Background: Neonatal septicemia is a severe life-threatening
bacteremia in which multiplying bacteria release toxins into the blood stream
which increases production of cytokines causing clinical manifestations like
fever, chills, tissue anoxia, reduced blood pressure, collapse etc. Enterococci
are one of the important global pathogens in neonatal septicemia and were
considered colonizers in the past. Their gaining resistance has been
highlighted mainly to Vancomycin and high level aminoglycosides.
Aim: This study was carried out to emphasize the growing relevance of
multi-drug-resistant Enterococci in newborns, which were previously solely
non-harmful colonists.
Materials and Methods: It was a retrospective study in which blood culture
samples from the neonatal intensive care unit received in the laboratory were
considered. Processing of samples and identification of organisms were done as
per standard guidelines.
Results: Enterococci accounted for 16% of the isolation rate. 78% of them
showed early onset septicemia with male predominance. Vancomycin resistance
Enterococci (VRE)was observed in only one isolate (11%) while high level
aminoglycoside resistance was observed in 80% of them. Clinical history
suggested low birth weight, prematurity, fever, catheterization and raised C-
reactive protein levels.
Conclusions: The study shows an upsurge of VRE and highlevel aminoglycoside
resistance (HLAR) in neonatal septicemia with the need for periodic training
and active surveillance culture program for rapid identification of colonizers
as the main cause of bacteremia and increase awareness amongst the health care
workers about the rising multi drug resistant infectious incidence of
Enterococci.
Manali Hitenbhai Shah,
Government Medical College, Surat, India.
Summaiya Abdulvahed Mullan,
Government Medical College, Surat, India and M.P. Shah Medical College, Jamnagar, India.
Please see the link here: https://stm.bookpi.org/RUDHR-V1/article/view/13212
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