Pattern of bacterial profile and antibiotic susceptibility among neonatal sepsis cases at Cairo University Children Hospital

Almohammady, Mohammad N.; Eltahlawy, Eman; Reda, Nashwa

doi:10.1016/j.jtumed.2019.12.005

Cited by 24 publications

(31 citation statements)

References 35 publications

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“… 27 , 28 It has shown resistance to drugs such as Carbapenems, expanded spectrum Cephaloporins and Colistin in the studies done in India, Nepal and Egypt which is an alarming sign. 12 , 16 , 29 However, in our study, it showed high sensitivity to the antibiotics like Colistin, Carbapenems, Levofloxacin, Tigecycline and Polymixin and moderate sensitivity to Aminoglycosides.…”

Section: Discussioncontrasting

confidence: 50%

Study of Antibiotic Susceptibility among Bacterial Isolates in Neonatal Intensive Care Unit of a Tertiary Care Hospital: A Descriptive Cross-sectional Study

et al. 2020

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Introduction: Neonatal sepsis is a major cause of neonatal morbidity and mortality worldwide, especially in developing countries like Nepal. Antibiotic resistance among microorganisms poses new challenges in the treatment of neonatal sepsis. The present study is conducted with the objectives of determining clinico-bacteriological profile and antibiotic susceptibility among isolated bacteria in a neonatal intensive care unit. Methods: A descriptive cross-sectional study was conducted from January 1, 2017, to December 31, 2019, in the neonatal intensive care unit of a tertiary care hospital after obtaining ethical clearance from Institutional Review Committee (Reference Number: 2020-064). The sample size was calculated and 77 neonates with culture-proven sepsis were included in the study. The antibiotic susceptibility tests of the isolates were done by Kirby-Bauer disc diffusion method. Data entry was done in Statistical Packages for the Social Sciences version 20. Results: Of the 841 specimens (blood, cerebrospinal fluid, urine, tracheal aspirate and pus) processed for culture, bacteria were isolated in 84 (10.0%) specimens. Among the 84, gram-negative bacilli were the predominant isolates 76 (90.5%); of which Acinetobacter baumannii was the most common 27 (32.1%). Both the Gram-negative and the Gram-positive bacteria showed high resistance to Penicillin and Cephalosporins. Gram-negative bacteria showed maximum sensitivity to Colistin, Carbapenems, Tigecycline and Fluoroquinolones. Gram-positive bacteria showed maximum susceptibility to Amikacin, Vancomycin and Carbapenems. Conclusions: Judicious use of antibiotics based on the updated knowledge of prevalent organisms in the local hospital setting and their antibiotic sensitivity pattern is of utmost importance for the effective treatment of neonatal sepsis.

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Section: Discussioncontrasting

confidence: 50%

Study of Antibiotic Susceptibility among Bacterial Isolates in Neonatal Intensive Care Unit of a Tertiary Care Hospital: A Descriptive Cross-sectional Study

et al. 2020

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“…Sadly, infant mortalities from CR/PR-GNB remains substantially high in many countries, including China and Brazil (Fig. 6), albeit treatment with carbapenems (at higher doses), colistin, and tigecycline have been shown to be very efficient in clearing the infection and saving lives 7,10,28,45,56,73 . Instructively, Kumar et al (2014) observed that the absence of effective treatment led to higher all-cause mortalities in neonates 54 .…”

Section: P a G Ementioning

confidence: 99%

“…To avoid depleting our antibiotics arsenals against infectious pathogens, certain agents are reserved as last-line drugs to fight difficult-totreat infections [6][7][8] . Currently, carbapenems, polymyxins (colistin) and tigecycline are used as reserved agents for MDR infections 9,10 . However, the continual use of carbapenems and polymyxins to treat bacterial infections resistant to penicillins, cephalosporins, and carbapenems are increasing the rate of resistance to these last-resort antibiotics 2,4,9,11 .…”

Section: Introductionmentioning

confidence: 99%

“…Specifically, extended-spectrum β -lactamases (ESBLs), fluoroquinolones, aminoglycosides, tetracycline, sulphamethoxazole-trimethoprim, and macrolide ARGs are also found in CR-GNB and PR-GNB. Hence, under antibiotic selection pressure, MDR plasmids and clones proliferate, leading to outbreaks 10,27,34,35 . It is thus not surprising that most neonatal CRE infections occur in NICUs during clonal outbreaks in which the isolates harbour multiple ARGs on mobile plasmids 20,25,26,30,36,37 .…”

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confidence: 99%

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Molecular Epidemiology, Risk Factors and Clinical Outcomes of Carbapenem- and Polymyxin-Resistant Gram-negative Bacterial Infections in Pregnant Women and Infants: A Systematic Review

Sekyere

Reta

2020

Preprint

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BackgroundCarbapenems and polymyxins are last-resort antibiotics used to treat multidrug-resistant bacterial infections. However, resistance is increasing, even in vulnerable groups such as pregnant women and infants, for whom therapeutic options are limited.MethodUsing a diversity of databases, the literature was searched for studies investigating carbapenem and polymyxin resistance in pregnant women and infants (< 5 years).ResultA final set of 73 manuscripts were used. In almost all countries, carbapenem/polymyxin-resistant Klebsiella pneumoniae, Escherichia coli, and Acinetobacter baumannii infect and/or colonizes neonates and pregnant women, causing periodic outbreaks with very high infant mortalities. Plasmid-borne blaNDM, blaKPC, blaOXA-48, blaIMP,blaVIM and blaGES-5 and ompK35/36 downregulation in clonal strains accelerate the horizontal and vertical transmission of carbapenem resistance in these pathogens. High prevalence of carbapenem/polymyxin resistance and carbapenemases were present in India, China, Pakistan, Thailand, Taiwan, Turkey, Egypt, Italy, USA, South Africa, Algeria, Ghana, and Madagascar. Factors such as antibiotic therapy, prolonged hospitalization, invasive procedures, mother/infant colonization, mechanical ventilation, low-birth weight and preterm state placed infants at high risk of carbapenem/polymyxin-resistant infections. Infant mortalities ranged from 0.2% to 36.8% in different countries.ConclusionUse of polymyxins to treat carbapenem-resistant infections is selecting for resistance to both agents, restricting therapeutic options for infected infants and pregnant women. However, appropriate infection control and antibiotic therapy can contain outbreaks and clear these infections. Antibiotic stewardship, periodic rectal and vaginal screening, and strict infection control practices in neonatal ICUs are necessary to forestall future outbreaks and deaths.HighlightsCarbapenems & polymyxins are last-resort antibiotics used for multidrug-resistant infectionsResistance to these two agents are reported in infants & pregnant womenK. pneumoniae, E. coli, and A. baumannii are the most common pathogensCarbapenem & polymyxin resistance cause outbreaks with high infant mortalitiesAppropriate treatment & infection control can outbreaks & save lives

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“…Neonatal sepsis is caused by various microorganisms [ 2 , 9 ]. Data obtained from some neonatal intensive care units in Egyptian hospitals identified Staphylococcus aureus as one of the leading Gram-positive neonatal sepsis causes [ 10 , 11 , 12 ]. Preliminary data, obtained from internal surveillance studies conducted by the Infection Control Unit in Cairo University Hospitals, indicated that the most common causes of neonatal sepsis in these settings were; Klebsiella pneumoniae, Enterobacter cloacae , and S. aureus .…”

Section: Introductionmentioning

confidence: 99%

A Novel Surface-Exposed Polypeptide Is Successfully Employed as a Target for Developing a Prototype One-Step Immunochromatographic Strip for Specific and Sensitive Direct Detection of Staphylococcus aureus Causing Neonatal Sepsis

et al. 2020

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Neonatal sepsis is a life-threatening condition and Staphylococcus aureus is one of its major causes. However, to date, no rapid and sensitive diagnostic tool has been developed for its direct detection. Bioinformatics analyses identified a surface-exposed 112-amino acid polypeptide of the cell wall protein NWMN_1649, a surface protein involved in cell aggregation and biofilm formation, as being a species-specific and highly conserved moiety. The polypeptide was cloned, purified, and used to immunize mice to raise specific immunoglobulins. The purified antibodies were conjugated to gold nano-particles and used to assemble an immunochromatographic strip (ICS). The developed prototype ICS detected as low as 5 µg purified polypeptide and 102 CFU/mL S. aureus within 15 min. The strip showed superior ability to directly detect S. aureus in neonatal sepsis blood specimens without prior sample processing. Moreover, it showed no cross-reaction in specimens infected with two other major causes of neonatal sepsis; coagulase-negative staphylococci and Klebsiella pneumoniae. The selected NWMN_1649-derived polypeptide demonstrates success as a promising biomolecule upon which a prototype ICS has been developed. This ICS provides a rapid, direct, sensitive, and specific option for the detection of S. aureus causing neonatal sepsis. Such a tool is urgently needed especially in resources-limited countries.

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Pattern of bacterial profile and antibiotic susceptibility among neonatal sepsis cases at Cairo University Children Hospital

Cited by 24 publications

References 35 publications

Study of Antibiotic Susceptibility among Bacterial Isolates in Neonatal Intensive Care Unit of a Tertiary Care Hospital: A Descriptive Cross-sectional Study

Study of Antibiotic Susceptibility among Bacterial Isolates in Neonatal Intensive Care Unit of a Tertiary Care Hospital: A Descriptive Cross-sectional Study

Molecular Epidemiology, Risk Factors and Clinical Outcomes of Carbapenem- and Polymyxin-Resistant Gram-negative Bacterial Infections in Pregnant Women and Infants: A Systematic Review

A Novel Surface-Exposed Polypeptide Is Successfully Employed as a Target for Developing a Prototype One-Step Immunochromatographic Strip for Specific and Sensitive Direct Detection of Staphylococcus aureus Causing Neonatal Sepsis

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