Frequency, Bacteriological Profile, and Outcome of Neonatal Sepsis with Carbapenem-Resistant Gram-Negative Bacteria at the Tertiary Neonatal Intensive Care Unit, Ahvaz, Iran

Abstract

Background: One of the leading causes of neonatal mortality in low- and middle-income countries (LMICs) is neonatal sepsis caused by carbapenem-resistant gram-negative bacteria. Objectives: This study aimed to determine the frequency, bacterial profile, and outcome of carbapenem-resistant Gram-negative neonatal sepsis in southwest Iran. Methods: This 15-month retrospective cross-sectional descriptive study was conducted at a level 3 referral training hospital. The study included all neonates hospitalized from birth who had positive blood cultures for Gram-negative bacteria. Patients were divided into carbapenem-resistant and carbapenem-sensitive groups. Results: During the study, Gram-negative bacteria were isolated from the blood cultures of 113 neonates. Positive Gram-negative bacteria blood cultures and carbapenem-resistant cases were 2.38% and 1.52%, respectively. In these cases, 66 (58.4%) of the infants were males, 100 (88.4%) were preterm, and 74 (65.4%) required mechanical ventilation within the first three days of life. The study found 45 (39.8%) infants with early-onset sepsis. Acinetobacter was the most common isolated organism, while Enterobacter had the lowest isolation rate. Carbapenem resistance was discovered in 72 (63.7%) positive blood cultures. Acinetobacter had the highest prevalence of carbapenem resistance, while Pseudomonas had the lowest. Mortality rates in infants infected with carbapenem resistance bacteria (CRB) were 89.3% compared to 10.7% in those infected with carbapenem-sensitive bacteria (CSB). Conclusions: The frequency of carbapenem-resistant Gram-negative sepsis in our ward was 1.52 percent of all admissions, and Acinetobacter bacteria was the most common cause of this type of neonatal sepsis. Infants infected with CRB had a higher mortality rate than those infected with CSB, 89.3% versus 10.7%.

Frequency of Meningitis in Neonatal Sepsis

“…According to the study, males had a 2-5-fold higher risk of having septicemia than females, and our findings were consistent with prior findings (1,10) . The prevalence of meningitis observed in our study, which is consistent with other international studies, indicates an unavoidable and early need for neonatal meningitis recognition, necessitating screening in every case of late-onset sepsis and planning strategies to prevent any lethal losses as a result.…”

Evaluation of four ornamental plant extracts as insecticidal, antimicrobial, and antioxidant against the West Nile vector, Culex pipiens (Diptera: Culicidae) and metabolomics screening for potential therapeutics

“…Antimicrobial activity of the acetone and aqueous extracts of L. camara, D. regia, B. glabra, and P. orientalis was tested against unicellular fungi (C. albicans), Gram-positive bacteria (L. monocytogenes), and Gram-negative bacteria (Salmonella sp. and P. aeruginosa) via the agar diffusion approach according to Aletayeb et al [42]. The bacteria were grown in a nutrient-liquid medium on a shaker bed at 200 rpm for 24 h at 37 °C.…”