新生儿耐甲氧西林金黄色葡萄球菌感染--重大关切和行动呼吁。

Samaha Saleh Mustapha, Musa Aishatu Zaidu, Muhammad Shamsuddeen Yusuf, Shamsudin Aliyu, Isa Abdulkadir
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摘要

背景:耐甲氧西林金黄色葡萄球菌(MRSA)既是一种人类共生菌,也是一种导致新生儿感染的病原体,与严重的发病率和死亡率有关。其基因的灵活性和多功能性使其具备了对多种抗生素产生抗药性的能力。据报道,新生儿重症监护室爆发感染以及社区感染主要发生在发达国家。然而,有关发展中国家新生儿 MRSA 感染的数据却很少。本研究的目的是重点分析 MRSA 感染病例,描述临床表现,并概述本院足月新生儿的抗生素敏感性模式:这是一项基于医院的前瞻性横断面研究,开展时间为 2018 年 10 月至 2019 年 7 月。共有 248 名疑似败血症的足月新生儿被纳入研究,并采集了他们的血液样本进行检查,包括血液培养。分别使用MicrobactTM24E(Oxiod UK)和Staph ID及改良柯比-鲍尔盘扩散技术进行细菌鉴定和抗生素敏感性模式:在参与研究的 248 名受试者中,34.2% 已证实患有败血症,其中葡萄球菌占 56.4%。在患有葡萄球菌败血症的患者中,56.3%被发现感染了 MRSA。值得注意的是,大多数病例(94.4%)来自院外,表现为新生儿败血症,临床特征不明确。药敏试验显示,环丙沙星和氯霉素是对已确定病原体最有效的抗生素:结论:新生儿中出现的 MRSA 感染对公共卫生构成了严重威胁。这一趋势凸显了抗菌药耐药性的出现,可能会影响治疗效果并危及新生儿的健康。必须采取紧急果断的措施来遏制这一趋势。
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Methicillin resistant staphylococcus aureus infection in neonates- a major concern and a call for action.

Background: Methicillin-Resistant Staphylococcus aureus (MRSA) is both a human commensal and a pathogen that causes neonatal infection which is associated with significant morbidity and mortality. Its genetic flexibility and versatility have equipped it with the ability to develop resistance to numerous antibiotics. Outbreaks of infections in neonatal intensive care units as well as community infections have been reported mostly in developed countries. However, there is a paucity of data on neonatal MRSA infection in developing countries. The study aims to highlight cases of MRSA infection, describe the clinical presentation, and outline the antibiotic susceptibility pattern among term neonates in our facility.

Methodology: It was a prospective cross-sectional hospital-based study carried out from October 2018 to July 2019. A total of 248 term neonates with suspected sepsis were enrolled in the study and had their blood samples taken for investigations including blood culture. Bacterial identification and antibiotic susceptibility patterns were carried out using MicrobactTM24E (Oxiod UK) and Staph ID and modified Kirby-Bauer disk diffusion technique respectively.

Results: Out of the 248 subjects enrolled in the study, 34.2% had proven sepsis, with Staphylococcus species accounting for 56.4% of these cases. Among those with staphylococcal sepsis, 56.3% were found to have MRSA infection. Notably, the majority (94.4%) of cases originated from outside the hospital, presenting as neonatal sepsis with non-specific clinical features. Sensitivity testing revealed that ciprofloxacin and chloramphenicol were the most effective antibiotics against the identified pathogens.

Conclusion: The presence of MRSA infections in neonates poses a critical public health threat. This trend underscores the emergence of antimicrobial resistance, potentially compromising treatment efficacy and jeopardizing neonatal well-being. Urgent and decisive measures are necessary to curb this trajectory.

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