Microbiota profile associated with neonatal sepsis in reference maternity in State of Pará, Amazon, Brazil

Authors

DOI:

https://doi.org/10.33448/rsd-v13i6.42123

Keywords:

Neonatal sepsis; Microorganisms; Resistance/Sensitivity.

Abstract

Neonatal sepsis is a clinical syndrome that affects neonates due to the transmission/colonization of microbial agents during pregnancy or childbirth, unregulated development of the microbiota of the skin and gastrointestinal tract or through exposure to catheters during hospitalization. To determine the pathogenic profile implicated in neonatal sepsis and its sensitivity/resistance to antimicrobials. The study analyzed 803 medical records of neonates born between 2020 and 2022 at the reference maternity hospital in the State of Pará, Amazon, Brazil. They had a clinical diagnosis of sepsis with positive blood cultures. The prevalence of the disease was 13.77%, death 18.80% and lethality 19.95%. Staphylococcus epidermidis was the most frequent (56.29%) and was resistant to oxacillin and clindamycin. Klebsiella pneumoniae was observed in 36.57% of the cases and associated with death, it proved to be multiresistant to Ampicillin, Cefepime, Ceftazidime, Cefuroxime and Ceftriaxone. Sensitivity was observed for Meropenem, Amikacin and Imipenem. Conclusion: Estimating the prevalence of circulating microbial profiles that cause neonatal sepsis, as well as their resistance/sensitivity, was of paramount importance to support strategies that improve timely diagnosis and adequate treatment, avoiding the empirical and indiscriminate use of antibiotics.

References

Basu, S. (2014). Neonatal sepsis: the gut connection. Eur J Clin Microbiol Infect Dis, 34, pp. 215–222. https://doi.org/doi: 10.1007/s10096-014-2232-6.

Brasil. (2011). Atenção à saúde do recém-nascido: guia para os profissionais de saúde. Ministério da Saúde. Brasília, DF.

Brasil. (2013). Critérios Diagnósticos de Infecções Relacionadas à assistência à Saúde Neonatologia. 2013. Disponível em:. ANVISA, Agência Nacional De Vigilância Sanitária. Fonte: https://bvsms.saude.gov.br/bvs/publicacoes/criterios_diagnosticos_infeccoes_assistencia_s

Byrd, A. L., Belkaid, Y., & Sagre, J. A. (Mar de 2018). The human skin microbiome. Nat Rev Microbiol., 16(3), pp. 143-155. https://doi.org/10.1038/nrmicro.2017.157

Celik, I. H., Hanna, M., Canpolat, F. F., & Pammi, M. (jan de 2022). Diagnosis of neonatal sepsis: the past, present and future. Pediatr Res., 91(2), pp. 337-350. https://doi.org/10.1038/s41390-021-01696-z

Cruz, L. P., Alves, J. S., & Pol-Fachin , L. (Apr de 2022). Óbitos Por Sepse Neonatal No Estado De Alagoas No período De 2010-2019: Um Estudo epidemiológico. Brazilian Journal of Health Review,, 5(2), pp. 7311-7326. https://doi.org/10.34119/bjhrv5n2-291

Dong, Y., & Speer, C. P. (jUL de 2014). The role of Staphylococcus epidermidis in neonatal sepsis: guarding angel or pathogenic devil? Int J Med Microbiol, 304, pp. 513-520. https://doi.org/10.1016/j.ijmm.2014.04.013

Fleischmann, S. C., Reichert, F., Cassini, A., Horner, R., Harder, T., Markwart, R., . . . Eckmanns, T. (22 de Jan de 2021). Global incidence and mortality of neonatal sepsis: a systematic review and meta-analysis. Arch Dis Child, 106(8), pp. 745–52. https://doi.org/10.1136/archdischild-2020-320217

Fleischmann, S. C., Reichert, F., Cassini, A., Harder, T., Kissoon, N., & Reinhart, K. (2020). Global assessment of neonatal sepsis incidence and case fatality. 30th European Congress of Clinical Microbiology and Infectious Diseases, (pp. 18-21). Paris France.

Fortunov, R. M., Hulten, K. G., Hammerman, W. A., Mason, E. O., & Kaplan, S. L. (Sep de 2006). Community-acquired Staphylococcus aureus infections in term and near-term previously healthy neonates. Pediatrics, 118(3), pp. 874-81. https://doi.org/10.1542/peds.2006-0884

Garrido, F., Allegaert, K., Arribas, C., Villamor, E., Raffaeli, G., Paniagua, M., & Cavallaro, G. (27 de Aug de 2021). On Behalf Of European Antibiotics Study Group Easg. Variations in Antibiotic Use and Sepsis Management in Neonatal Intensive Care Units: A European Survey. Antibiotics (Basel), 10(9), p. 1046. https://doi.org/10.3390/antibiotics10091046

Glaser, M. A., Hughes, L. M., Jnah, A., & Newberry, D. (1 de Feb de 2021). Neonatal Sepsis: A Review of Pathophysiology and Current Management Strategies. Adv Neonatal Care, 21(1), pp. 49-60. https://doi.org/10.1097/ANC.0000000000000769

Gordon, A. I. (Jan de 2006). Late onset neonatal Gram-negative bacillary infection in Australia and New Zealand: 1992-2002. Pediatr Infect Dis J., 25(1), pp. 25-29. https://doi.org/10.1097/01.inf.0000195628.35980.2e.

Gupta, A. (2002). Hospital-acquired infections in the neonatal intensive care unit-Klebsiella pneumoniae. Semin Perinatol, 26, pp. 340–45. https://doi.org/10.1053/sper.2002.36267

Healy, C. M., Palazzi, D. L., Edwards, M. S., Campbell, J. R., & Baker, C. J. (Oct de 2004). Features of invasive staphylococcal disease in neonates. Pediatrics, 114(4), pp. 953-61. https://doi.org/10.1542/peds.2004-0043

Huber, S., knoll, M. A., Berktold, M., Würzner, R., Brindlmayer, A., Weber, V., . . . Weinberger, J. (2021). Genomic and Phenotypic Analysis of Linezolid-Resistant Staphylococcus epidermidis in a Tertiary Hospital in Innsbruck, Austria. Microorganisms, 9(5), p. 1023. https://doi.org/doi.org/10.3390/microorganisms9051023

Iroh, T. Y., & Bendel, C. M. (Oct de 2017). Diagnostics for neonatal sepsis: current approaches and future directions. Pediatr Res, 82(4), pp. 574-583. https://doi.org/10.1038/pr.2017.134

Li, J., Xiang, L., Chen, X., Li, S., Sun, Q., Cheng, X., & Hua, Z. (May de 2023). Global, regional, and national burden of neonatal sepsis and other neonatal infections, 1990-2019: findings from the Global Burden of Disease Study 2019. Eur J Pediatr, 182(5), pp. 2335-2343. https://doi.org/10.1007/s00431-023-04911-7

Li, X., Arias, C. A., Aitken, S. L., Galloway Peña, J., Panesso, D., Chang, M., . . . Shelburne, S. A. (18 de Jul de 2018). Clonal Emergence of Invasive Multidrug-Resistant Staphylococcus epidermidis Deconvoluted via a Combination of Whole-Genome Sequencing and Microbiome Analyses. Clin Infect Dis, 67(3), pp. 398-406. https://doi.org/10.1093/cid/ciy089

Malaki, M. (2015). Klebsiella pneumoniae bacteremia presenting on a neonatal intensive care unit during the first week of life. J Pediatr Infect Dis, 1, pp. 12-15. https://doi.org/10.1055/s-0035-1554971

Martin, R. M., & Bachman, M. A. (2018). Colonization, infection, and the accessory genome of Klebsiella pneumoniae. Front Cell Infect Microbio, 8, pp. 1–15. https://doi.org/10.3389/fcimb.2018.00004

Miselli, F., Cuoghi-Costantini, C., Creti, R., Sforza, F., Fanaro, S., Ciccia, M., . . . Berardi, A. (21 de Set de 2022). Escherichia coli Is Overtaking Group B Streptococcus in Early-Onset Neonatal Sepsis. Microorganisms, 10(10), p. 1878. https://doi.org/10.3390/microorganisms10101878

Mitra, S., Mukherjee, S., Naha, S., Chattopadhyay, P., Dutta, S., & Basu, S. (2019). Evaluation of co-transfer of plasmid-mediated fluoroquinolone resistance genes and blaNDM gene in Enterobacteriaceae causing neonatal septicaemia. Mitra S, Mukherjee S, Naha S, Chattopadhyay P, Dutta S, Basu S. Evaluation of co-transfer of plasmid-mediated fluoroquinolone rAntimicrob Resist Infect Control, 8, p. 46. https://doi.org/10.1186/s13756-019-0477-7

Mukherjee, S., Mitra, S., Dutta, S., & Basu, S. (11 de Jun de 2021). Mukherjee S, Mitra S, Dutta S, Basu S. Neonatal Sepsis: The Impact of Carbapenem-Resistant and Hypervirulent Klebsiella pneumoniae. Front Med (Lausanne), 8. https://doi.org/10.3389/fmed.2021.634349

Odabasi, I. O., & Bulbul, A. (2020). Sepse neonatal. Şişli Etfal Hastanesi Tip Bülteni, 54 (2), pp. 142-158. https://doi.org/10.14744/SEMB.2020.00236

Oliveira, C. P., Souza, J. S., Machado, R. C., Feijão, A. R., & Souza, N. L. (2016). Risk factors for neontal sepsis in neontal intensive care unit: Evidence study. Cogitare Enferm, 21(2), pp. 01-09. https://doi.org/10.5380/ce.v21i2.42845

Pire, S. A., & Almeida, N. M. (2016). Mortalidade por septicemia bacteriana: um estudo descritivo no período perinatal. Rev Enferm Contemp, 5(1), pp. 78-86.

Procianoy , R. S., & Silveira, R. C. (Mar-Apr de 2020). The challenges of neonatal sepsis management. J Pediatr, Suppl 1, pp. 80-86. https://doi.org/10.1016/j.jped.2019.10.004

Puopolo, K. M., Benitz, W. E., & Zaoutis, T. E. (Dec de 2018). COMMITTEE ON FETUS AND NEWBORN; COMMITTEE ON INFECTIOUS DISEASES. Management of Neonates Born at ≥35 0/7 Weeks' Gestation With Suspected or Proven Early-Onset Bacterial Sepsis. Pediatrics, 142(6), p. e20182894. https://doi.org/10.1542/peds.2018-2894

Sands, K., Carvalho, M. J., Portal, E., Thomson, K., Dyer, C., Akpulu, C., . . . Walsh, T. R. (2021). Characterization of antimicrobial-resistant Gram-negative bacteria that cause neonatal sepsis in seven low- and middle-income countries. Nature Microbiology, 6(4), pp. 512–523. https://doi.org/10.1038/s41564-021-00870-7

Schrag, S. J., Farley, M. M., Petit, S., Reingold, A., Weston, E. J., Pondo, T., . . . Lynfield, R. (Dec de 2016). Epidemiology of Invasive Early-Onset Neonatal Sepsis, 2005 to 2014. Pediatrics, 138(6), p. e20162013. https://doi.org/10.1542/peds.2016-2013

Shane, A. L., Sánchez, P. J., & Stoll, B. J. (14 de Oct de 2017). Neonatal sepsis. Lancet, 390(10104), pp. 1770-1780. https://doi.org/10.1016/S0140-6736(17)31002-4

Sousa, N. A., Coelho, C. G., Mesquita, C. S., Pires, F. B., Rosa, P. B., & Brito, I. L. (2019). Neonatal sepsis – microbiological profile and antimicrobial sensitivity in a hospital in the Northeast of Brazil. Brazilian Journal of Clinicl Analyses, 51(1), pp. 46-51. https://doi.org/10.21877/2448-3877.201900775

Stoll, B. J., Hansen, N. I., Bell, E. F., Walsh, M. C., Carlo, W. A., Shankaran, S., . . . Higgins, R. D. (2015). Trends in Care Practices, Morbidity, and Mortality of Extremely Preterm Neonates, 1993-2012. JAMA: the journal of the American Medical Association, 314(10), pp. 1039-1051. https://doi.org/10.1001/jama.2015.10244

Stoll, B. J., Puopolo, K. M., Hansen, N. I., Sánchez, P. J., Bell, E. F., Carlo, W. A., . . . Higgins, R. D. (1 de Feb de 2021). Early-Onset Neonatal Sepsis 2015 to 2017, the Rise of Escherichia coli, and the Need for Novel Prevention Strategies. JAMA Pediatr, 175(2), p. 212. https://doi.org/10.1001/jamapediatrics.2020.0593

Stranieri, I., Kanunfre, K. A., Rodrigues, J. C., Yamamoto, L., Nadaf, M. V., Palmeira, P., & Okay, T. S. (26 de Oct de 2018). Assessment and comparison of bacterial load levels determined by quantitative amplifications in blood culture-positive and negative neonatal sepsis. Rev Inst Med Trop Sao Paulo, 60, p. e61. https://doi.org/10.1590/S1678-9946201860061

Viswanathan, R., Singh, A. K., Basu, S., Chatterjee, S., Sardar, D., & Isaacs, D. (2012a). Multi-drug resistant gram negative bacilli causing early neonatal sepsis in India. Arch Dis Child, 97, pp. F182-187. https://doi.org/10.1136/archdischild-2011-300097

Viswanathan, R., Singh, A. K., Ghosh, C., Dasgupta, S., Mukherjee, S., & Basu, S. (2012b). Profile of neonatal septicaemia at a district-level sick newborn care unit. J Heal Popul Nutr, 30, pp. 41-48. https://doi.org/10.3329/jhpn.v30i1.11274

Zangirolami-Raimundo, J., Oliveira, J., & Echeimberg, C. L. (2018). Tópicos de metodologia de pesquisa: Estudos de corte transversal. Journal of Human Growth and Development, 28(3), pp. 356-360. https://doi.org/10.7322/jhgd.152198

Published

21/06/2024

How to Cite

SANTOS , E. S. .; SENA, B. E. P. .; SARATY , S. B. . Microbiota profile associated with neonatal sepsis in reference maternity in State of Pará, Amazon, Brazil. Research, Society and Development, [S. l.], v. 13, n. 6, p. e12713642123, 2024. DOI: 10.33448/rsd-v13i6.42123. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/42123. Acesso em: 30 jun. 2024.

Issue

Section

Health Sciences