Antimicrobial resistance by bacteria that colonize neonates with suspected sepsis

Abstract

Objective - The aim of this study was to determine the antibiotic resistance in bacteria that colonized neonates with suspected sepsis, born in the Department of Gynecology and Obstetrics, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina from December 1, 2008 to December 31, 2009.

Methods - The study included neonates who were discharged from the Maternity ward, who developed clinical signs of suspected sepsis after forty eight hours of life, and were therefore rehospitalized at the Department of Pediatrics in Tuzla.

Results - The study showed that 55 of 4299 newborns were diagnosed with suspected sepsis. The cumulative incidence of suspected sepsis was 1.3% The bacteria that most often colonized neonates was Klebsiella pneumoniae, that was isolated in 42 (76.4%) newborns. In 14 cases (33.3%) Klebsiella was ESBL–producing. Moreover we found Escherichia coli in 5 neonates (9%), Enterococcus faecalis in 5 neonates (9%) and Enterobacter Cloacae in 3 neonates (5.4%). The bacteria that colonized newborns showed high resistance to ampicillin (91% of cases), slightly lower to cefotaxime (53.3%), gentamicin (43.6%), amikacin 12%, amoxiclav 14.3%, and imipenem and meropenem (2.1%).

Conclusions - The high degree of resistance among the enterobacteriacae that were isolated from our neonates indicates the need to investigate the risk factors for colonization of newborns with antibiotic resistant bacterial strains. The promotion of breastfeeding could be a preventive intervention.