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  • Title: Aerobic and facultative bacterial isolates from blood cultures of children with clinically diagnosed septicaemia.
    Author: Odhiambo FA, Wamola IA, Ndinya-Achola JO.
    Journal: East Afr Med J; 1991 Nov; 68(11):869-74. PubMed ID: 1800080.
    Abstract:
    A total of 120 sets of blood cultures were performed aerobically from 60 children with clinically diagnosed septicaemia at Kenyatta National Hospital, Nairobi. Out of these, 36 (30%) sets from 19 (31.7%) patients yielded bacterial growth while 84 (70%) sets from 41 (68.3%) were negative. Salmonella typhimurium was the most frequently isolated bacteria (63%), followed by Staphylococcus aureus (15.8%). Salmonella typhimurium isolates were mostly multi-antibiotic resistant, most of them only sensitive to amikacin and cefotaxime, while all were resistant to ampicillin and co-trimoxazole, the most frequently used antibiotic in this hospital. 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.
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