Multi-resistant Bacteria to Antibiotics in Hospitals: The Case of Neonatology Services of the University Hospitals Centers of Abidjan, Côte d'Ivoire

Background: Multidrug-resistant bacteria (MDR) represent a global health scourge. Their emergence in hospital services complicates the clinical management of infections caused in particular in immunocompromised persons. The objective of our work was to evaluate the prevalence of MDR in the neonatal services of the University Hospitals Centers of Abidjan.

Materials and Methods: The present study took place from September to November 2020 and from January to June 2021. The samples collected consisted of venous blood samples for blood cultures, rectal swabs from newborns, nasal and hand swabs from health care workers, and swabs from inert surfaces and neonatal care equipment. Bacterial identification methods, antibiotic susceptibility testing, and Chi-square testing were performed.

Results: A total of 513 samples were obtained from which 215 organisms were isolated and identified. These bacteria consisted of 52.1% Gram-negative bacilli, of which 77.7% were Enterobacteriaceae and 47.9% Gram-positive cocci. Klebsiella pneumoniae (K. pneumoniae) (25.6%), coagulase-Negative Staphylococcus (CoNS) (24.6%), and Staphylococcus aureus (S. aureus) (23.2%) were the most isolated bacteria. The overall prevalence of MDR was 73.9%. The main antibiotic resistance phenotypes described were the production of Broad Spectrum β-lactamases (ESBL) in 71.9% of Enterobacteriaceae and methicillin resistance (Meti-R) in 75.6% of Staphylococcus. ESBL-producing Enterobacteriaceae (E-ESBL) were mainly observed in rectal carriage and Meti-R strains in blood cultures in newborns in the respective proportions of 45.6% and 56.4%.

Conclusion: In our work, the results obtained showed a high prevalence of MDR in neonatal services and newborns are the most affected subjects. Improving hygiene rules and control and rationalizing the use of antibiotics are highly recommended control strategies to reduce the hospital dissemination of MDR.