Multi-Drug Resistant Bacterial Isolates Among Septicemia Suspected Under Five Children In Tikur Anbesa Specialized Hospital, Addis Ababa Ethiopia
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Date
2018-07
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Addis Ababa Universty
Abstract
Background: Bloodstream infections due to bacterial pathogens are a major cause of morbidity
and mortality among pediatric patients. Emergence of drug resistance in high classes of
antibiotics among the bacterial pathogens is another issue of the public health concern.
Objective: To determine Multi-Drug Resistant Bacterial Isolates among Septicemia Suspected
under Five Children in Tikur Anbesa Specialized Hospital, Addis Ababa Ethiopia.
Methods: Across-sectional study was conducted from September 2017 to June 2018 among
pediatric patients with febrile illness aged under five in Tikur Anbesa Specialized Hospital.
Three hundred forty blood samples were collected and processed following standard
microbiological techniques and culture was performed using BacT/Alert machine in combination
with conventional method. Antimicrobial susceptibility testing of the isolates was performed by
Kirby-Bauer disc diffusion method and MIC technique
Result: A total of 137(40.2%) bacterial pathogens were isolated from 340 pediatric patients
suspected of BSI with febrile illness. Of these isolates, about 46% of them were Gram positive
and 54% were Gram negative bacteria. Of the isolates 43 (31.4%) Klebsiella pneumoniae,
29(21.2%) S. aureus, 15(10.9%) CoNS and 12 (8.7%) Acinitobactor species were the most
frequently isolated pathogens. The overall prevalence of MDR 51.1%, CRE 30.5% and ESBL
25.4% were alarmingly high in bacterial isolates. Klebsiella pneumoniae isolates were 95.6%
MDR, 23.7% ESBL, and 27.1% CRE dominated followed by Staphylococcus aureus 55.2%
MRSA in children.
Conclusion and Recommendation:
In this study, Klebsiella pneumoniae and S. aureus are common pathogens associated with BSI
in pediatrics with high antimicrobial resistance. High frequency of staphylococcus species and
MRSA were a treat of children. Emergency of an intermediate vancomycin susceptibility of an
isolate among MRSA calls an attention on treatment options. ESBL producing organisms were
common in Klebsiella species and Escherichia coli isolates. Since most of isolates exhibit
multidrug resistant, routine in-vitro susceptibility of antimicrobials and update antibiogram for
treatment is essential.
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Keywords
Blood stream infection, BacT/Alert, multi-drug resistance, ESBL, MRSA, CRE, VRSA