Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2015, vol. 24, nr 1, January-February, p. 15–22

doi: 10.17219/acem/38170

Publication type: original article

Language: English

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Microbiological Spectrum and Susceptibility Pattern of Clinical Isolates from the Neonatal Unit in a Single Medical Center

Aneta Nitsch-Osuch1,A,B,C,D,E, Irena Choroszy-Król2,A,B,C,D,E, Ernest Kuchar3,A,B,C,D,E, Krzysztof Korzeniewski4,A,B,C,D,E, Katarzyna Życińska1,A,B,C,D,E, Kazimierz Wardyn1,A,B,C,D,E

1 Department of Family Medicine, Warsaw Medical University, Poland

2 Department of Basic Sciences, Wroclaw Medical University, Poland

3 Department of Pediatric Infectious Diseases, Wroclaw Medical University, Poland

4 Department of Epidemiology and Tropical Medicine, Military Institute of Medicine, Warszawa, Poland

Abstract

Background. Infections are a frequent and significant cause of morbidity and mortality in neonatal units. The bacterial pathogens and their susceptibility patterns should be monitored in hospital settings. The aim of the study was to describe the distribution of the bacterial agents and their antibiotic resistant and susceptibility patterns in the Special Neonatal Care Unit (SNCU).
Material and Methods. A retrospective analysis of results of microbiologically tested samples (blood, cerebrospinal fluid, urine, stool, eye excretions, external ear swabs, nasopharyngeal swabs and skin swabs) taken from newborns hospitalized in one SNCU in Warsaw (Poland) was conducted. The period analyzed was from July 1st, 2010 to December 31st, 2010.
Results. A total of 838 cultured samples were collected in the period analyzed. Three hundred seventy three of them (44.5%) were positive. The majority of the cultured microorganisms were classified as colonization: 338/373 (91%) strains. Gram negative bacteria were predominant colonizing flora: 227/338 (67%) strains. Gram positive bacteria were predominant causative agents in newborns with infections: 26/35 (74%) strains. 57.9% of Escherichia coli isolates were resistant to amoxicillin and ampicillin. 100% of Klebsiella pneumoniae were resistant to amikacin and netilmicin. Staphylococcus aureus methicillin resistant strains were cultured in 2.7% of cases.
Conclusion. Gram negative species continue to be predominant agents of neonatal colonizing flora while gram positive bacteria remain important causative agents for symptomatic infections. Continuous monitoring of bacterial flora and its antibiotic susceptibility pattern is necessary to provide a successful antibiotic policy. Current results may be used for future national and international comparison.

Key words

neonatal ward, infections, bacteria, antibiotic susceptibility.

References (26)

  1. Gotoff S: Infections of the neonatal infant. Nelson textbook of Pediatrics, W.B. Saunders Company, Philadelphia 1999, 538–552, 16th ed.
  2. Guerina N: Bacterial and fungal infections. Manual of neonatal care. John P Cloherty and Ann R Stark. Boston 1998, 271–299, 4th ed.
  3. May M, Daley A, Donath S: Early onset neonatal meningitis in Australia and New Zealand, 1992–2002. Arch Dis Child Fetal Neonatal 2005, 90, 324–327.
  4. Zaidi A, Huskings D, Thaver D: Hospital-acquired neonatal infections in developing countries. Lancet 2005, 365, 1175–1188.
  5. Mahmood M, Karamat K, Butt T: Neonatal sepsis: high antibiotic resistance of the bacterial pathogens in a neonatal intensive care unit in Karachi. JPMA 2002, 52, 348.
  6. Rotimi V, Duerden B: The development of the bacterial flora in normal neonates. J Med Microbiol 1982, 14, 51–62.
  7. Lee C, Chen P, Huang F, Lin C: Microbiological spectrum and susceptibility pattern of clinical isolates form the pediatric intensive care unit in a single medical center – 6 years’ experience. J Microbiol Immunol Infect 2009, 42, 160–165.
  8. Cifuentes Y, Riuz A, Leal A, Munoz L, Herrera M, Jimenez L: Microbiological profiling of isolates from the neonatal unit of a third-level hospital in Bogota, Colombia. Rev Salud Publica 2005, 7, 191–200.
  9. Monsef A, Eghbaklian F: Antibiotic sensitivity pattern of common bacterial pathogens in NICU and neonatal ward in Hammedan province of Iran. Health 2010, 2, 625–629.
  10. Shaw C, Shaw P, 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, 153–160.
  11. Aurangzeb B, Hameed A: Neonatal sepsis in hospital-born babies: bacterial isolates and antibiotic susceptibility patterns. J Colleg Phys Surg Pakistan 2003, 13, 629–632.
  12. Bhat R, Lewis L, Ke V: Bacterial isolates of early-onset neonatal sepsis and their antibiotic susceptibility pattern between 1998 and 2004: an audit form a center in India. Italian J Pediatr 2011, 37, 32–36.
  13. Hyde T, Hilger T, Reingold A, Farley M, O’Brien K, Schuchat A: Trends in incidence and antimicrobial resistance of early onset sepsis: population-based surveillance in San Francisco and Atlanta. Pediatrics 2002, 11, 690–695.
  14. Patzer J, Dzierżanowska D, Turner P: Trends in antimicrobial susceptibility of Gram-negative isolates from a paediatric intensive care unit in Warsaw: results from the MYSTIC programme (1997–2007). J Antimicrob Chemother 2009, 62, 369–375.
  15. Gray J: Surveillance of infection in neonatal intensive care units. Early Hum Dev 2007, 83, 157–163.
  16. Burnie J, Naderi-Nasab M, Loudon W, Matthews R: An epidemiological study of blood culture isolates of coagulase-negative staphylococci demonstrating hospital-acquired infection. J Clin Microbiol 1997, 35, 1746–1750.
  17. Gupta B, Amin E: Changing pattern of blood borne sepsis care baby unit, Khoula Hospital. Oman Med J 2010, 25, 100–103.
  18. Fioriti D, Mischitelli M, Penta M: Detection of the microbial patterns in a cohort of infants admitted to neonatal intensive care. New Microbiologica 2009, 32, 303–310.
  19. Stoll B, Gordon T, Korones S: Early-onset sepsis in very low birth weight neonates: a report from the National Institute of Child Health and Human Development Neonatal Research Network. J Pediatr 1996, 129, 72–80.
  20. Cordero L, Sananes M, Ayers L: Bloodstream infections in a neonatal intensive-care unit: 12 years experience with an antibiotic control program. Infect Control Hosp Epidemiol 1999, 20, 242–246.
  21. Freedman R, Ingram D, Gross I, Ehrenkranz R, Warshaw J, Baltimore R: A half century of neonatal sepsis at Yale: 1928 to 1978. Am J Dis Child 1981, 135, 140–144.
  22. Aftab R, Iqbal I: Changing pattern of bacterial isolates and their antibiotic sensitivity in neonatal septicemia: a hospital based study. Nishtar Med J 2009, 1, 3–8.
  23. Jackowska T, Pawlik K, Załeska-Ponganis J, Kłyszewska M: Etiology of urinary tract infections and antimicrobial susceptibility: a study conducted on a population of children hospitalized in the Department of Pediatrics at Warsaw Bielany Hospital; 2004–2006]. Med Wieku Rozw 2008, 12, 705–712.
  24. El-Feky E, Rahaman Z, Mansi Y: Retrospective analysis of neonatal bacteremia and antimicrobial resistance pattern in neonatal intensive care unit. Res J Medicine Med Sci 2001, 62, 62–68.
  25. Ganatra H, Stoll B, Zaidi A: International perspective on early-onset neonatal sepsis. Clin Perinatol 2010, 37, 501–523.
  26. Yalaz M, Cetin H, Akisu M, Aydemi, S, Tunger A: Neonatal nosocomial sepsis in a level III NICU: evaluation of the causative agents and antimicrobial susceptibilities. Turkish J Pediatr 2006, 48, 13–18.
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