*[1],[2]Ontsira Ngoyi, E. N., 1,[3]Mieret, T.,2Moundzele, L., 1,[4]Ngakengy, N.,1Niabia, O. E., and 1,4Ekouya, G.
1Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Congo 2Bacteriology-Virology Laboratory, Brazzaville University Hospital, Congo 3National Public Health Laboratory, Brazzaville, Congo 4Neonatology Department, Brazzaville University Hospital, Congo *Correspondence to: esther_muller20023@yahoo.fr
Abstract:
Background: Antibiotic resistance represents a major threat in neonatology, particularly in sub-Saharan Africa where local data remain limited. The present study aims to establish the profile of multidrug-resistant bacteria isolated from cases of neonatal nosocomial infections at the Brazzaville University Hospital, Congo.
Methodology: This analytical cross-sectional study, conducted at the Brazzaville University Hospital on newborns with nosocomial infections between May and September 2023, characterized the bacterial organisms and their antimicrobial resistance profiles. Blood samples were collected from the neonates and cultured for bacterial isolation using conventional bacteriology methods. Antibiotic susceptibility test of each isolated bacterium was determined by the disc diffusion method and interpreted according to CA-SFM 2023 standards.
Results: Of 542 hospitalized patients during the period of study, 97 were neonates, 33 of whom had nosocomial infections, giving a prevalence of 34.0%. Bacteremia was the most common nosocomial infection with 78.8%, pneumonia (12.2%), urinary catheter infection (6.0%) and omphalitis (3.0%). Enterobacteriaceae, notably Klebsiella pneumoniae and Escherichia coli, dominated the infectious landscape, with marked multi-drug resistance (MDR) profile, nearly 80.0% of which is due to presumptive carbapenemase production. Gram-positive cocci and nonfermentative bacilli also present high resistance profiles. Factors significantly associated with nosocomial neonatal infection on multivariate analysis are low birthweight (<2500g) (OR=5.27, p=0.014) and requirement for oxygen (OR=8.12, p=0.003). But factors such as prematurity and the place of care of the newborns were not significantly associated with neonatal nosocomial infection on multivariate analysis (p>0.05).
Conclusion: These results highlight the vulnerability of newborns with low birth weight to nosocomial infection caused by MDR bacterial pathogen. There is need to strengthen antibiotic stewardship and integrate local data into hospital surveillance and infection prevention strategies.
Keywords: Nosocomial, Neonate, Infection, Multidrug resistance, Brazzaville-Congo
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