Okomo Uduak A, Garba Danlami, Fombah Augustin E, Secka Ousman, Ikumapayi Usman N A, Udo Jacob J, Ota Martin O C
Medical Research Council (UK) Laboratories, Atlantic Road, Fajara, P.O. Box 273, Banjul, Gambia.
Int J Pediatr. 2011;2011:825123. doi: 10.1155/2011/825123. Epub 2011 Jul 14.
Background. Establishing the pattern of infection and antimicrobial sensitivities in the local environment is critical to rational use of antibiotics and the development of management algorithms. Methods. Morbidity history and physical examination of 140 children with severe acute malnutrition were recorded. Their blood, stool, and urine samples were cultured and antibiotic sensitivity patterns determined for any bacterial pathogens isolated. Results. Thirty-eight children had a pathogen isolated from blood culture, 60% of which were considered contaminants. Coagulase negative staphylococcus was the predominant contaminant, while the major causes of bacteraemia were nontyphoidal Salmonella (13%), S. pneumoniae (10%), and E. coli (8%). E. coli accounted for 58% of the urinary isolates. No pathogen was isolated from stool. In vitro sensitivity by disk diffusion showed that 87.5% of the isolates were sensitive to ampicillin and/or gentamicin and 84.4% (27/32) to penicillin and/or gentamicin. Conclusions. A combination of ampicillin and gentamicin provides adequate antibiotic cover for severely malnourished children in The Gambia.
背景。确定当地环境中的感染模式和抗菌药物敏感性对于合理使用抗生素以及制定管理方案至关重要。方法。记录了140名重度急性营养不良儿童的发病史和体格检查情况。对他们的血液、粪便和尿液样本进行培养，并确定分离出的任何细菌病原体的抗生素敏感性模式。结果。38名儿童的血培养分离出病原体，其中60%被认为是污染物。凝固酶阴性葡萄球菌是主要污染物，而菌血症的主要原因是非伤寒沙门氏菌（13%）、肺炎链球菌（10%）和大肠杆菌（8%）。大肠杆菌占尿液分离株的58%。粪便中未分离出病原体。纸片扩散法体外药敏试验显示，87.5%的分离株对氨苄西林和/或庆大霉素敏感，84.4%（27/32）对青霉素和/或庆大霉素敏感。结论。氨苄西林和庆大霉素联合使用可为冈比亚重度营养不良儿童提供足够的抗生素覆盖。
