Multi-resistant Bacteria to Antibiotics in Hospitals: The Case of Neonatology Services of the University Hospitals Centers of Abidjan, Côte d'Ivoire
South Asian Journal of Research in Microbiology, Volume 15, Issue 3,
Page 47-56
DOI:
10.9734/sajrm/2023/v15i3290
Abstract
Background: Multidrug-resistant bacteria (MDR) represent a global health scourge. Their emergence in hospital services complicates the clinical management of infections caused in particular in immunocompromised persons. The objective of our work was to evaluate the prevalence of MDR in the neonatal services of the University Hospitals Centers of Abidjan.
Materials and Methods: The present study took place from September to November 2020 and from January to June 2021. The samples collected consisted of venous blood samples for blood cultures, rectal swabs from newborns, nasal and hand swabs from health care workers, and swabs from inert surfaces and neonatal care equipment. Bacterial identification methods, antibiotic susceptibility testing, and Chi-square testing were performed.
Results: A total of 513 samples were obtained from which 215 organisms were isolated and identified. These bacteria consisted of 52.1% Gram-negative bacilli, of which 77.7% were Enterobacteriaceae and 47.9% Gram-positive cocci. Klebsiella pneumoniae (K. pneumoniae) (25.6%), coagulase-Negative Staphylococcus (CoNS) (24.6%), and Staphylococcus aureus (S. aureus) (23.2%) were the most isolated bacteria. The overall prevalence of MDR was 73.9%. The main antibiotic resistance phenotypes described were the production of Broad Spectrum β-lactamases (ESBL) in 71.9% of Enterobacteriaceae and methicillin resistance (Meti-R) in 75.6% of Staphylococcus. ESBL-producing Enterobacteriaceae (E-ESBL) were mainly observed in rectal carriage and Meti-R strains in blood cultures in newborns in the respective proportions of 45.6% and 56.4%.
Conclusion: In our work, the results obtained showed a high prevalence of MDR in neonatal services and newborns are the most affected subjects. Improving hygiene rules and control and rationalizing the use of antibiotics are highly recommended control strategies to reduce the hospital dissemination of MDR.
- Bacterial resistance
- neonatal infections
- healthcare associated infections
- Côte d'Ivoire
How to Cite
References
Bhatta RD, Subramanya HS, Hamal D, Shrestha R, Gauchan E, Basnet S, et al. Bacterial contamination of neonatal intensive care units: How safe are the neonatal. Antimicrob Resist Control. 2021; 10:26.
Yusuf JB, Okwong OK, Mohammed A, Abubakar KS, Babayo A, Barma MM, et al. Bacterial contamination of intensive care units at a tertiary hospital in Bauchi, North Eastern Nigeria. AJIM. 2017;5(3):46-51.
Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, et al. Multidrug resistant, extensively drug-resistant and pandrug-resistant bacteria: An international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect. 2012; 18(3):268-81.
Institute Pasteur. Résistance aux antibiotiques; 2021 [cited Aug 1, 2022].
Available:https://www.pasteur.fr/fr/centre-medical/fiches-maladies/resistance-aux-antibiotiques
Zaidi AKM, Huskins WC, Thaver D, Bhutta ZA, Abbas Z, Goldmann DA. Hospital- acquired neonatal infections in developing countries. Lancet. 2005;365(9465):1175-88.
Zea-Vera A, Ochoa TJ. Challenges in the diagnosis and management of neonatal sepsis. J Trop Pediatr. 2015;61(1):1-13.
Reddy K, Bekker A, Whitelaw AC, Esterhuizen TM, Dramowski A. A retrospective analysis of pathogens profile antimicrobial resistance and mortality in neonatal hospital-acquired bloodstream infections from 2009-2018 at Tygerberg Hospital, South Africa. Plos One. 2021; 16(1):e0245089.
Qiu Y, Yang J, Chen Y, Yang J, Zhu Q, Li S, et al. Microbiology profiles and antimicrobial resistance patterns of pediatric bloodstream pathogens in China, 2016-2018. Eur J Clin Microbiol Infect Dis. 2020;40(4):739-49.
Fernandes LF, Souza GÁAD, de Almeida AC, Cardoso L, de Souza Xavier AM, Pinheira TPP, et al. Identification and characterization of methicillin- resistant Staphylococcus spp isolated from surfaces near patients in an intensive care unit of a hospital in Southeastern Brazil. Journal of the Brazilian Society of Tropical Medecine. Rev Soc Bras Med Trop. 2020;53: e20200244.
Watanabe A, Watanabe T, Kokeguchi S, Yamamoto Y, Matsushita O, Yokota K. Environmental survey of methicillin-resistant Staphylococci in a hospital in Japan. Biocontrol Sci. 2021;26(3): 137-45.
Tiaconelli E. Mangrini N. Global priority list of antibiotic resistant bacteria to guide research, discovery, and development of new antibiotics. 2017;7.
Zou H, Jia X, He X, Su Y, Zhou L, Shen Y, et al. Emerging threat of multidrug resistant pathogens from Neontal sepsis. Front Cell Infect Microbiol. 2021;11: 694093.
Arhoune B, El Fakir S, Himri S, Moutaouakkil K, El Hassouni S, Benboubker M, et al. Intensive intestinal carriage and Subsequent acquisition of multi-drug -resistant Entero bacteria in neonatal intensive care unit in Morocco. Plos One. 2021;16(6):e0251816.
Nordberg V, Quizhpe Peralta AG, Galindo T, Turlej-Rogacka A, Iversen A, Giske CG, et al. High proportion of intestinal colonization with successful epidemic clones of ESBL- producing entero Bacteriaceae in a neonatal intensive care unit in Ecuador. Plos One. 2013;8(10):e76597.
Pragosa H, Marçal M, Gonçalves E, Martins F, Lopo-Tuna M. Multidrug-resistant Entero bacteriaceae in a Portuguese neonatal intensive care unit. J Hosp Infect. 2017;96(2):130-1.
Yin L, He L, Miao J, Yang W, Wang X, Ma J, et al. Carbapenem-resistant Enterobacterales colonization and subsequent infection in a neonatal intensive care unit in Shanghai, Chine. Infect Prev Pract. 2021;3(3):100147.
Bharadway A, Rastogi A, Pandley S, Gupta S, Sohal SJ. Multidrug resistant bacteria: their mechanism of action prophylaxis. Biomed Res Int. 2022;22.
Kooli I, Kadri Y, Ben Abdallah H, Mhalla S, Haddad O, Noomen S, et al. Epidémiologie des bactéries multi-résistantes dans une unité néonatale tunisienne. J Pédiatr Puéric. 2014;27(5):236-42.
Sydnor ERM, Perl TM. Hospital Epidemiology and Infection Control in Acute care Settings. Clin Microbiol Rev. 2011;24(1):141-73.
Lozano C, Torres C. Update on antibiotic resistance in gram positives. Enferm Infecc Microbiol Clin. 2017;35;Suppl 1: 2-8.
Teklu DS, Negeri AA, Legese MH, Bedada TL, Woldemariam HK, Tullu KD. Extended-spectrum beta-lactamase production and multidrug resistance among Enterobacteriaceae isolated in Addis-Abeba, Ethiopie. Antimicrob Resist Infect Control. 2019;8:39.
Ouedraogo AS, Sanou M, Kissou A, Sanou S, Solaré H, Kaboré F et al. High prevalence of extended spectrum β-lactamase producing enterobacteriaceae among clinical isolates in Burkina Faso. BMC Infect Dis. 2016;16:326.
Paterson DL, Bonomo RA. Extended-spectrum beta-lactamases: A clinical update. Clin Microbiol Rev. 2005; 18(4):657-86.
Azargun R, Sadeghi MR, Soroush Barhaghi MH, Samadi Kafil H, Yeganeh F, Ahangar Oskouee M et al. The prevalence of plasmid-mediated quinolone resistance and ESBL-production in Enterobacteriaceae isolated from urinary tract infections. Infect Drug Resist. 2018;11:1007-14.
Salah FD, Soubeiga ST, Ouattara AK, Sadji AY, Metuor-Dabire A, Obiri-Yeboah D, et al. Distribution of quinolone resistance gene (qnr) in ESBL- producing Escherichia coli and Klebsiella spp. in Lomé, Togo. Antimicrob Resist Infect Control. 2019;8:104.
Kagia N, Kosgei P, Ooko M, Wafula L, Mturi N, Anampiu K et al. Carraiage and acquisition of extended-spectrum β-lactamase- producing Entero bacterales among neonates admitted to hospital in Kilifi, Kenya. Clin Infect Dis. 2019;69 (5):751-9.
Milic M, Siljic M, Cirkovic V, Jovicevic M, Perovic V, Markovic M, et al. Colonization with multi-drug Resistant Bacteria in the First week of life among hospitalized preterm neonates in serbia: Risk factors and outcomes. Microorganisms. 2021;9 (12):2613.
Álvarez A, Fernández L, Gutiérrez D, Iglesias B, Rodríguez A, García P. Methicillin -Resistant Staphylococcus aureus in hospitals: Latest trends and treatments based on bacteriophages. J Clin Microbiol. 2019;57(12):e01006-19.
Irfan S, Ahmed I, Lalani F, Anjum N, Mohammad N, Owais M, et al. Methicillin resistant Staphylococcus aureus outbreak in a neonatal intensive care unit. East Mediterr Health J. 2019;25(7):514-8.
Kristinsdotttir I, Haradsson A, Thorkelsson T, Haradsson G, Kristinsson KG, Larsen J, et al. MRSA outbreak in a tertiary neonatal intensive care unit in Iceland. Infect Dis. 2019;0(0):1-9.
Gideskog M, Melhus Å. Outbreak of methicillin-resistant Staphylococcus aureus in a hospital center for children’s and women’s health in a Swedish County. APMIS. 2019;127(4):181-6.
Danelli T, Duarte FC, de Oliveira TA, da Silva RS, Alfieri DF, Gonçalves GB, et al. Nasal carriage by Staphylococcus aureus among healthcare workers and Students Attending a University Hospital in Southern Brazil: prevalence, phenotypic and Molecular Characteristics. Interdiscip Perspect Infect Dis. 2020:11p:Article ID 3808036.
Al Wahaibi L, Al Sudairi R, Balkhair A, Al-Awaisi H, Mabruk M. Methicillin resistant Staphylococcus aureus colonization among healyhcare workers in Oman. J Infect Dev Ctries. 2021;15(10):1426-35.
Zaky AI, Mahmoud RM, Abelraheem WR, Zaki SH. Detection of methicillin resistance of Staphylococcus aureus among Minia University Hospitals Patients. Minia Journal of Medical Research. 2022;31 (4):56-8.
Castro-Orozco C, Consuegra-Mayor C, Mejia-Chavez G, Hernandez-Escobar J, Guzman. Alvis. Rev Fac Med,. Antimicrobial Resistance Trends in Methicillin-Resistant and Methicillin-Susceptible Staphylococccus aureus and Staphylococcus epidermidis Isolates obtained from patients admitted to intensive care units 2010-2015. 2019; 67(3):409-16.
Rossato AM, Primon-Barros M, Rocha LDL, Reiter KC, Dias CAG, d’Azevedo PA. Resistance profile to antimicrobials agents in methicillin-resistant Staphylococcus aureus isolated from hospitals in South Brazil between 2014-2019. Rev Soc Bras Med Trop. 2020;53:(e20200431).
Alarjani KM, Almutairi AM, AlQahtany FS, Soundharrajan I. Methicillin and multidrug resistant pathogenic Staphylococcus aureus associated Sepsis in hospitalized neonatal Infections and antibiotic Susceptibility. J Infect Public Health. 2021;14(11):1630-4.
Sorsa A, Früh J, Stötter L, Abdissa S. Blood culture result profile and antimicrobial resistance pattern: a report from neonatal intensive care unit (NICU), Asella teaching and referral hospital, Asella, South East Ethiopia. Antimicrob Resist Infect Control. 2019;8:42.
Geng W, Qi Y, Li W, McConville TH, Hill-Ricciuti A, Grohs EC et al. Epidemiology of Staphylococcus aureus in neonates on admission to a Chinese neonatal intensive care unit. Plos One. 2020;15(2):e0211845.
Pillay D, Naidoo L, Swe Swe-Han KS, Mahabeer Y. Neonatal Sepsis in a tertiary Unit in South Africa. BMC Infect Dis. 2021;21(1):225.
-
Abstract View: 23 times
PDF Download: 11 times