Pediatric blood culture isolates and antibiotic sensitivity pattern in a Nigerian tertiary hospital

Ogunkunle, TO; Abdulkadir, MB; Katibi, Oludolapo Sherifat; Bello, SO; Raheem, RA; Olaosebikan, Rasaq

doi:10.4103/njm.njm_55_20

Cited by 6 publications

(12 citation statements)

References 13 publications

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“…In our study, Salmonella typhi, Staphylococcus aureus and Klebsiella pneumonia were the predominant organisms cultured, this was similar to findings by Obaro et al where Salmonella species account for 24%-59.8% of bacteremia in Central and Northwest Nigeria. This however, differs from findings by Ogunkunle et al where Staphylococcus aureus was the most predominant organism isolated from their patients [21] . This further signifies that there is a significant variation in the bacterial organisms causing sepsis even within the same region and country.…”

Section: Discussioncontrasting

confidence: 99%

“…This study found case fatality rate for sepsis to be 10.7%. This was comparable to similar studies in Nigeria [21,22] and studies by El-Mashad et al in Egypt [23] where the mortality rate was 8.8% but lower than 22% reported by Novosad et al [24] and 23.8% reported in Saudi Arabia [25] . This difference could be due to difference in the studied population where their patients were those admitted into the pediatric intensive care unit only, indicating the level of severity of the disease.…”

Section: Discussionsupporting

confidence: 90%

“…A quarter (25.9%) of the patients were less than one year of age. This is similar to many Nigerian studies where most of their patients were less than five years [21,22,26] . It is also similar to the study by Novosad et al where 39% of their patients were less than one year [24] .…”

Section: Discussionsupporting

confidence: 89%

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Assessing Predictors of Mortality Among Children admitted with Sepsis at a Referral Tertiary Health Center, Northwestern Nigeria

Hassan-Hanga

Kabir

Ibrahim

et al. 2022

Preprint

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Background Sepsis is a life-threatening infection that can lead to organ failure and death. We aim to assess predictors of mortality among children admitted with Septicemia at a referral health facility in Northwestern Nigeria. Methods We conducted a prospective cross-sectional study of children aged 0-14 years admitted to various units of the pediatrics department of the health facilities. Children were recruited between September 2018 and November 2019. All recruited children were followed up on clinical progress until either discharge, abscondment, or death. We assessed the children clinically daily and collected whole-blood samples for laboratory tests. We conducted a univariate and multivariable analysis using STATA-16 to assess identified predictive factors with our outcome variable. Results A total of 326 children were recruited, median age: 2-years. About 54.0% of the children were boys, and 53.1% were within 1-5 years age-group. Predominant organisms cultured from the blood of the children were Salmonella typhi (5.7%), Klebsiella pneumoniae (2.3%), and Staphylococcus aureus (2.0%). A total of 35 deaths were recorded with a case fatality rate (CFR) of 10.7%. CFR is highest in children <1years (13.6%). Child’s vaccination status, mother’s education level as well as blood lactate levels, GCS, qSOFA score and positive blood culture were significantly associated with child’s mortality. Factors associated with increase mortality include; children with incomplete vaccination history [OR=1.72, 95%CI: 2.74–15.53] versus those with full vaccination; children whose mothers had no formal education [OR=14.39, 95%CI: 3.24–63.99] when compared to those children whose mothers have tertiary level of education. Furthermore, children with whole blood lactate level between 4-8mmol/l [OR=3.23, 95%CI: 1.15–9.07], or greater than 8mmol/l [OR=10.54, 95%CI: 3.68–30.14] versus children with whole blood lactate level less than 4mmol/l; children with qSOFA score of 3 [OR=15.62, 95%CI: 3.31–73.60] versus children with qSOFA score of 1; and children who had a positive blood culture [OR=6.90, 95%CI: 3.04–15.64]. Conclusion We found a high prevalence of severe sepsis at pediatrics department of AKTH. Serum lactate levels, GCS, and qSOFA scores were predictive of mortality. Routine measurement and monitoring of these parameters will improve case management and reduce sepsis related mortality in the hospital.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 90%

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Assessing Predictors of Mortality Among Children admitted with Sepsis at a Referral Tertiary Health Center, Northwestern Nigeria

Hassan-Hanga

Kabir

Ibrahim

et al. 2022

Preprint

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“…The preponderance of enteric Gram-negative pathogens in the study location, like in most resource-poor settings, could be related to the high presence of predisposing factors such as high level of poverty, limited access to clean water, poor sanitation, and malnutrition (37). In contrast, some studies have reported predominantly Gram-positive pathogens, especially Staphylococcus aureus among febrile children (38)(39)(40). While this difference might reflect geographical variations of bloodstream bacterial pathogens, the characteristics of the study participants and the study design could also account for the differences in the organisms isolated.…”

Section: Discussionmentioning

confidence: 91%

A Prospective Cohort Study of the Clinical Predictors of Bacteremia in Under-Five Children With Acute Undifferentiated Fever Attending a Secondary Health Facility in Northwestern Nigeria

et al. 2022

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BackgroundChildren with acute febrile illness with no localizing signs often receive antibiotics empirically in most resource-poor settings. However, little is known about the burden of bacteremia in this category of patients, and an appraisal is thus warranted. This will guide clinical practice and promote rational antibiotics use.MethodsWe prospectively followed up 140 under-five children who presented with acute undifferentiated fever at the emergency/outpatient pediatric unit of a secondary healthcare facility. Baseline clinical and laboratory information was obtained and documented in a structured questionnaire. We compared baseline characteristics between participants with bacteremia and those without bacteremia. We further fitted a multivariable logistic regression model to identify factors predictive of bacteremia among the cohort.ResultThe prevalence of bacteremia was 17.1%, and Salmonella Typhi was the most frequently (40.9%) isolated pathogen. The majority (78.6%) of the study participants were managed as outpatients. The participants who required admission were four times more likely to have bacteremia when compared to those managed as outpatients (AOR 4.08, 95% CI 1.19 to 14.00). There is a four times likelihood of bacteremia (AOR 4.75, 95% CI 1.48 to 15.29) with a fever duration of beyond 7 days. Similarly, participants who were admitted with lethargy were six times more likely to have bacteremia (AOR 6.20, 95% CI 1.15 to 33.44). Other significant predictors were tachypnea and lymphopenia.ConclusionAmong under-five children with acute undifferentiated fever, longer duration of fever, lethargy, inpatient care, tachypnea, and lymphopenia were the significant predictors of bacteremia.

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“…Ogunkunle et al, Iregbu et al, and Uzodima et al , all from Nigeria, reported blood culture positivity rates of 19.0%, 22.0% and 35.0%, respectively, among suspected cases of BSI. 10 , 11 , 12…”

Section: Introductionmentioning

confidence: 99%

Bacteriological profile and antibiogram of blood culture isolates from bloodstream infections in a rural tertiary hospital in Nigeria

Oyekale

Ojo²,

Olajide

et al. 2022

Afr. J. Lab. Med.

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Background: Bloodstream infections (BSIs) are a cause of significant morbidity and mortality requiring urgent antibiotic treatment. However, there is widespread antibiotic-resistance from the bacterial causes, necessitating regular surveillance for drug-resistant bacteria and their antibiograms.Objective: This study isolated and identified various bacterial causes of BSIs, determined their antibiotic susceptibility patterns, and determined the best empirical treatment for cases of BSI in the setting.Methods: A cross-sectional study was carried out at the Federal Teaching Hospital, Ido-Ekiti, Nigeria between June 2020 and February 2021 on 177 blood culture samples from cases of BSI. Identification of isolated bacteria and antibiotic susceptibility testing of the isolates were carried out following the standard protocol.Results: Culture positivity in this study was 19.2%. No significant difference was seen in culture positivity between male and female participants (p = 0.97). Gram-negative enteric bacteria were predominantly isolated (67.6%), including Escherichia coli (29.4%) and Klebsiella aerogenes (20.6%). Staphylococcus aureus was the most common Gram-positive bacterium isolated (23.5%). Three (37.5%) S. aureus isolates were methicillin-resistant. All isolates were sensitive to meropenem, and 97.1% were sensitive to imipenem; other sensitivity patterns were: ceftazidime (85.3%), ciprofloxacin (79.4%), ofloxacin (79.4%), and gentamicin (76.5%). There was low sensitivity to ampicillin (32.4%) and cotrimoxazole (38.2%). All Gram-positive isolates, including methicillin-resistant S. aureus, were sensitive to vancomycin.Conclusion: Regular surveillance of isolate sensitivity patterns, formulation of hospital antibiotic policies based on existing data and compliance with treatment guidelines will promote rational antibiotic use and reduce resistance among bacteria.

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Pediatric blood culture isolates and antibiotic sensitivity pattern in a Nigerian tertiary hospital

Cited by 6 publications

References 13 publications

Assessing Predictors of Mortality Among Children admitted with Sepsis at a Referral Tertiary Health Center, Northwestern Nigeria

Assessing Predictors of Mortality Among Children admitted with Sepsis at a Referral Tertiary Health Center, Northwestern Nigeria

A Prospective Cohort Study of the Clinical Predictors of Bacteremia in Under-Five Children With Acute Undifferentiated Fever Attending a Secondary Health Facility in Northwestern Nigeria

Bacteriological profile and antibiogram of blood culture isolates from bloodstream infections in a rural tertiary hospital in Nigeria

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