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Prevalence and antimicrobial resistance of bacterial isolates in neonatal blood-stream infections

Abstract number: 1733_1041

Ikonomopoulou E., Vlachou M., Michail P., Paratiras S., Stavropoulou G., Verra C., Regli A.

Objectives: The aim of this study was to determine the prevalence and the antibiotic resistance of bacterial isolates from blood-stream infections in the neonatal care unit of our hospital.

Methods: During a three year period (2003–2005) a total of 1,152 blood cultures were obtained from neonates that were suspect of infection. Blood cultures were performed using the Bactec 9120 (Becton Dickinson) and Bact–alert (bioMérieux) during 2003 and 2004–2005, respectively. The identification and the antimicrobial resistance of bacterial isolates were carried out by the VITEK system (bioMérieux) or the mini API system (bioMérieux).

Results: A total of 90 (7.8%) neonates had positive blood culture. The most common pathogens were: Coag(-) staphylococci 38, Escherichia coli 24, Klebsiella pneumoniae 10. Other Gram-negative bacteria were: Serratia marcescens 3, Proteus mirabilis 2, Enterobacter cloacae 1, Citrobacter freundii 1 and Stenotrophomonas maltophilia 1. Other Gram-positive bacteria were: Staphylococcus aureus 3, Enterococcus faecalis 2, Streptococcus viridans 2, Streptococcus group C 1, and Candida krusei 1. E. coli strains were 50% resistant to ampicillin, 29% to piperacillin, 33% to ticarcillin, 17% to cefalothin, 8% to nalidixic acid and ciprofloxacin, 12.5% to gentamicin and trimethoprim/sulfamethoxazole and 0% to amikacin, netilmicin, tobramycin, amoxycillin/clavulanic acid, cefotaxime, ceftriaxone ceftazidime, imipenem, meropenem and aztreonam. K. pneumoniae strains were 100% resistant to ampicillin and ticarcillin, 50% to cefalothin and 0% to piperacillin, amoxycillin/clavulanic acid, cefotaxime, ceftriaxone ceftazidime, imipenem, meropenem, aztreonam, nalidixic acid, ciprofloxacin, gentamicin, amikacin, netilmicin, tobramycin and trimethoprim/sulfamethoxazole. E. coli and K. pneumoniae strains were ESBL negative. Although Coag(-) staphylococci sometimes considered to be a contaminant were 17% resistant to oxacillin, 29% to erythromycin, 5% to gentamycin, 16% to fusidic acid and trimethoprim/sulfamethoxazole.

Conclusions: Considering the most common pathogens and their antibiotic resistance especially to ampicillin perhaps we should revise the present choise of empirical treatment of ampicillin and one aminoglycoside until a pathogen has been isolated.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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