BACTERIAL ISOLATES AND THEIR ANTIMICROBIAL RESISTANCE PATTERNS IN NEONATAL SEPSIS RECORDED AT HEVI TEACHING HOSPITAL IN DUHOK CITY / KURDISTAN REGION OF IRAQ

IBTESAM SALIH ABDULRAHMAN; ABDULRHAMAN T. SAADI

IBTESAM SALIH ABDULRAHMAN Lecturer, Department of Clinical Pharmacy, University of Duhok, Kurdistan Region, Iraq.
ABDULRHAMAN T. SAADI Assistant Professor, Department of Microbiology, University of Duhok, Kurdistan Region, Iraq.

Keywords: Antibiotic, Resistance, Neonatal sepsis

Abstract

https://doi.org/10.31386/dmj.2019.12.1.9

Background: Neonatal sepsis is one of the commonest causes of neonatal mortality in the developing world. There is a continuous change in the patterns of microbial flora and their antimicrobial susceptibility. The aim of this study was to determine the microbial agents causing neonatal sepsis, the susceptibility of these microorganisms to the commonly used antimicrobial agents at Hevi Hospital and to compare the causative agents during the last four years.

Methods:A retrospective study was conducted over a period of four years. From the recorded data of archives of Hevi Teaching Hospital from 2014 till 2017, a total of 1058 blood cultures were taken. The positive and negative cultures were 536 and 522 respectively. From the positive cultures, 555 pathogens were isolated.

Results: The present study revealed that the female to male ratio for neonatal sepsis was 1.5:1 and the most common microorganisms isolated were Coagulase-Negative Staphylococci consisting (58.5%) of cases; followed by Staphylococcus aureus (16.6%) and Escherichia coli (7.6%). The higher percentage of neonatal sepsis (30%) was recorded in 2017. There is no statistical significant difference regarding the causative microorganism for the early and late neonatal sepsis except for the Enterococcus species; with their highest percentage among late neonatal sepsis.

Conclusions: This study revealed that resistance against many commonly used antibiotics have been increased which limits the options for treating of neonatal sepsis. This is resulted from uncontrolled use of the antibiotics and lack of policies and guidelines for their use in public health.

Downloads

Download data is not yet available.

References

1. Lawn JE, Cousens S and Zupan J. Four million neonatal deaths: When? Where? Why? Lancet. 2005; 365 (9462): 365,891– 900.
2. Peterside O, Pondei K and Akinbami, FO. Bacteriological Profile and Antibiotic Susceptibility Pattern of
Neonatal Sepsis at a Teaching Hospital in Bayelsa State, Nigeria. Trop. Med. Health. 2015; 43:183–190.
3. Kaistha N, Mehta M, Singla N, Garg R and Chander J. Neonatal septicemia isolates and resistance patterns in a tertiary care hospital of North India. J. Infect. Dev. Ctries. 2010;4:055–057.
4. Shaw CK, Shaw P and Thapalial A. Neonatal sepsis bacterial isolates and antibiotic susceptibility patterns at a NICU in a tertiary care hospital in western Nepal: a retrospective analysis. Kathmandu Univ. Med. J. 2007; 5:153–60.
5. Pradeep V, Pramod KB, Niranjan N, Sarika S, Prathusha J and Satya N. Neonatal sepsis: epidemiology, clinical spectrum, recent antimicrobial agents and their antibiotic susceptibility pattern. Int. J. Contemp. Pediatr. 2015; 2:176–180.
6. Tilahun T, Yibeltal T, Birhanie M, Mequanint F, Tsigiereda D, Amare B,et al.Clinical outcome and risk factors of neonatal sepsis among neonates in FelegeHiwot referral Hospital, Bahir Dar, Amhara Regional State, North West Ethiopia 2016. Aretrospective chart review.BMC Res. Notes. 2017; 10:1–7.
7. Shah BA and Padbury JF. Neonatal sepsis: an old problem with new insights. Virulence.2014:5,170 – 178.
8. Du Pont-Thibodeau G, Joyal, JS & Lacroix J. Management of neonatal sepsis in term newborns. F1000 Prime Rep. 2014; 6: 67.
9. Tsai MH, Hsu JF, Chu SM, Lien R, Huang HR, Chiang MC, et al. Incidence, Clinical Characteristics and Risk Factors for Adverse Outcome in
Neonates With Late-onset Sepsis. Pediatr. Infect. Dis.J.2014;33(1):e7– e13.
10. Basavaraj P, Jyothi P and Basavaraj M. Bacteriological profile of neonatal septicemia and antibiotic susceptibility pattern of the isolates. J. Nat. Sci. Biol. Med. 2013; 4:306.
11. Downie L, Armiento R, Subhi R, Kelly J, Clifford V, Duke T, et al. Community-acquired neonatal and infant sepsis in developing countries: Efficacy of WHO’s currently recommended antibiotics - Systematic review and meta-analysis. Arch. Dis. Child. 2013; 98:146–154.
12. Laxminarayan R, Matsoso P, Pant S, Brower C, Røttingen JA, Klugman K, et al. Access to effective antimicrobials: A worldwide challenge. Lancet. 2016; 387:168– 175.
13. World Health Organization. World health report 2005. Make every mother and child count. World Health (WHO Press, 2005). 111-119. Available from: http://www.geopsy.com/memoires_the ses/whr2005_en.pdf
14. Leigue L, Montiani F and Moore BA. Antimicrobial susceptibility and minimal inhibitory concentration of Pseudomonas aeruginosa isolated from septic ocular surface disease in different animal species. Open Veterinary J.2016; 6(3): 215-222.
15. Mashaly GE, El-Sabbagh, AM, ElKazzaz, SS and Nour I. MBL2 & Gene Polymorphism and the Association with Neonatal Sepsis in Egyptian Neonates, a Case Control
Study. Open J. Immunol.2016;6: 111– 119.
16. Vergnano S, Menson E, Kennea N, Embleton N, Russell AB, Watts T,et al. Neonatal infections in England: the Neon IN surveillance network. Arch. Dis. Child. Fetal Neonatal Ed.2011; 96: F9–F14.
17. Emma SL, Elisabet G and Sara MS. Neonatal Sepsis by Bacteria: A Big Problem for Children. Clin. Microbiol.2012; 2(6): 125.
18. Majeda SH, Abdullah AT, Sameer YA,Hussain B, Anwar K, Laila MA, et al. Late-onset neonatal sepsis in Arab states in the Gulf region: twoyear prospective study. Int. J. Infect. Dis. 2017; 55: 125–130.
19. Mahmood A, Karamat KA and Butt T. Neonatal sepsis: high antibiotic resistance of the bacterial pathogens in a neonatal intensive care unit in Karachi. J. Pakistan Med. Assoc. 2002; 52: 348–350.
20. Amare G, Wubishet L, Feleke M, Beyene M, Belay A, Gizachew Y et al. Bacterial profile and drug susceptibility pattern of neonatal sepsis in Gondar University Hospital, Gondar northwest Ethiopia. Der Pharmacia Lettre.2012; 4(6): 18111816.
21. Jumah DS, Hassan MK. Predictors of mortality outcome in neonatal sepsis. Med J Basrah University. 2007; 25(1): 11–18.
22. Kardana IM. Incidence and factors associated with mortality of neonatal sepsis. PaediatrIndones. 2011; 51(3): 144-148.
23. Petit PL & van JK. Analysis of hospital records in four African
countries, 1975-1990, with emphasis on infectious diseases. J. Trop. Med. Hyg. 1995; 98: 217–27.
24. Angele MK, Pratschke S, Hubbard WJ and Chaudry IH. Gender differences in sepsis: Cardiovascular and immunological aspects. Virulence. 2014; 5:12–19.
25. Omoregie R, Egbe CA, Ogefere HO, Igbarumah I and Omijie RE. Effects of gender and seasonal variation on the prevalence of bacterial septicemia among young children in Benin City, Nigeria. Libyan J. Med. 2009;4:107– 109.
26. Mathur M, Shah H, Dixit K, Khambadkone S and Chakrapani A. Bacteriological profile of neonatal septicemia casesIrani S. J Postgrad Med. 1994; 40:18–20.
27. Mokuolu AO, Jiya N, Adesiyun OO. Neonatal septicaemia in Ilorin: bacterial pathogens and antibiotic sensitivity pattern. Afr J Med Med Sci. 2002; 31(2): 127–130.
28. Yusef D, Shalakhti T, Awad S, Algharaibeh H and Khasawneh W. Clinical characteristics and epidemiology of sepsis in the neonatal intensive care unit in the era of multidrug resistant organisms: A retrospective review. Pediatr. Neonatol. 2018; 59:35–41.
29. Bernabé K J, Langendorf C, Ford N, Ronat JB and Murphy RA. Antimicrobial resistance in West Africa: a systematic review and meta