Prevalence and Antibiotic Resistance of Neonatal Sepsis Pathogens in Neyshabour, Iran

Behmadi, Homayoon; Borji, Abasalt; Taghavi-Rad, Azadeh; Soghandi, Leyla; Behmadi, Reza

doi:10.5812/pedinfect.33818

Cited by 11 publications

(15 citation statements)

References 25 publications

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“…Often, doubts resulting from laboratory tests lead to unnecessary treatment of newborns (SINHA et al, 2018;VIEIRA, 2004). Escherichia coli is considered one of the most common pathogens related with the precocious sepsis in full-term newborns and with low weight birth (CORTESE et al, 2016), and the increasing resistance degree to antibiotics it has been decisive in the increment of pathogen virulence (BEHMADI et al, 2016;STOLL et al, 2002). Mohsen et al, (2017) found larger resistance of Gram-negative bacteria to ampicillin, cephalosporins and piperacillin-tazobactam, and smaller resistance was evidenced to aminoglycosides, carbapenems and quinolones.…”

Section: Discussionmentioning

confidence: 99%

Neonatal sepsis: evaluation of risk factors and histopathological examination of placentas after delivery

Duarte¹,

Marcon²,

Akagi³

et al. 2019

Biosci. J.

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Neonatal sepsis is a clinical syndrome defined by systemic signs of infection in newborns accompanied by bacteremia. Can be responsible for serious consequences for the newborn child, characterized at the birth as early sepsis or late onset sepsis, with high rate of neonatal morbidity and mortality. Pathological agents such as Escherichia coli (E. coli), Streptococcus agalactiae (S. agalactiae), Ureaplasma urealyticum and Mycoplasma hominis are most often responsible for intrauterine infections. The objective of this study is to evaluate the factors of neonatal sepsis predisposition in pregnant women through histopathological examination and the apoptotic index of placental tissues and detect DNA of E. coli and S. agalactiae using the Polymerase Chain Reaction (PCR). Histopathological analyses were made and the apoptotic index was determined to verify the levels of possible inflammatory infiltrates and cell death. Placenta samples were collected from November 2013 to May 2014. After DNA extraction, a PCR was performed amplifying the target fragment from the conserved regions of the rpoB (beta-RNA polymerase) polymorphism of E. coli and the factor 1 of S. agalactiae. The apoptosis index was tested with Acridine Orange and the histological procedure with Hematoxylin-Eosin staining. Among 100 samples of placental tissues analyzed by PCR, 48 represented the control group and did not present a risk factor associated with neonatal sepsis, and 52 samples representing the study group had at least one risk factor. Among these 52 samples, 7 (13.4%) had a PCR positive for E. coli. No placenta samples showed a positive PCR for S. agalactiae. The quantification of the apoptotic index did not show statistical significances between the groups and no inflammatory infiltrates were observed. However, histological sections showed fibrinoid necrosis, infarct areas and areas of calcification in all samples. Therefore, the results allow to conclude that the seven patients of experimental group with positive PCR for E. coli had eminent risk factors of neonatal sepsis, and the infection of the urinary tract (UTI) is the main aggravating circumstance. The histopathological examination demonstrated that the risk factors caused significant alterations, producing fibrinoid necrosis and infarcted areas in the placenta, contrary to apoptotic index that didn't differ from the group with unprecedented risk.

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Section: Discussionmentioning

confidence: 99%

Neonatal sepsis: evaluation of risk factors and histopathological examination of placentas after delivery

Duarte¹,

Marcon²,

Akagi³

et al. 2019

Biosci. J.

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“…The most frequent isolates were K. pneumoniae, E. coli and coagulase negative staphylococci isolates in this research. Behmadi et al reported coagulase-negative staphylococci were the most prevalent pathogens isolated from blood specimens in LOS and EOS (23). K. pneumoniae and coagulase-negative staphylococci were identified as the most common bacterial isolates in the study by Lamia Mohsen et al (22).…”

Section: Discussionmentioning

confidence: 99%

Detection of bla and bla OXA-48 genes in Gram-negative isolates from neonatal sepsis in central of Iran

Shakiba

Sadeghnia

Karbasizade

2019

IJM

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Background and Objectives: The aim of this study was to determine the prevalence of neonatal sepsis with a focus on antibiotic resistance and the frequency of the bla CTX-M-15 OXA-48 genes in Gram-negative isolates. Materials and Methods: A total of 108 Umbilical Cord Blood (UCB) and 153 peripheral blood samples were cultured via BACTEC from May 2017 to June 2018. The bacterial isolates were identified using phenotypic and genotypic analyses. The antibiotic susceptibility profile of the isolates was determined by disk diffusion. PCR was used to determine the frequency of β-lactamase genes. Results: Among the 153 infants, 21 (13.7%) proved positive for sepsis. Escherichia coli, Staphylococcus epidermidis and Klebsiella pneumoniae were the most frequent isolates in the peripheral blood cultures. E. coli and Stenotrophomonas malto- philia were isolated from two UCB cultures. The highest resistance among the Gram-positive strains was to cefixime, ceftri- axone, cefotaxime and clindamycin. In the Gram-negative bacteria the highest rates of resistance were to ampicillin (91.7%). The frequency of bla CTX-M-15 genes was 25% and 50%, respectively. Conclusion: The high antibiotic resistance among the isolates reveals the importance of monitoring antibiotic consumption and improving control standards in the health care system, especially in neonatal wards.

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“…We read with great interest the original article by Behmadi et al (1) in the most recent issue of your journal. We would like to commend the authors for their endeavor but at the same time feel that few necessary clarifications and comments would benefit the general readers of the journal:…”

Section: Dear Editormentioning

confidence: 96%

Letter to the Editor: Prevalence and Antibiotic Resistance of Neonatal Sepsis Pathogens

Mandal

Sahi

2016

Arch Pediatr Infect Dis

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We read with great interest the original article by Behmadi et al. (1) in the most recent issue of your journal. We would like to commend the authors for their endeavor but at the same time feel that few necessary clarifications and comments would benefit the general readers of the journal:1) The abstract mentions that "the aim of this study was to determine the prevalence and evaluate the antimicrobial susceptibility patterns of bacterial infections at a neonatal unit," but the main text states that the objective was "to determine the frequency and antibiotic resistance of pathogens at the neonatal intensive-care unit (NICU) and neonatal ward of our hospital." The study, being "crosssectional" in design, is able to give prevalence but not frequency or incidence (2). Furthermore, the pathogens associated with neonatal sepsis include viruses and parasites, in addition to bacteria (3).2) The authors mention the total number of culture (blood, urine and cerebrospinal fluid (CSF)) samples and their positivity rates, but not the total number of newborns being assessed (sample size). Therefore, the percentage of newborns who ultimately have culture (blood, urine or CSF)-positive sepsis indicative of prevalence of bacterial infection, which is one of the study's primary objectives, can never be ascertained.3) The authors do not provide a definition for terms such as "late-onset sepsis" and "clinical findings suggesting urinary tract infection (UTI)." Different epidemiological studies have used cut-offs ranging from 3 to 7 days to define late-onset sepsis, depending on the gestational age and birth weight of the newborn (4). Also, there are no clinical findings that specifically suggest UTI in a newborn.4) The methodology does not state how the urine sample for bacterial culture was collected. It should ideally be collected by suprapubic aspiration (5); other methods are associated with high chances of contamination.5) The authors also do not mention whether hospitalacquired infections were included in the late-onset sepsis group. The causative organisms and the antibiotic sensitivity pattern are expected to vary considerably depending on whether the source of infection is the community or a heath care facility (5). Hospital-acquired pathogens could also explain the high prevalence of antibiotic resistance in the isolated organisms.6) The finding that coagulase-negative staphylococcus (CONS) was the commonest organism in both early-and late-onset sepsis should be viewed with caution in light of the great controversy about the criteria for defining CONS sepsis in newborns (6). These criteria have often resulted in CONS being overrepresented as a true pathogen in neonatal sepsis (7). In an attempt to decrease falsepositivity rates, various investigators have proposed different diagnostic algorithms based upon quantitative culture and colony count, presence of an indwelling central venous catheter (8) or time to positivity of blood culture (9).

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Prevalence and Antibiotic Resistance of Neonatal Sepsis Pathogens in Neyshabour, Iran

Cited by 11 publications

References 25 publications

Neonatal sepsis: evaluation of risk factors and histopathological examination of placentas after delivery

Neonatal sepsis: evaluation of risk factors and histopathological examination of placentas after delivery

Detection of bla and bla OXA-48 genes in Gram-negative isolates from neonatal sepsis in central of Iran

Letter to the Editor: Prevalence and Antibiotic Resistance of Neonatal Sepsis Pathogens

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