Aerobic and facultative bacterial isolates from blood cultures of children with clinically diagnosed septicaemia
Odhiambo, F.A.; Wamola, I.A.; Ndinya-Achola, J.O.
East African Medical Journal 68(11): 869-874
1991
ISSN/ISBN: 0012-835X PMID: 1800080 Document Number: 376039
Between March 1987-January 1988, physicians enrolled 60 pediatric patients with a fever who were admitted to the Kenyatta National Hospital in Nairobi, Kenya for various clinical conditions in a study to determine the types, frequency, and antibiotic sensitivity patterns of aerobic and facultative bacterial isolates. Most of the patients were 13 months-4 years old (45%). 31.7% of the patients had positive blood cultures. Staphylococcus aureus was the 2nd most common bacteria (15.8%) among these patients. Laboratory personnel isolated Salmonella typhimurium in most patients (63%). In fact, during the same period, the Diagnostic Microbiology Laboratory at the hospital identified Salmonella species in 48% of all isolated bacteria and 35% of these were S. typhimurium. S. typhimurium tended to be present in children with gastroenteritis (41.8%) or a fever of unknown origin (33.3%). S. typhimurium was very sensitive to amikacin and cefotaxime, but resistant to ampicillin and sulfamethoxazole-trimethoprim. Health workers in Kenya have frequently administered ampicillin and sulfamethoxazole-trimethoprim, but not amikacin and cefotaxime. 67% of the strains of S. typhimurium were resistant to gentamicin and 33% to chloramphenicol. These results along with those of other reports from this hospital indicated a dramatic rise in Gram negative bacteria resistance to antibiotics. Therefore physicians should no longer consider gentamicin as a 1st line antibiotic in treating suspected septicemia patients.