Antimicrobial Resistance Among Gram-Negative Bacteria Isolated in the Newborn Intensive Care Unit at ABDERREZAK-BOUHARA Hospital of Skikda, Algeria.

This study aimed to determine the epidemiology of gram-negative bacteria (GNB) isolated in the newborn intensive care unit (NICU) population, to assess their antibiotic susceptibility patterns and possible associated risk factors. All neonates admitted to the NICU of ABDERREZAK-BOUHARA hospital (Skikda, Algeria) with a clinical diagnosis of neonatal infections from March to May 2019 were included in the study. The extended-spectrum β-lactamase ESBLs), plasmidic cephalosporinase (pAmpC), and carbapenemases genes were screened by polymerase chain reaction (PCR) and sequencing. PCR amplification of among carbapenem-resistant isolates was also performed. The clonal relatedness of the ESBLs isolates was studied using multilocus sequence typing MLST). Among 148 clinical specimens, 36 (24.3%) GNB strains were isolated from urine ( = 22), wound ( = 8), stool ( = 3), and blood ( = 3) samples. The bacterial species identified were ( = 13), ( = 5), ( = 3), ( = 3), spp. ( = 3), ( = 1), ( = 5), and ( = 3). PCR and sequencing showed that eleven isolates harbored the gene, two isolates harbored the gene, and three isolates harbored both and genes. Also, five strains of were found to harbor mutations in the gene. MLST showed that the strains belonged to ST13 and ST189, belonged to ST69, and belonged to ST214. Different risk factors that could predict positive GNB cultures were found, including female sex, Apgar score <8 at 5 min of life, enteral nutrition, antibiotic use, and extended length of hospitalization. Our study highlights the importance of determining the epidemiology of pathogens causing neonatal infections, their sequence types (ST), and their antibiotic susceptibility patterns to address rapidly a correct antibiotic treatment regimen.