New Cellularand Molecular Biotechnology Journal
مجله تازه هاي بيوتكنولوژي سلولي و مولكولي
NCMBJ
Basic Sciences
http://ncmbjpiau.ir
1
admin
2228-5458
2228-6926
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8888
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fa
jalali
1390
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1
gregorian
2011
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online
1
fulltext
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تعیین نقش عوامل باکتریایی شایع در عفونت خون نوزادان بیمارستان شهید عارفیان ارومیه
study of the role of common bacterial etiology in neonatal sepsis in Urumiah Shahid
میکروبیولوژی
Microbiology
مقاله پژوهشی
Research Article
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<b><span lang="AR-YE" style="font-size: 16pt line-height: 120%"></span></b><b><span lang="AR-YE" style="font-size: 12pt line-height: 120%"></span></b></font>
</div><p style="margin-bottom: 0.0001pt font-family: times new roman,times,serif text-align: justify" dir="rtl" class="MsoTitle"><font size="2"><b><span lang="AR-YE" style="font-size: 14pt line-height: 120% letter-spacing: -0.15pt">سابقه و هدف</span></b><b><span lang="AR-YE" style="font-size: 12pt line-height: 120% letter-spacing: -0.1pt">:</span></b><b><span style="font-size: 12pt line-height: 120% letter-spacing: -0.1pt" dir="ltr"></span></b><span dir="rtl"></span><span lang="AR-YE" style="font-size: 12pt line-height: 120% letter-spacing: -0.1pt"><span dir="rtl"></span> هدف از این تحقیق تعیین شایع ترین
عوامل باکتریال عفونت خون نوزادان بوده است. این مطالعه از نوع توصیفی مقطعی بوده
که در طی سال های 85-1384 در بیمارستان شهید عارفیان ارومیه بر روی 402 نوزاد
مشکوک به عفونت خون نوزادان انجام پذیرفت. </span><span lang="AR-YE" style="font-size: 12pt line-height: 120%"></span></font></p><div style="text-align: justify"> </div><p style="margin-bottom: 0.0001pt font-family: times new roman,times,serif text-align: justify" dir="rtl" class="MsoTitle"><font size="2"><b><span lang="AR-YE" style="font-size: 12pt line-height: 120% letter-spacing: -0.25pt">مواد و روش</span></b><span dir="ltr"></span><b><span lang="AR-YE" style="font-size: 12pt line-height: 120% letter-spacing: -0.25pt" dir="ltr"><span dir="ltr"></span> </span></b><b><span lang="AR-YE" style="font-size: 12pt line-height: 120% letter-spacing: -0.25pt">ها</span></b><b><span lang="AR-YE" style="font-size: 12pt line-height: 120%">:</span></b><b><span style="font-size: 12pt line-height: 120%" dir="ltr"></span></b><span dir="rtl"></span><span lang="AR-YE" style="font-size: 12pt line-height: 120%"><span dir="rtl"></span> پس از جمع</span><span style="font-size: 12pt line-height: 120%" dir="ltr"></span><span lang="AR-YE" style="font-size: 12pt line-height: 120%">آوری نمونه خون از این نوزادان و انجام کشت میکروبی،
ارزیابی حساسیت آنتی</span><span style="font-size: 12pt line-height: 120%" dir="ltr"></span><span lang="AR-YE" style="font-size: 12pt line-height: 120%">بیوتیکی سویه</span><span style="font-size: 12pt line-height: 120%" dir="ltr"></span><span lang="AR-YE" style="font-size: 12pt line-height: 120%">های باکتریال جداسازی شده با به کارگیری روش انتشار دیسک
منطبق با اصــــول کمیتـــه بین</span><span style="font-size: 12pt line-height: 120%" dir="ltr"></span><span lang="AR-YE" style="font-size: 12pt line-height: 120%">المللی بالینی آزمایشگاه</span><span dir="ltr"></span><span lang="AR-YE" style="font-size: 12pt line-height: 120%" dir="ltr"><span dir="ltr"></span> </span><span dir="rtl"></span><span lang="AR-YE" style="font-size: 12pt line-height: 120%"><span dir="rtl"></span>(</span><span style="font-size: 12pt line-height: 120%" dir="ltr">CLSI</span><span dir="rtl"></span><span lang="AR-YE" style="font-size: 12pt line-height: 120%"><span dir="rtl"></span>)<span> </span>صورت پذیرفت.</span></font></p><div style="text-align: justify"> </div><p style="margin-bottom: 0.0001pt font-family: times new roman,times,serif text-align: justify" dir="rtl" class="MsoTitle"><font size="2"><b><span lang="AR-YE" style="font-size: 12pt line-height: 120%">یافته</span></b><b><span style="font-size: 12pt line-height: 120%" dir="ltr"></span></b><b><span lang="AR-YE" style="font-size: 12pt line-height: 120%">ها:</span></b><span lang="AR-YE" style="font-size: 12pt line-height: 120%"> از 402 نمونه خون مورد مطالعه، (9/8</span><span lang="AR-YE" style="font-size: 12pt line-height: 120%">%</span><span lang="AR-YE" style="font-size: 12pt line-height: 120%">) 36 کشت خون مثبت
حاصل شد که شیوع عفونت در نوزادان پسر با (1/61</span><span lang="AR-YE" style="font-size: 12pt line-height: 120%">%</span><span lang="AR-YE" style="font-size: 12pt line-height: 120%">) 22 مورد بیشتر از
نوزادان دختر با (9/38</span><span lang="AR-YE" style="font-size: 12pt line-height: 120%">%</span><span lang="AR-YE" style="font-size: 12pt line-height: 120%">) 14 مورد و از این نوزادان، 23 نوزاد حاصل
زایمان طبیعی و 13 نوزاد حاصل زایمان سزارین بودند و رابطه معنی داری بین نوع
زایمان و شیوع بیماری وجود نداشت (</span><span style="font-size: 12pt line-height: 120%" dir="ltr">P=0/093</span><span dir="rtl"></span><span lang="AR-YE" style="font-size: 12pt line-height: 120%"><span dir="rtl"></span>)</span><span dir="ltr"></span><span style="font-size: 12pt line-height: 120%" dir="ltr"><span dir="ltr"></span>.</span><span dir="rtl"></span><span lang="AR-YE" style="font-size: 12pt line-height: 120%"><span dir="rtl"></span>
میانگین وزن 36 نوزاد 837 2117 گرم بود و رابطه معنی</span><span style="font-size: 12pt line-height: 120%" dir="ltr"></span><span lang="AR-YE" style="font-size: 12pt line-height: 120%">داری بین وزن کم
هنگام تولد و افزایش شیوع عفونت مشاهده شد (</span><span style="font-size: 12pt line-height: 120%" dir="ltr">P =0</span><span dir="rtl"></span><span lang="AR-YE" style="font-size: 12pt line-height: 120%"><span dir="rtl"></span>)</span><span dir="ltr"></span><span style="font-size: 12pt line-height: 120%" dir="ltr"><span dir="ltr"></span>.</span><span dir="rtl"></span><span style="font-size: 12pt line-height: 120%"><span dir="rtl"></span> </span><span lang="AR-YE" style="font-size: 12pt line-height: 120%">شایع ترین
میکروارگانیسم</span><span style="font-size: 12pt line-height: 120%" dir="ltr"></span><span lang="AR-YE" style="font-size: 12pt line-height: 120%">های مولد عفونت خـــون نوزادان به ترتیب، استافیلوکوک کوآگولاز منــــفی
(50 درصد) و کلبسیلا پنومونیه (4/19 درصد) بودند. بیشترین مقاومت باکتری های گرم
مثبت به آمپی سیلین و سویه</span><span style="font-size: 12pt line-height: 120%" dir="ltr"></span><span lang="AR-YE" style="font-size: 12pt line-height: 120%">های گرم منفی به سفوتاکسیم و بیشترین حساسیت باکتری های
گرم مثبت به وانکومایسین و سویه</span><span style="font-size: 12pt line-height: 120%" dir="ltr"></span><span lang="AR-YE" style="font-size: 12pt line-height: 120%">های گرم منفی به سیپروفلوکساسین و عامل خطرزای اصلی در
ابتلا به عفونت، نارس بودن و وزن کم حین تولد بود.</span></font></p><div style="text-align: justify"> </div><p style="margin-bottom: 0.0001pt font-family: times new roman,times,serif text-align: justify" dir="rtl" class="MsoTitle"><font size="2"><b><span lang="AR-YE" style="font-size: 12pt line-height: 120%">نتیجه گیری:</span></b><span lang="AR-YE" style="font-size: 12pt line-height: 120%"> با توجه به افزایش شیوع عفونت با استافیلوکوک کوآگولاز
منفی در این مطالعه و مطالعات مشابه، با درمان صحیح آنتی</span><span style="font-size: 12pt line-height: 120%" dir="ltr"></span><span lang="AR-YE" style="font-size: 12pt line-height: 120%">بیوتیکی منطبق با
نتایج دقیق آنتی</span><span style="font-size: 12pt line-height: 120%" dir="ltr"></span><span lang="AR-YE" style="font-size: 12pt line-height: 120%">بیوگرام به همراه رعایت اصول بهداشتی در بخش زایمان، نوزادان و مراقبت های
ویژه نوزادان و مراقبت</span><span style="font-size: 12pt line-height: 120%" dir="ltr"></span><span lang="AR-YE" style="font-size: 12pt line-height: 120%">های مناسب قبل از تولد برای جلوگیری از تولد نوزاد نارس
می</span><span style="font-size: 12pt line-height: 120%" dir="ltr"></span><span lang="AR-YE" style="font-size: 12pt line-height: 120%">توان از مرگ</span><span style="font-size: 12pt line-height: 120%" dir="ltr"></span><span dir="rtl"></span><span lang="AR-YE" style="font-size: 12pt line-height: 120%"><span dir="rtl"></span> و میر و ناتوانی</span><span style="font-size: 12pt line-height: 120%" dir="ltr"></span><span lang="AR-YE" style="font-size: 12pt line-height: 120%">های حاصل از این
بیماری کاست.</span></font></p><div style="text-align: justify"> </div><div style="text-align: justify"> </div><p style="margin-bottom: 0.0001pt font-family: times new roman,times,serif text-align: justify" dir="rtl" class="MsoTitle"><font size="2"><span style="font-size: 12pt line-height: 120%" dir="ltr"> </span></font></p>
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etiology in neonatal sepsis which has been carried out during<span> </span>the years 2005-2006 at Urumiah Shahid Arefian
Hospital. </span></p>
<p style="margin-bottom: 0.0001pt text-align: justify line-height: 120% vertical-align: middle" class="MsoNormal"><b><span style="font-size: 14pt line-height: 120% font-family: "Times New Roman","serif" color: black">Materials and Methods</span></b><span style="font-size: 12pt line-height: 120% font-family: "Times New Roman","serif" color: black">. In this cross-sectional study, after collecting blood samples
from 402 newborns who were suspicious to sepsis and performing microbial
culture and bacterial isolation, disk diffusion antibiotic susceptibility test
was done according to the CLSI guidelines. </span></p>
<p style="margin-bottom: 0.0001pt text-align: justify line-height: 120% vertical-align: middle" class="MsoNormal"><b><span style="font-size: 14pt line-height: 120% font-family: "Times New Roman","serif" color: black">Results</span></b><span style="font-size: 12pt line-height: 120% font-family: "Times New Roman","serif" color: black">. Overall, 36 positive cultures were acquired. The prevalence of
sepsis were higher in the male infants (61/1%) than female (38/9%)</span><span dir="rtl"></span><span style="font-size: 12pt line-height: 120% font-family: "B Nazanin" color: black" dir="rtl"><span dir="rtl"></span> </span><span dir="ltr"></span><span style="font-size: 12pt line-height: 120% font-family: "Times New Roman","serif" color: black"><span dir="ltr"></span>(P=0) Among these, 63/9% were born with
normal vaginal delivery and 36/1% were</span><span dir="rtl"></span><span style="font-size: 12pt line-height: 120% font-family: "B Nazanin" color: black" dir="rtl"><span dir="rtl"></span> </span><span style="font-size: 12pt line-height: 120% font-family: "Times New Roman","serif" color: black">c-section delivered babies (P=0/093). The mean weight of 36
neonates was 2117837</span><span dir="rtl"></span><span style="font-size: 12pt line-height: 120% font-family: "B Nazanin" color: black" dir="rtl"><span dir="rtl"></span> </span><span style="font-size: 12pt line-height: 120% font-family: "Times New Roman","serif" color: black">gr and there was a
significant relationship between low birth weight and prevalence of sepsis
(p=0). The most common microorganisms of neonatal sepsis were coagulase
negative staphylococci (50%) and klebsiella pneumoniea (19/4%). The
gram-positive isolates showed the highest sensitivity and resistance rates to
vancomycin and to Ampicillin, respectively. The highest sensitivity and
resistance rates for the gram negatives were towards ciprofloxacin and
cefotaxime, respectively. Low birth weight and prematurity were</span><span dir="rtl"></span><span style="font-size: 12pt line-height: 120% font-family: "B Nazanin" color: black" dir="rtl"><span dir="rtl"></span> </span><span style="font-size: 12pt line-height: 120% font-family: "Times New Roman","serif" color: black">the major risk factors of sepsis. </span></p>
<p style="margin-bottom: 0.0001pt text-align: justify line-height: 120% vertical-align: middle" class="MsoNormal"><b><span style="font-size: 14pt line-height: 120% font-family: "Times New Roman","serif" color: black">Conclusion</span></b><span style="font-size: 12pt line-height: 120% font-family: "Times New Roman","serif" color: black">. With respect to increasing prevalence of neonatal sepsis with
coagulase negative staphylococci, in this study and similar studies, with
appropriate antibiotical therapy according to antibiogram results, with
considering hygienic principles in hospitals and prenatal care, we may able to
decrease mortality and morbidity of neonatal sepsis.</span></p>
عفونت خون، عوامل باکتریائی، مقاومت آنتیبیوتیکی، نوزاد نارس
Neonatal sepsis, bacterial agent, Antibiotic resistance, Prematurity
17
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http://ncmbjpiau.ir/browse.php?a_code=A-10-47-11&slc_lang=fa&sid=1
Gholamreza
Bakhsi khaniki
غلامرضا
بخشی خانیکی
bakhshi@pnu.ac.ir
1003194753284600599
1003194753284600599
Yes
Islamic Azad University, Parand Branch
دانشگاه آزاد اسلامی واحد پرند
Farzin
Asgharisana
فرزین
اصغری ثنا
1003194753284600600
1003194753284600600
No
Urmiah Payame Noor University
دانشگاه پیام نور ارومیه
Shahsanam
Gaibi
شاه صنم
غیبی
1003194753284600601
1003194753284600601
No
Urmiah Shahid Arefian Hospital
دانشگاه علوم پزشکی واحد ارومیه