Bacterial profile, antimicrobial Sensitivity pattern and outcome of blood stream infection among febrile patients at Zewditu Memorial Hospital, Addis Ababa, Ethiopia
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Date
2021-06
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Addis Abeba University
Abstract
Abstract:
Background: Throughout the world infectious disease like bloodstream infection become a
major cause of morbidity and mortality. The excessive and irrational use of antibiotics has led to
an increase in the multidrug-resistant and thus worsened the condition.
Objective: To determine Bacterial profile, antimicrobial susceptibility pattern of blood stream
isolates, and mortality of febrile patients admitted at Zewditu Memorial Hospital, Addis Ababa,
Ethiopia
Methods: A cross-sectional and prospective observational study was performed in 198 febrile
patients at Zewditu Memorial hospital from May to Dec, 2019. Demographic and clinical data
were collected by interviewing patients, reviewing medical records and outcome was followed
until their discharge or death. Venous blood was collected aseptically into TSB, incubated at 35
+2°C and checked for sign of bacterial growth. Bottles which showed signs of growth were
further sub-culturedon chocolate agar, blood agar,macconkey agar. Bacterial isolates were
identified by colony morphology, gram staining reaction, and biochemical. Kirby Bauer disc
diffusion technique was used to test Antibiotic susceptibility. Multiple Logistic regression
analysis was used to see the association between variablesusing SPSS software version 20.
Results: A total of 198 blood cultureswere performed fromfebrile inpatients of ZMH of those
93(47%) were females and 105(53%) were males with the age range of 1 day to 8 years. From
the total 43(21.7%) showed bacterial growth. The gram positive and negative bacteria accounted
for 69.7% (30/43) and 30.3 %( 13/43)respectively. The commonest gram positive organisms
were S.aureus 20 (66.66%).Among gram negative isolates the most predominate organisms were
K.pneumonia 6(46.1%). For gram positive bacteria Penicillin and Trimethoprimsulphamethoxazole
showed highest resistance andComplete Sensitivity were seen for
Vancomycin in all the isolate.Relatively 80(%) of gram negative isolates expressed susceptibility
towards Amikacin andhighest resistancewere seen in Trimethoprim- sulphamethoxazole.
Mortality among patients with positive culture was 51.1% (22/43), which was higher than
mortality recorded for patients with negative blood culture 14.8% (23/155).
Conclusion: In this study high prevalence of septicemia and greater resistances of antibiotic
which increase the mortality risk three fold was found in the hospital settings. Therefore special
attention has to be given to infection prevention control and antibiotic prescription policy
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Keywords
Blood stream infection, bacterial isolate, drug resistance, Mortality