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.
Highlights
Bloodstream infections in neonates and infants are life-threatening emergencies
This initiative is undermined by the fact that the spectrum of bacteria and their susceptibility patterns may vary over time, depending on the prevailing conditions such as patient population, antimicrobial drug usage and healthcare worker’s infection control practices
In order to guide empirical therapy, this study reports on bacterial isolates and their susceptibility to commonly-used antimicrobial agents in the empirical treatment of suspected bacterial septicaemia in children presenting at the Tamale Teaching Hospital
Summary
Bloodstream 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. Blood culture and antimicrobial susceptibility testing results are usually available between 48-72 hours after the specimen is obtained and initial antimicrobial treatment has been usually empirical with the aim that the most likely pathogens would be susceptible to the chosen drugs [5] This initiative is undermined by the fact that the spectrum of bacteria and their susceptibility patterns may vary over time, depending on the prevailing conditions such as patient population, antimicrobial drug usage and healthcare worker’s infection control practices. If not monitored, this could lead to inappropriate use of antibiotics and a subsequent increase in antimicrobial resistant organisms [13,14,15]. In order to guide empirical therapy, this study reports on bacterial isolates and their susceptibility to commonly-used antimicrobial agents in the empirical treatment of suspected bacterial septicaemia in children presenting at the Tamale Teaching Hospital
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