Neonatal bacteriemia isolates and their antibiotic resistance pattern in neonatal insensitive care unit (NICU) at Beasat Hospital, Sanandaj, Iran.
AbstractBacteremia continues to result in significant morbidity and mortality, particularly among neonates. There is scarce data on neonatal bacteremia in among Iranian neonates. In this study, we determined neonatal bacteremia isolates and their antibiotic resistance pattern in neonatal insensitive care unit at Beasat hospital, Sanandaj, Iran. During one year, all neonates admitted to the NICU were evaluated. Staphylococcal isolates were subjected to determine the prevalence of MRS and mecA gene. A total of 355 blood cultures from suspected cases of sepsis were processed, of which 27 (7.6%) were positive for bacterial growth. Of the 27 isolates, 20 (74%) were Staphylococcus spp as the leading cause of bacteremia. The incidence of Gram negative bacteria was 04 (14.8%). The isolated bacteria were resistant to commonly used antibiotics. Maximum resistance among Staphylococcus spp was against Penicillin, and Ampicillin. In our study, the isolated bacteria were 7.5 % Vancomycin and Ciprofloxacin sensitive. Oxacillin disk diffusion and PCR screened 35% and 30% mec a positive Staphylococcus spp. The spectrum of neonatal bacteremia as seen in NICU at Beasat hospital confirmed the importance of pathogens such as Staphylococcus spp. Penicillin, Ampicillin and Cotrimoxazol resistance was high in theses isolates with high mecA gene carriage, probably due to antibiotic selection.
Ogunleye VO, Ogunleye AO, Ajuwape ATP, et al. Childhood septicaemia due to salmonella species in Ibadan, Nigeria. Afr J Biomed Res 2005;8(3):131-4.
Kilani RA, Basamad M. Pattern of proven bacterial sepsis in a neonatal intensive care unit in Riyadh, Saudi Arabia: a 2-year analysis. J Med Liban 2000;48(2):77-83.
Klinger G, Levy I, Sirota L, et al. Epidemiology and risk factors for early onset sepsis among very-low-birth weight infants. Am J Obstet Gynecol 2009;201(1):38.e1-6.
Adeleke SI, Belonwu RO. Bacterial Isolates in Neonatal septicemia in Kano, Nigeria (2002-2003). Pinnacle Int J Med Sci 2006;1(1):17- 20.
Thaver D, Ali SA, Zaidi AK, . Antimicrobial Resistance Among Neonatal Pathogens in Developing Countries. Pediatr Infec Dis J 2009; 28(1 Suppl):S19-21.
Qazi SA, Stoll BJ. Neonatal Sepsis: A Major Global Public Health Challenge. Pediatr Infect Dis J 2009;28(1 Suppl):S1-2.
Ghotaslou R, Ghorashi Z, Nahaei MR. Klebsiella pneumoniae in neonatal sepsis: A 3 year study in the Pediatric hospital of Tabriz, Iran. Jpn J Infect Dis 2007;60(2-3):126-8.
Frieden TR. Antibiotic Resistance and the Threat to Public Health. U.S. department of Health & Human Services. (Accessed in Feb 16, 2014, at, http://www.hhs.gov/asl/testify/2010/04/t20100428b.html).
Bahmani N. Study of prevalence of neonatal Septicaemia and detection of antibiotic resistance in Beasat Hospital in Iran. Iran J Public Health 2007;36(1 Sup):1-2.
Baron J, Fingold S. Methods for identification of etiologic agents of infectious diseases. In: Forbes BA, Sahm D, Weissfeld AS, editors. Bailly's and Scottos Diagnostic microbiology. 10th ed. London: Mosby Inc.; 1998: p93-119..
Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing; 20th informational supplement. (Accessed in Feb 14, 2014, at http://www.techstreet.com/products/preview/1662846).
Cekovska Z, Panovska N, Petrovska M. MRSA: Comparison of susceptibility test methods with mecA gene analysis for determining oxacillin (methicillin) resistance in our clinical isolates. Bratisl Lek Listy 2005;106(4-5):163-7.
Cunney RJ, Smyth EG. The impact of laboratory reportingpractice on antibiotic utilization. Int J Antimicrob Agents 2000;14(1):13-9.
Munson EL, Diekema DJ, Beekmann SE, et al. Detection and treatment of bloodstream infection: laboratory reporting and antimicrobial management. J Clin Microbiol 2003;41(1):495-7.
von Eiff C, Becker K, Machka K, et al. Nasal carriage as a source of Staphylococcus aureus bacteraemia. N Engl J Med 2001;344(1):11-6.
Fluit AC, Jones ME, Schmitz FJ, et al. Antimicrobial susceptibility and frequency of occur- rence of clinical blood isolates in Europe from the SENTRY antimicro- bial surveillance program, 1997 and 1998. Clin Infect Dis 2000;30(3):454-60.
Mamishi S, Pourakbari B Ashtiani MH, et al. Frequency of isolation and antimicrobial susceptibility of bacteria isolated from bloodstream infections at Children’s Medical Center, Tehran, Iran, 1996–2000. Int J Antimicrob Agents 2005;26(5):373-9.
Douglas MW, Lum G, Roy J, et al. Epidemiology of community-acquired and nosocomial bloodstream infections in tropical Australia: a 12-month prospective study. Trop Med Int Health 2004;9(7):795-804.
Dombrowski JC, Winston LG. Clinical failures of appropriately-treated methicillin-resistant Staphylococcusaureus infections. J Infect 2008;57(2):110-5.
Diep BA, Stone GG, Basuino L, et al. The arginine catabolic mobile element and staphylococcal chromosomal cassette mec linkage: convergence of virulence and resistance in the USA300 clone of methicillin-resistant Staphylococcus aureus. J Infect Dis 2008;197(11):1523-30.
Gheibi Sh, Fakoor1 Z, Karamyyar M, et al. Coagulase Negative Staphylococcus; the Most Common Cause of Neonatal Septicemia in Urmia, Iran. Iran J Pediatr 2008;18(3):237-43.
Kalantar E, Motlagh M, Lordnejad H, Beiranvand S. The prevalence of bacteria isolated from blood cultures of iranian children and study of their antimicrobial susceptibilities. Jundishapur J Nat Pharm Prod2008;3(1):1-7.
Eslami Nejad Z, Ghafouri E, Farahmandi-Nia Z, et al. Isolation, Identification, and Profile of Antibiotic Resistance of Bacteria in Patients with Cancer. Iran J Med Sci 2010;35(2):109-15.
Shoja S, Nahaei MR, Nahaei M, et al. Study of MRSS isolated from blood culture. Med J Tabriz Univ Med Sci 2009;31(1):39-44.