Body Surfaces Colonization of Newborn Babies with ESBL-producing Enterobacteriaceae on Delivery at Lagos University Teaching Hospital, Lagos, Nigeria
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 10
Abstract
Considering that body surface colonization of the new born by multi-drug resistant bacterial strains could predispose to early onset neonatal sepsis (EONS) this study was embarked upon at the Lagos University Teaching Hospital (LUTH), Lagos to investigate the percentage body surfaces colonization of the newborn and the vagina of their respective mothers by extended-spectrum β-lactamase producing Enterobacteriaceae (ESBL-PE). The study also evaluated the percentage of babies so colonized, who manifested with signs and symptoms of sepsis in the first 7 days of postnatal life. The antibiotic susceptibility, resistance patterns and risk factors for ESBL- colonization of the newborn in pregnancy were also determined. This investigation was conducted amongst 350 newborn babies delivered in the labour wards of LUTH, Lagos and their mothers, between January 2014 and May, 2015. Structured questionnaires were used to collect mothers’ socio-demographic data. The body surfaces swabs from the newborns and maternal high vagina swabs were cultured and isolates were tested both for antibiotic susceptibility and ESBL production. The babies whose body surfaces were colonized by Enterobacteriaceae were monitored for the first 7 days of postnatal life for signs and symptoms of EONS. Multivariate logistic regression model was constructed to determine the risk factors for newborn ESBL-PE colonization. A total of 243 (69.4%) babies were colonized by Enterobacteriaceae, 187 (53.4%) were non-ESBL-PE, 56 (16%) of the Isolates were conformed ESBL-PE. Out of the 56 confirmed cases ESBL-PE, 11 (19.6%) on postnatal monitoring, manifested with signs and symptoms of EONS. Maternal vagina ESBL-PE colonization in pregnancy was an independent risk factor for neonatal colonization (p- <0.05). ESBL-production was associated with cross resistance to other antibiotic classes. Antenatal screening of pregnant women for vaginal colonization with ESBL-PE is recommended. Further research to determine if a correlation exists between vaginal ESBL-PE in pregnancy and EONS should be encouraged.
Authors and Affiliations
Godwin I. Ogban, Anthony A. Iwuafor, Ubleni E. Emanghe, Simon N. Ushie, Thomas U. Agan
Keywords
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