Study of Antimicrobial Susceptibility And Biofilm Formation of Cronobacter Sakazakii Isolates From Neonatal Sepsis In Southwest Iran

Abstract

Background: The Cronobacter genus is a member family of the Enterobacteriaceae The isolates of C. sakazakii have been suggested to be responsible for fatal neonatal infections, which gives rise to sepsis, necrotizing enterocolitis, and meningitis, with a high mortality rates. The aim of the present study was to investigate the antimicrobial susceptibility and biofilm formation of C. sakazakii isolates from neonatal sepsis in Southwestern Iran.Results: During the period of study, 734/1045 bacterial positive growth samples were collected from patients. Overall, from 734 bacterial positive growth samples 120 isolates were C. sakazakii based on culture, biochemical tests and PCR amplification. seventy-four (61%) neonates had primary sepsis and (33%) had late sepsis. Regarding birth bodyweight, (22%) neonate weighted below 1000 gr, 61 (50%) between 1500 and 2500, and (26%) more than 2500 gr. In case of C. sakazakii isolates, the highest resistance rates belonged to Ampicillin (70%), followed Amoxicillin (%59) and Ampicillin/sulbactam (83%). However, C. sakazakii had low levels resistance to cefepime and tetracycline. In total, of the 120 isolated bacteria, (70%) were biofilm producers, of which, (37%) produced strong biofilms, (15%) produced moderate biofilms, (17%) were weak biofilm producers and (28%) were not biofilm producers.Conclusion: Taken together, the high rate of C. sakazakii in neonates was high in the NICU. Age, higher birthweight, and caesarian delivery were the most remarkable risk factors for C. sakazakii. The majority of C. sakazakii strains were hospital-associated, which is the indication of NICU admission patterns. Our findings suggest that the active surveillance of neonates for C. sakazakii is required to be considered as a part of strategies to detect importation and prevent transmission of C. sakazakii within the NICU.