Square Hospitals Ltd, Bangladesh
Title: Emerging Multi-drug Resistant Bacterial Strain in Neonatal Intensive Care Unit (NICU)s in a developing country-Bangladesh
Biography: Aftab Yusuf Raj
Background: Neonatal sepsis remains a major health problem in any NICU worldwide. As, compared to developed countries, the use of antimicrobials in Bangladesh is less regulated and enough data are not available.
Aim: The aim of the study was to determine the causative bacteria and the level of their resistance to commonly used antibiotics in NICUs of Bangladesh.
Materials & Methods: A total of 1724 blood samples were analyzed (culture and sensitivity tests) from neonates from three major referral NICUs of Bangladesh, who were clinically diagnosed as sepsis. Only culture-positive sepsis was included in the study.
Result: Among total, 363 (21.05%) culture positive sepsis, gram negative and gram positive bacteria were found in 88.15% (n=320) and 11.84% (n=43) respectively. Acinetobacter was the most frequent (40.22%) isolated gram negative organism followed by Klebsiella pneumoniae (32.5%), Escherichia coli (7.3%) and Pseudomonas (3%). Overall, 78% of the isolates were multidrug-resistant (68% of gram-positive bacteria and 85.4% of gram-negative bacteria) against commonly used antibiotics such as ampicillin, amoxicillin, cefotaxime, ceftriaxone, gentamicin, linezolid and vancomycin. This study found new emerging bacteria- Burkholderia cepacia (n=5) and Stenotrophomonas maltophilia (n=4), which were both multidrug-resistant and only sensitive to meropenem and colistin respectively.
Conclusions: Very high percentage of multi drug resistance to the commonly used antibiotics including emerging multi drug resistant Burkholderia cepacia and Stenotrophomonas maltophilia in NICUs in Bangladesh is alarming and challenge to the management of neonatal sepsis. Continuous surveillance for antibiotic susceptibility is needed to ensure proper empirical therapy.