Detection of Extended Spectrum β-Lactamases (ESBL) Producing Bacteria in Sepsis Suspected Neonates

Abstract

Introduction: Neonatal sepsis is a clinical syndrome that is caused when the bloodstream of an infant is invaded by bacteria in the first month after birth. Objective: The objective of the study was to identify bacteria involved in the infection and to determine “extended-spectrum beta-lactamase” (ESBL) producing bacteria from blood samples of sepsis suspected neonates in the Neonatal Intensive Care Unit and Special Care Baby Unit. Methods: This cross-sectional study was conducted from January to July 2019 at Microbiology laboratory of Paropakar Maternity and Women’s Hospital. A total of 380 venous blood specimens were included in the study. The blood culture was performed and organisms were identified with standard microbiological methods. The Antibiotic susceptibility test was performed using the modified Kirby Bauer disk diffusion method. Screening of the organisms was done using cefotaxime and ceftazidime antibiotic disc and confirmation of ESBL was done by combined disk test. The data were considered statistically significant if the p-value was < 0.05. Results: Out of a total of 380 blood specimens, the prevalence of neonatal sepsis was found to be 21.05% among which 57.5% were EOS type and 42.5% were LOS type. In EOS, E. coli (72.73%) was the predominant isolate while CoNS (100%) was the predominant isolate in LOS. Of the total 80 isolates, 65% isolates were found multidrug-resistant (MDR) whereas 58.75% of isolates were found to be ESBL producers. Conclusions: This study concludes that routine bacterial surveillance and study of their resistance patterns is an essential component of the neonatal care unit. Keywords: Extended-spectrum β-Lactamases; neonates; neonate intensive care unit; special care baby unit; sepsis.

Bacteriological Profile and Detection of β-Lactamase Producing Bacteria Isolated from Blood Samples of Neonates

“…Hence, the prevalence of neonatal sepsis was 17%. A similar finding was reported by Yadav et al (2018) and Nepal et al (2021) where the prevalence rate of neonatal sepsis was 16.9% and 21.05% respectively. Few research depicted a higher incidence rate of neonatal sepsis in other developing countries such as Bangladesh (34.88%), Uganda 37%), Ethiopia (44.7%), and Nigeria (45.9%) (Shehab El-Din et al 2015) while lower incidence rate was depicted in Southern Africa (9.8%) (Mudzikati and Dramowski, 2015), Nepal (12.6%) (Ansari, 2015) and Pakistan (8.9%) (Raha et al, 2014).…”

“…K. oxytoca were 100% resistant to Ampicillin followed by Piperacillin/tazobactam, Cefepime, Cefotaxime, Ceftazidime and Gentamicin with equal sensitivity of 29 (93.5%). Similar findings were reported where K. oxytoca were demonstrated to be 100% sensitive to Meropenerm and resistant to Cefotaxime 7(100%) and Ceftazidime 7(100%) (Nepal et al, 2021).…”

“…was sensitive to Meropenem 1(50%) and resistant to Ampicillin 2(100%) (Alharbi 2022). Nepal et al (2021) reported Enterobacter spp. was highly resistant to Cefotaxime 6(100%) followed by Ceftazidime 6 (100%) and Amikacin 5(83.33%).…”

Systematic Review and Meta-analysis on Extended-Spectrum β-lactamases Producing Klebsiella pneumoniae in Nepal

“…21,22 The problem has been frequently accounted in developing countries such as Nepal, where the prevalence of MDR and ESBL-producing bacteria has increased over the past years. 23,24 There are some scattered studies that reported ESBL-KP in Nepal. However, these are not available in an organized form.…”