Samuel S O, Fadeyi A, Akanbi A A, Ameen N B, Nwabuisi C, Onile B A
Department of Medical Microbiology, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria.
Afr J Med Med Sci. 2006 Jun;35(2):137-41.
Periodic bacteriologic surveillance of blood cultures is a necessity. To determine currently prevalent bacterial pathogens of blood cultures in patients with suspected septicaemia in Ilorin. Nigeria. Three thousand and fifty-seven patients from all age and sex groups with clinical suspicion of septicaemia underwent bacteriologic screening of their blood specimen over a 13 month period starting from January. 2003. Twenty point three percent were positive for bacterial growth. An incidence of 41.7 per 1000 admissions was recorded which was a statistically significant (p< 0.05) marginal increase when compared with the previous incidence of 37.9 per 1000 admissions from this centre. Majority of the isolates were gram negative (51.61%) though the single predominant isolate was Staphylococcus aureus (35.85%). Other isolates included Escherichia coli (32.48%), Klebsiella pneumoniae (11.74%), Proteus spp (0.32%), coagulase negative Staphylococcus (1.61%), Salmonella typhi (0.48%). beta-hemolytic Streptococcus (0.48%) and Acinetobacter spp (0.32%). No anaerobe was isolated. Most isolates were sensitive to fluoroquinolones (ofloxacin, perfloxacin and ciprofloxacin) and third generation cephalosporins (ceftriaxone and ceftazidime) except Acinetobacter that was 100% resistant to both groups of antibiotics. Gram positive isolates were resistant to the second generation cephalosporin, cefuroxime. We hereby recommend the use of combination of a third generation cephalosporin and fluoroquinolones where not contraindicated, in the empiric treatment of septicaemia before sensitivity results are available.
定期对血培养进行细菌学监测是必要的。为了确定尼日利亚伊洛林疑似败血症患者血培养中当前流行的细菌病原体。从2003年1月开始的13个月期间,对3057名各年龄和性别的临床疑似败血症患者的血标本进行了细菌学筛查。20.3%的患者血培养细菌生长呈阳性。记录到每1000例入院患者中有41.7例发病,与该中心之前每1000例入院患者37.9例的发病率相比,这是一个具有统计学意义(p<0.05)的小幅上升。大多数分离株为革兰氏阴性菌(51.61%),尽管单一最主要的分离株是金黄色葡萄球菌(35.85%)。其他分离株包括大肠杆菌(32.48%)、肺炎克雷伯菌(11.74%)、变形杆菌属(0.32%)、凝固酶阴性葡萄球菌(1.61%)、伤寒沙门菌(0.48%)、β溶血性链球菌(0.48%)和不动杆菌属(0.32%)。未分离到厌氧菌。大多数分离株对氟喹诺酮类(氧氟沙星、培氟沙星和环丙沙星)和第三代头孢菌素(头孢曲松和头孢他啶)敏感,除不动杆菌对这两类抗生素均100%耐药。革兰氏阳性分离株对第二代头孢菌素头孢呋辛耐药。在此,我们建议在获得敏感性结果之前,在无禁忌证的情况下,使用第三代头孢菌素和氟喹诺酮类药物联合进行败血症的经验性治疗。