Body Surfaces Colonization of Newborn Babies with ESBL producing Enterobacteriaceae on Delivery at Lagos University Teaching Hospital, Lagos, Nigeria
DOI: 10.21276/sjams.2018.6.10.94 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 b 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 ESBLcolonization 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 ESBLPE is recommended. Further research to determine if a correlation exists between vaginal ESBL PE in pregnancy and EONS should be encouraged.