Bacterial Blood Isolates in Children: Conventional vs. Bactec Automated Blood Culture System in a Tertiary Health Centre in Gombe, North East Nigeria

Abstract

Background/Aim: Blood culture is critical in the diagnosis and treatment of blood stream infections (BSIs) especially in children. BSIs are among the most common cause of morbidity/mortality and blood culture has remained the gold standard for diagnosis. We sought to compare Blood Culture Isolates (BCI) from conventional and Bactec automated blood culture system (ABCS) among paediatric patients at the Federal Teaching Hospital Gombe (FTHG) Nigeria. Methods: BCI in children (0 - 18 years) by conventional method from 2008-2012 and Bactec Automated culture system from 2015-2020 were retrieved from the clinical microbiology laboratory register. Information analyzed included, age, sex, month, and year and blood culture isolates. Results: There were 5276 (56.9% males, 43.1% females) and 1169 (54% males, 46% females) Blood Culture Isolates by CM and ABCS respectively. Overall positive culture isolates were 9.7% (515/5276) in CM and 45.9% (536/1169) in ABCS (p = 0.01). Positivity rate in newborn was 13.3% (282/2114) by CM and 40.9% (219/263) by ABCS p = 0.01; under-5 was 10.5% (448/4253) vs. 37% (359/873) (p = 0.01); Gram positive 32.6% (172) vs. 65% (759) (p = 0.01; Gram negative 55% (2910) vs. 34% (397) (p = 0.01). Staph aureus 22% (114/515) by CM vs. 61.9% (332/536)) by ABCS (p = 0.01); Klebsiella 24.9% (128/515) by CM vs. 7.5% (40/536) p = 0.01) in ABCS, E. coli 8.9% (46/515) vs. 2.1% (11/536) p = 0.01; Proteus vs. 1.1% (6/515) by ABCS, Pseudomonas 3.3% (17/515) vs. 5.6% (30/536) p = 0.05, Alkaligenes 1% (5/515) vs. 8.2% (44/536) p = 0.01 and Citrobacter 1% (5/515) vs. 8.4% (45/536) p = 0.01. Conclusion: Blood culture yield was five times higher with Bactec compared with Conventional method.