The Bacteriology and Its Virulence Factors in Neonatal Infections: Threats to Child Survival Strategies

Abstract

Background Neonatal infection refers to the infection of the newborn during the first twenty-eight days of life. It is one of the causes of infant morbidity and mortality worldwide. The aim of the study is to determine the relative contribution of the different pathogens to the overall disease burden. It will also determine the mechanisms of virulence of these pathogens that cause neonatal infections at Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH), Awka. Methods Biological samples were collected from 30 neonates admitted at the special care baby unit (SCBU) of COOUTH and cultured using selective media and nutrient agar. The isolates were identified using microbiological and biochemical tests. The antibiogram study was determined using Kirby-Bauer disc diffusion method on Mueller Hinton Agar. Several methods previously reported in literature were used for the characterization of the virulence factors. Results From the 30 blood samples collected, Pseudomonas spp. (19.7%), Escherichia coli (23%), Salmonella spp. (24.6%), and Staphylococcus aureus (32.8%) were isolated. Male to female ratio of study population was 1.5: 1. The isolates were 100 % resistant to ticarcillin, cephalothin, ceftazidime, and cefuroxime but appreciably susceptible to only levofloxacin (88.85%). They were moderately susceptible to ceftriaxone/sulbactam (39.05%) and azithromycin (26.46%). Common virulence factors identified among the isolates (up to 90 %) were hemolysin, biofilm formation, and acid resistance. Less common virulence factors were proteases (50 %), deoxyribonucleases (50 %), enterotoxins (63%), and lipopolysaccharide (70%). The virulence factors were found mostly among the S. aureus isolates. Conclusions Pseudomonas spp., Escherichia coli, Salmonella spp., and Staphylococcus aureus were implicated in neonatal infections in the center and most of them were resistant to conventional antibiotics. The organisms showed marked virulence and multidrug resistance properties. Levofloxacin, a fluoroquinolone, had superior activity on the isolates compared to other antibiotics used in the study.

<p>Pharmaceutical Quality of Selected Metronidazole and Ciprofloxacin Infusions Marketed in South Eastern Nigeria</p>

“…Presence of any living microorganisms in the product meant to be passed into the blood stream could result in nosocomial septicemia 27 , 28 and can consequently cause blood stream infections. 29 Contamination level as high as 18.75% in products that supposed to be sterile is alarming and calls for immediate caution and readdressing of the production system by the pharmaceutical companies concerned. Clinically important, microbiological contamination is most dangerous for patients when it affects parenteral therapy.…”

Carbapenem-Resistant Enterobacteriaceae Posing a Dilemma in Effective Healthcare Delivery

“…The total number of isolates that showed intermediate susceptibility to carbapenems (20.5%) is of clinical importance as some of them may have the inherent ability of producing carbapenemase enzymes and this may be an indicative of low level resistance which if left undetected may escalate to high level resistance [10,28]. The mechanisms of antimicrobial resistance [29,30] and virulence [31] among Gram-negative enterobacteriaceae and among CRE vary widely (7,8,9). Also, it is not impossible that there could be cross-resistance between the carbapenems, the penicillins and the cephalosporins as they are all beta-lactam antibiotics and are dipeptide mimics [32].…”

Multi-Antibiotic Resistance and Factors Affecting Carriage of Extended Spectrum β-Lactamase-Producing Enterobacteriaceae in Pediatric Population of Enugu Metropolis, Nigeria

“…Antimicrobial resistance has been identified as one of the greatest threats to human health, and developing countries like Nigeria are worst hit by this crisis [1]. The major cause of this crisis is the indiscriminate and widespread use of antimicrobial agents [2], especially antibiotics containing a β-lactam ring, in prophylaxis and the treatment of bacterial diseases [3]. The misuse and abuse of β-lactam antibiotics has led to antibiotic selective pressure and the development of resistance to these drugs by most bacteria, particularly the Enterobacteriaceae, of which β-lactamase production remains the most important contributing factor to this resistance [4,5].…”