Antibiogram and ESBL Production Among Neonatal Blood Stream Infections in Intensive Care Units of Selected Hospitals in Delta State, Nigeria

Antimicrobial resistance in neonatal bloodstream infections (BSI) is a threat to the health system and a major contributor to morbidity and mortality within neonatal intensive care units.This study was carried out to determine the prevalence of BSI, antimicrobial resistance, and Extended Spectrum Beta Lactamase (ESBL) production.We carried out a cross-sectional study of newborns admitted to three hospitals in Delta State, Nigeria.Blood samples were collected aseptically, cultured on MacConkey, Blood and Chocolate agar respectively.Isolated bacteria were identified based on morphology, Gram stain and standard biochemical tests.Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method.Phenotypic testing for ESBL production was carried out using the double-disc diffusion method according to CLSI guidelines.A plasmid curing test was performed on ESBL-producing isolates using 10% sodium dodecyl sulphate.A total of 70 bacterial isolates were detected in 180 blood samples, of which 50 (27.8%)were Gram-negative and 20 (11.1%) were Gram-positive.The most frequently isolated pathogen was Escherichia coli (19; 27.1%).A total of 19 (10.6%) isolates were from early-onset BSI, while 51 (28.3%) were from late-onset infection.A high rate of resistance was observed with Gentamicin and fluoroquinolone resistance being over 50% in E. coli and Klebsiella pneumoniae.All Staphylococcus aureus were resistant to erythromycin and trimethoprim-sulfamethoxazole.Twenty of the 50 Gram-negative isolates (40%) were ESBL producers with E. coli being 26.0%(13), and all harboured plasmids.Regular monitoring of pathogen spectrum and antimicrobial resistance patterns will help clinicians use drugs rationally in clinical management.