Infectious Diseases Prevention and Control

Permanent URI for this collection

https://hdl.handle.net/20.500.11888/18810

Browse

Browsing Infectious Diseases Prevention and Control by Author "Bayan Asem Mohammad Ibrahim"

Now showing 1 - 1 of 1
  • Thumbnail Image
    Item
    BACTERIOLOGIC PROFILE AND ANTIBIOTIC SUSCEPTIBILITY PATTERN OF SEPTICEMIA IN NEONATAL INTENSIVE CARE UNITS, PALESTINE (2019-2021)
    (2022-12-29) Bayan Asem Mohammad Ibrahim
    Background: Neonatal sepsis (NS) is a public health concern worldwide because of its high morbidity and mortality, in addition to the growing resistance towards World Health Organization (WHO) recommended empiric regimens. The aim of this study is to evaluate the matching status of WHO empiric antibiotic regimens with the causative pathogens of NS at three tertiary care hospitals in Palestine. Methods: This is a retrospective study where records of neonates with suspected NS admitted to neonatal intensive care units of three tertiary care units in the period of January 2019 to December 2021 were extracted from the Ministry of Health electronic database. Univariate analysis and multivariate logistic regressions were performed for factors associated with culture-proven NS, generating odds ratios and confidence intervals. Results: Out of 6090 suspected cases of NS, 884 (14.5%) cases had positive blood cultures. The prevalence rate of NS was 9 per 1000 live births and 4 per 1000 live births for early-onset sepsis, with an overall mortality prevalence of (17.2%). The predominantly isolated organisms were 499/884 (56.4%) Coagulase-negative Staphylococcus (CoNS), 119/884 (13.5%) Klebsiella pneumonia, and 66/884 (7.5%) Streptococcus spp. Moreover, most of the isolated bacteria (79.6%) didn’t match any of the WHO empiric regimens and the probability of matching for both WHO regimens among EOS was found 2.4 times the matching probability among LOS by doing multiple logistic regressions. (21.6%) of the Isolated bacteria (excluding CoNS) were multi-drug resistant (MDROs). Antibiotic susceptibility for Gram-negative bacteria was high among amikacin (63%), meropenem (70%), piperacillin-tazobactam (65.6%), and colistin (100%). Alternately, it was low for ampicillin (7.1%), cefotaxime (21.8%), and ceftazidime (29%). On the other hand, Gram-positive bacteria were sensitive to vancomycin (99.8%), and (81%) of Gram-positive other than Staphylococcus spp. were sensitive to ampicillin. Conclusions: The culture-proven NS prevalence rate is 10 folds the rate of high-income countries, and the majority of isolated pathogens were resistant to empiric WHO regimens. Hence, a careful review of empiric treatment for NS is warranted. Moreover, strict infection control and antimicrobial stewardship programs should be implemented to slow down the emergence of resistant organisms among the neonatal population. Keywords: Aantibiotic susceptibility; Empiric regimens; Neonatal sepsis; Prevalence rate of NS.