ISOLATION, IDENTIFICATION AND ANTIBIOTIC SUSCEPTIBILITY OF PATHOGENIC BACTERIA ASSOCIATED WITH NEONATAL SEPTICEMIA AT NEONATAL CARE UNIT IN MATERNITY AND CHILDREN TEACHING HOSPITAL IN RAMADI, IRAQ

摘要

Neonatal septicemia is reported to be a serious healthcare threat. Resistance of pathogenic bacteria to antibiotics is well-known as another global risk factor, and can be the major public health challenge in recent years. The research aimed to isolate and identify bacterial pathogens responsible for neonatal septicemia at neonatal care unit in Maternity and Children Teaching Hospital in Ramadi, Iraq. In addition to determine the antibiotic susceptibility pattern of isolated bacteria. During the 7-month study period, from November 2017 till May 2018, a total of 760 various specimens were collected. The blood samples (160) were obtained from neonates aged from 1-28 days admitted into the neonatal intensive care unit. Meanwhile, the internal hospitalenvironmental samples (600) were collected from different sites of the hospital. The samples were cultured using Brain Heart Infusion (BHI) broth, incubated at 37°C for seven days and observed daily to detect positive growth. Subculture was done, usingsuitable media, if any growth appears during this period. Positive cultures were identified according to standard bacteriological and biochemical criteria. Antibiotic sensitivity tests of isolated pathogens against selected antibacterial agents were carried out according to the Kirby-Bauer method. One hundred thirty eight bacterial cultures were obtained, 47 (29.4%) were obtained from blood samples and 91 (15.2%) from the hospital environmental samples. Gram positive bacteria were more frequent than gram-negative bacteria with 91(65.9%) and 47 (34.1%) isolates, respectively. Staphylococcus aureus and Staphylococcus epidermidis were the major isolated pathogens representing 56.5% (78 isolates out of 138 isolates) followed by Klebsiella pneumoniae (21%,29 isolates). All the gram-positive isolates were found to be resistant to cloxacillin and were sensitive to vancomycin and doxycycline. While, all the gram-negative isolated bacteria were completely sensitive to levofloxacin, amikacin and Imipenem. Theimportant exception was the high resistance (100%) of these microorganisms to trimethoprim. Findings from this study indicate that the major pathogens responsible for neonatal septicemia were Staphylococcus aureus, Staphylococcus epidermidis and Klebsiella pneumoniae. Most of the isolates were multidrug resistant and this is a serious finding. There was a correlation of bacteria isolated from the newborns blood to those isolated from the hospital environment. So, the causative agents of septicemia may be acquired in the hospital. Vancomycin and doxycycline were highly active antibiotics against tested Gram positive bacteria. While, levofloxacin, amikacin and Imipenem were against tested Gram negative.