm the presence of E. coli ) by PCR from extracted bacterial DNA. Results Most patients were preterm (64%) and low birth weight (LBW) (68%). In total, 42.7% presented with early onset sepsis (EOS). LBW was significantly associated with EOS ( P -value=0.03). Although the blood culture and PCR results were similar in EOS, the PCR results were significantly higher than those of blood culture in detecting bacteria (85.3% vs 68%, respectively, P -value=0.001). Blood culture showed 100% specificity. The most common pathogen was E. coli (86.2%) in EOS and Staphylococcus spp . (45.5%) in late-onset sepsis (LOS) ( P -value=0.001 and 0.02, respectively). The most effective antibiotics against Gram-negative bacteria were ofloxacin, ciprofloxacin, imipenem, and amikacin, while vancomycin, oxacillin, and imipenem were the most effective antibiotics against Gram-positive bacteria. Conclusion EOS was mainly caused by E. coli , while LOS was mainly caused by Staphylococcus spp . The 16S rRNA PCR showed higher sensitivity with rapid and accurate diagnosis. Blood culture is the most suitable method for antimicrobial sensitivity testing.

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Section: Discussionsupporting

confidence: 84%

Rapid diagnosis of neonatal sepsis by PCR for detection of 16S rRNA gene, while blood culture and PCR results were similar in E.coli-predominant EOS cases

El-Amir¹,

El-Feky²,

Elwafa³

et al. 2019

IDR

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“…Similar results were also obtained in Egypt and Malawi (Mashaly and El-Mahdy 2017;Musicha et al 2017). CoNS were confirmed as a major pathogen isolated in further investigations on smaller groups of patients, mostly neonates in Egypt and Ethiopia (Seliem and Sultan 2018;Sorsa et al 2019). In contrast, a study from Zambia reports that the most frequent pathogen isolated from neonates with sepsis was Klebsiella sp.…”

Section: Epidemiology: Worldwide Distribution Of Staphylococcal Bloodstream Infectionsmentioning

confidence: 87%

Epidemiology and Pathogenesis of Staphylococcus Bloodstream Infections in Humans: a Review

Lisowska-Łysiak

Lauterbach

Międzobrodzki

et al. 2021

Polish Journal of Microbiology

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Staphylococci are among the most frequent human microbiota components associated with the high level of bloodstream infection (BSI) episodes. In predisposed patients, there is a high risk of transformation of BSI episodes to sepsis. Both bacterial and host factors are crucial for the outcomes of BSI and sepsis. The highest rates of BSI episodes were reported in Africa, where these infections were up to twice as high as the European rates. However, there remains a great need to analyze African data for comprehensive quantification of staphylococcal BSI prevalence. The lowest rates of BSI exist in Australia. Asian, European, and North American data showed similar frequency values. Worldwide analysis indicated that both Staphylococcus aureus and coagulase-negative staphylococci (CoNS) are the most frequent BSI agents. In the second group, the most prevalent species was Staphylococcus epidermidis, although CoNS were not identified at the species level in many studies. The lack of a significant worldwide decrease in BSI episodes indicates a great need to implement standardized diagnostic methods and research etiological factors using advanced genetic methods.

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“…These results agreed with Seliem and Sultan. 33 and Salama et al 23 who reported that the most causative agent of EONS was Klebsiella pneumoniae. EL-Amir et al 15 demonstrated a prevalence of Gram-negative bacteria among patients with EONS but they found that the most common Gram-negative bacteria causing EONS was E.coli.…”

Section: Discussionmentioning

confidence: 98%

Automated Blood Culture versus Amplification of 16S rRNA Gene Method for Detection of Neonatal Septicemia

Abdelmoneim

2021

Egyptian Journal of Medical Microbiology

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Background: Accurate and rapid diagnosis of neonatal septicemia is highly warranted because of high associated morbidity and mortality. Blood culture serves as a routine method for diagnosis of bacterial sepsis. However, it sometimes takes ≥ 72 hours for the results, with low sensitivity. Full automated blood culture method is superior to conventional methods in terms of speed and sensitivity. The polymerase chain reactionbased detection of 16S rRNA has reduced the laboratory turnaround time and has good sensitivity. Objectives: The aim of this study was to compare automated blood culture and amplification of 16srRNA gene by PCR in detection of aerobic bacterial infection in blood samples of hospitalized neonates with suspected neonatal sepsis and to determine the most common types of bacteria causing neonatal sepsis. Methodology: Blood samples collected from 40 neonates clinically suspected as neonatal sepsis were subjected to bacterial identification through automated blood culture by BacT/ALERT PF Plus Culture Bottles, and bacterial detection of 16S rRNA gene by PCR. Results: Out of 40 neonatal blood samples with suspected sepsis, 37(92.5%) neonates showed concordance between automated blood culture and PCR; 17(42.5%) showed positive results while 20 (50%) gave negative results by both methods. The remaining 3 cases (7.5%) were positive only by PCR. PCR sensitivity, specificity, positive and negative predictive values were 100%, 86.9%, 85% and 100% respectively. So, accuracy of PCR in relation to automated blood culture is 92.5%. The most common pathogens in cases of early onset neonatal sepsis were Klebsiella pneumoniae (7/15, 46.7%) followed by Streptococcus agalactiae (1/15, 6.6%) while the most common pathogens found in cases of late onset neonatal sepsis were Klebsiella pneumoniae and coagulase negative staphylococci (4/25,16% for each) then Staphylococcus aureus (1/25, 4%). Conclusion: 16S rRNA PCR showed accurate rapid diagnosis with higher sensitivity in diagnosis of neonatal septicemia. Klebsiella peumoniae was the main causative bacteria in early onset neonatal sepsis and late onset neonatal sepsis.

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Etiology of early onset neonatal sepsis in neonatal intensive care unit – Mansoura, Egypt

Cited by 17 publications

References 27 publications

<p>Rapid diagnosis of neonatal sepsis by PCR for detection of 16S rRNA gene, while blood culture and PCR results were similar in <em>E.coli</em>-predominant EOS cases</p>

<p>Rapid diagnosis of neonatal sepsis by PCR for detection of 16S rRNA gene, while blood culture and PCR results were similar in <em>E.coli</em>-predominant EOS cases</p>

Epidemiology and Pathogenesis of Staphylococcus Bloodstream Infections in Humans: a Review

Automated Blood Culture versus Amplification of 16S rRNA Gene Method for Detection of Neonatal Septicemia

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