OJMM  Vol.5 No.4 , December 2015
Predominance of Multi-Drug Resistant Klebsiella pneumonia and Other Gram Negative Bacteria in Neonatal Sepsis in Equatorial Guinea
ABSTRACT
The study was conducted on new-born babies in whom septicemia was suspected, to determine the prevalence of bacterial strains isolated and their sensitivity to antimicrobial drugs. The study was carried out at La Paz Medical Center, Microbiology section, Malabo, Equatorial Guinea from August 2013 to October 2015. Out of 293 septicemia suspected cases, 29 (10%) blood cultures were positive, 28 with bacterial growth and 1 with growth of Candida sp. The mortality rate of neonates caused by Gram negative bacterial sepsis was 34.7%. Among the Gram negative bacteria (24 isolates), the most common types were Klebsiella pneumoniae (16 = 69.6%), followed by Escherichia coli (4 = 17.4%) and Acinetobacter species (4 = 17.4%). Four Gram positive bacteria were also isolated and identified all ascoagulase-negative staphylococci. All the Klebsiella pneumoniae isolates and Acinetobacter species demonstrated Multi Drug Resistance against different antibiotics with Extended-spectrum β-lactamase (ESBL) activity. The most frequent causative agent of bacterial sepsis in new-born children was Klebsiella pneumoniae. An alarming level of Multi Drug Resistance (MDR) Klebsiella pneumoniae strains to the first choice antibiotic treatment was observed.

Cite this paper
Shatalov, A. , Awwad, F. , Mangue, P. and Foqahaa, R. (2015) Predominance of Multi-Drug Resistant Klebsiella pneumonia and Other Gram Negative Bacteria in Neonatal Sepsis in Equatorial Guinea. Open Journal of Medical Microbiology, 5, 254-258. doi: 10.4236/ojmm.2015.54031.
References
[1]   Qazi, S.A. and Stoll, B.J. (2009) Neonatal Sepsis: A Major Global Public Health Challenge. The Pediatric Infectious Disease Journal, 28, 1-2.
http://dx.doi.org/10.1097/INF.0b013e31819587a9

[2]   WHO (2006) Opportunities for Africa’s Newborns: Practical Data, Policy and Programmatic Support for Newborn Care in Africa. 12-22.

[3]   Klein, J.O. (2001) Bacterial Sepsis and Meningitis. In: Remington, J.S. and Klein, J.O., Eds., Infectious Diseases of the Fetus, Newborn, and Infants, 5th Edition, WB Saunders, Philadelphia, 943-984.

[4]   Vergnano, S., Sharland, M., Kazembe, P., Mwansambo, C. and Heath, P.T. (2005) Neonatal Sepsis: An International Perspective. Archives of Disease in Childhood-Fetal and Neonatal Edition, 90, 220-224.
http://dx.doi.org/10.1136/adc.2002.022863

[5]   Reddy, E.A., Shaw, A.V. and Crump, J.A. (2010) Community-Acquired Bloodstream Infections in Africa: A Systematic Review and Meta-Analysis. Lancet Infection Diseases, 10, 417-432.
http://dx.doi.org/10.1016/S1473-3099(10)70072-4

[6]   Zaidi, A.K.M., Thaver, S.M.D., Ali, S.A. and Khan, T.A. (2009) Pathogens Associated with Sepsis in Newborns and Young Infants in Developing Countries. The Pediatric Infectious Disease Journal, 28, 10-18.
http://dx.doi.org/10.1097/INF.0b013e3181958769

[7]   Musoke, R.N. and Revathi, G. (2000) Emergence of Multidrug-Resistant Gram-Negative Organisms in a Neonatal Unit and the Therapeutic Implications. Journal of Tropical Pediatrics, 46, 86-91.
http://dx.doi.org/10.1093/tropej/46.2.86

[8]   Antimicrobial Resistance: Global Report on Surveillance. WHO, 2014.
http://www.who.int/drugresistance/documents/surveillancereport/en/

[9]   Mokuolu, A.O., Jiya, N. and Adesiyun, O.O. (2002) Neonatal Septicaemia in Ilorin: Bacterial Phathogens and Antibiotic Sensivity Pattern. African Journal of Medicine and Medical Sciences, 31, 127-130.

[10]   Murray, P. (2003) Manual of Clinical Microbiology.

[11]   Clinical Laboratory Standards Institute (2014) Performance Standards for Antimicrobial Susceptibility Testing. Vol. 34, M100-S24.

[12]   Lochar, R.K., Omuse, G. and Revathi, G. (2011) A Ten-Year Review of Neonatal Bloodstream Infection in Tertiary Private Hospital in Kenia. The Journal of Infection in Developing Countries, 5, 799-803.

[13]   Ogunlesi, T.A. and Ogunfowora, O.B. (2010) Predictors of Mortality in Neonatal Septicemia in an Underresourced Setting. Journal of the National Medical Association, 102, 915-921

[14]   Mugalu, J., Nakakeeto, M.K., Kiguli, S. and Kaddu-Mulindwa, D.H. (2006) Aetiology, Risk Factors and Immediate Outcome of Bacteriologically Confirmed Neonatal Septicaemia in Mulago Hospital, Uganda. African Health Sciences, 6, 120-126.

[15]   Kheir, A.E.M. and Khair, R.A. (2014) Neonatal Sepsis; Prevalence and Outcome in a Tertiary Neonatal Unit in Sudan. Time Journals of Medical Sciences Report and Research, 2, 21-25.

[16]   Iregbu, K.C., Olufumilayo, Y.E. and Iretiola, B.B. (2006) Bacterialprofile of Neonatal Septicaemia in Tertiary Hospital in Nigeria. Africa Health Sciences, 6, 151-154.

[17]   Morata, F., Ballot, D.E. and Perovich, O. (2005) Epidemiology of Neonatal Sspsis at Johannesburg Hospital. The Southern African Journal of Epidemiology and Infection, 20, 90-93.

[18]   Hofer, N., Zacharias, E., Müller, W. and Resch, B. (2012) An Update on the Use of C-Reactive Protein in Early-Onset Neonatal Sepsis: Current Insights and New Tasks. Neonatology, 102, 25-36.
http://dx.doi.org/10.1159/000336629

[19]   Benitz, W.E., Han, M.Y., Madan, A. and Ramachandra, P. (1998) Serial Serum C-Reactive Protein Levels in the Diagnosis of Neonatal Infection. Pediatrics, 102, e41.
http://dx.doi.org/10.1542/peds.102.4.e41

[20]   Nwadioha, S., Nwokedi, E., Odimayo, M., Okwori, E. and Kashibu, E. (2009) Bacterial Isolates in Blood Cultures of Children with Suspected Septicaemia in Nigerian Tertiary Hospital. The Internet Journal of Infectious Diseases, 8, 1-5.

[21]   Ballot, D.E., Nana, T., Sriruttan, C. and Cooper, P.A. (2012) Bacterial Bloodstream Infections in Neonates in a Developing Country. ISRN Pediatrics, 2012, Article ID: 508512.

[22]   Onyedibe, K.I., Bode-Thomas, F., Victor Nwadike, V., et al. (2015) High Rates of Bacteria Isolates of Neonatal Sepsis with Multidrug Resistance Patterns in Jos, Nigeria. Annals of Tropical Pediatrics International Child Health, 3, 1052.

 
 
Top