Ali Jemal, Kebede Yenew
Department of Medical Microbiology and Parasitology, Faculty of Medicine, University of Gondar, P.O. Box 196, Gondar, Ethiopia.
Ethiop Med J. 2008 Apr;46(2):155-61.
Bacterial bloodstream infections cause substantial morbidity and mortality, with up to one-quarter of affected patients dying as a result of their infection. Up-to-date information on blood culture isolates and their antimicrobial susceptibility pattern is very important as guide for immediate prescription of antimicrobial agents and monitoring of emergence of drug resistant strains.
To determine the frequency of blood culture isolation and antimicrobial susceptibility pattern of isolates in Gondar University teaching hospital.
This was retrospective analysis of records of blood culture results for febrile patients seen at Gondar University teaching hospital, bacteriology section from March 2001 to April 2005.
During the four years period, blood cultures were done for a total of 472 febrile patients. Among these, 233 (49.4%) were females and 239 (50.6%) were males. The median age was 20.5 years (age range of 2 hours to 78 years). Out of these, total of 114 bacterial strains were isolated with culture positivity rate of 24.2%. Coagulase-negative Staphylococci (CoNS) were isolated with the highest frequency in 38 (33.3%), followed by Staphylococcus aureus in 34 (29.8%), Salmonella species other than Salmonella typhi in 12 (10.5%), Klebsiella species in 10 (8.8%), Streptococcus pneumoniae in 6 (5.3%), Salmonella typhi in 4 (3.5%), Enterobacter species in 3 (2.6%), Escherichia coli in 2 (1.7%). The gram positive and gram negative bacteria constituted 80 (70.2%) and 34 (29.8%) of the culture isolates, respectively. Culture positivity rates vary as for neonates, 63% (17 out of 27);followed by 25.6% (36 out of 141) in children and 20% (61 out of 304) in adults. The isolates especially gram negative bacteria showed multiple drug resistance, to Ampicillin and penicillin. However, ciprofloxacin is fairly effective against both gram negative and gram positive isolates.
An effective documented data may serve as a guide for initial empirical treatment of bloodstream infections but in view of these findings the presented data is only imperative to do large-scale prospective and quantitative studies. More importantly, an ongoing surveillance for antimicrobial susceptibility is of the essence to enhance efforts to identify resistance and attempt to limit its spread.
细菌血流感染会导致严重的发病和死亡，多达四分之一的受感染患者会因感染而死亡。有关血培养分离株及其抗菌药敏模式的最新信息对于指导抗菌药物的即时处方和监测耐药菌株的出现非常重要。
确定贡德尔大学教学医院血培养分离的频率及分离株的抗菌药敏模式。
这是对2001年3月至2005年4月在贡德尔大学教学医院细菌学科室就诊的发热患者血培养结果记录的回顾性分析。
在这四年期间，共对472名发热患者进行了血培养。其中，女性233名（49.4%），男性239名（50.6%）。中位年龄为20.5岁（年龄范围为2小时至78岁）。其中，共分离出114株细菌菌株，培养阳性率为24.2%。凝固酶阴性葡萄球菌（CoNS）分离频率最高，为38株（33.3%），其次是金黄色葡萄球菌34株（29.8%），非伤寒沙门氏菌12株（10.5%），克雷伯菌属10株（8.8%），肺炎链球菌6株（5.3%），伤寒沙门氏菌4株（3.5%），肠杆菌属3株（2.6%），大肠杆菌2株（1.7%）。革兰氏阳性菌和革兰氏阴性菌分别占培养分离株的80株（70.2%）和34株（29.8%）。培养阳性率因人群而异，新生儿为63%（27例中的17例）；儿童为25.6%（141例中的36例），成人则为20%（304例中的61例）。分离株尤其是革兰氏阴性菌对氨苄西林和青霉素表现出多重耐药性。然而，环丙沙星对革兰氏阴性菌和革兰氏阳性菌分离株都相当有效。
有效的记录数据可作为血流感染初始经验性治疗的指导，但鉴于这些发现，所呈现的数据仅迫切需要进行大规模前瞻性和定量研究。更重要的是，持续监测抗菌药敏情况对于加强识别耐药性并试图限制其传播的努力至关重要。
