Susceptibility of bacterial etiological agents to commonly-used antimicrobial agents in children with sepsis at the Tamale Teaching Hospital

Abstract

BackgroundBloodstream infections in neonates and infants are life-threatening emergencies. Identification of the common bacteria causing such infections and their susceptibility patterns will provide necessary information for timely intervention. This study is aimed at determining the susceptibilities of bacterial etiological agents to commonly-used antimicrobial agents for empirical treatment of suspected bacterial septicaemia in children.MethodsThis is a hospital based retrospective analysis of blood cultures from infants to children up to 14 years of age with preliminary diagnosis of sepsis and admitted to the Neonatal Intensive Care Unit (NICU) and Paediatric Wards of the Teaching Hospital Tamale from July 2011 to January 2012.ResultsOut of 331 blood specimens cultured, the prevalence of confirmed bacterial sepsis was 25.9% (86/331). Point prevalence for confirmed cases from NICU was 44.4% (28/63) and 21.6% (58/268) from the Paediatric ward. Gram positive cocci (GPC) were the predominant isolates with Coagulase positive (32.2%) and Coagulase-negative (28.7%) Staphylococci accounting for 60.9% of the total isolates. Gram negative rods (GNR) comprised 39.1% of all isolates with Klebsiella, E.coli and Salmonella being the most common organisms isolated. Klebsiella was the most frequent GNR from the NICU and Salmonella typhi was predominantly isolated from the paediatric ward. Acinetobacter showed 100.0% susceptibility to Ceftriaxone and Cefotaxime but was resistant (100.0%) to Ampicillin, Tetracycline and Cotrimoxazole. Escherichia coli and Klebsiella were 80.0% and 91.0% susceptible to Ceftriaxone and Cefotaxime respectively. Klebsiella species showed 8.3% susceptibility to Tetracycline but was resistant to Ampicillin and Cotrimoxazole. Escherichia coli showed 40.0% susceptibility to Ampicillin, Chloramphenicol and Cotrimoxazole; 20.0% susceptibility to Tetracycline and 80.0% susceptible to Gentamicin and Cefuroxime. Coagulase negative Staphylococci was susceptible to Gentamicin (72.0%) but Coagulase positive Staphylococci showed intermediate sensitivity to Gentamicin (42.9%).ConclusionCoagulase Negative, Coagulase Positive Staphylococci, Salmonella and Klebsiella were the aetiological agents of bloodstream infection among children at TTH. While gram-positive and gram-negative bacteria showed low susceptibility to Ampicillin, Tetracycline and Cotrimoxazole, the GNR were susceptible to Gentamicin and third-generation cephalosporins.

Prevalence of Septicaemia and Antibiogram of Different Etiological Agents in Patients of Intensive Care Units of a Tertiary Care Centre in Northern India

“…The analysis of microbiological characteristics of septicaemia in this study showed that Gram-negative bacteria were the most common pathogens in septicaemia (52.72%) which was quite different from the report that Gram-positive bacteria were predominant in previous studies 27,28 . However results in this study were consistent with some of previous studies 29,30,31 .…”

Bacteremia in children: epidemiology, clinical diagnosis and antibiotic treatment

“…Infections due to resistant Gram-negative bacteria are a growing concern worldwide. Published data from Ghana, Tanzania, South Africa and India have reported resistance rates to amoxicillin of 72-95%, co-trimoxazole (90%), gentamicin (13-80%), co-amoxiclav (20-80%), chloramphenicol (40-65%), fluoroquinolones (10-30%) and third-generation cephalosporins (19-25%) [97][98][99].…”

Healthcare Associated Infection in the Neonatal Intensive Care Unit of King Abdl Aziz Specialist Hospital, Taif, KSA

“…These perfect control measures require proper epidemiological studies and tracing of infection [14]. The principal method of diagnosing sepsis is the isolation of causative organisms from blood cultures and antimicrobial susceptibility testing [15,16]. Results are usually available between 48 -72 hours after specimen collection and therefore, initial antimicrobial treatment has been usually empirical with the aim that the most likely pathogens would be susceptible to the chosen drugs [15].…”

“…The principal method of diagnosing sepsis is the isolation of causative organisms from blood cultures and antimicrobial susceptibility testing [15,16]. Results are usually available between 48 -72 hours after specimen collection and therefore, initial antimicrobial treatment has been usually empirical with the aim that the most likely pathogens would be susceptible to the chosen drugs [15]. Therefore, this study was conducted in order to investigate the epidemiological characteristics of HAI in the aspects of infection rate, common pathogens and risk factors in our NICU in order to guide empirical therapy and improve better preventive measures.…”