TITLE:
Trends in Bacterial Blood Culture Isolates and Resistance in Children in Two Microbiologic Eras from a Tertiary Health Facility in North East Nigeria
AUTHORS:
Elon Warnow Isaac, Iliya Jalo, Mohammed M. Manga, Abubakar Joshua Difa, Mercy Raymond Poksireni, Oyeniyi Christianah, Ibrahim Mohammed, Muhammad Saminu Charanci
KEYWORDS:
Trend, Blood Culture Isolates, Children, Manual, Bactec, Resistance
JOURNAL NAME:
Open Journal of Medical Microbiology,
Vol.13 No.2,
June
30,
2023
ABSTRACT: Introduction: Antimicrobial Resistance
surveillance is predicated on blood culture as a priority clinical specimen in especially
resource limited settings. Establishing trends in blood stream infections and resistance
patterns can inform institutional and national policy on antimicrobial stewardship,
surveillance, infection prevention and control. Methodology: Blood Culture
isolates in children (0 - 18 years) by conventional method from 2008-2012 and Bactec Automated culture
system from 2015-2020 were retrieved. Information analyzed included age, sex, month,
and year and culture growth/identity of microorganisms and their sensitivity/resistance
patterns. Clinical and Laboratory Standards Institute (CLSI) guideline for antibiotic
susceptibility testing was used. Results: 20,540 children were admitted: 8964 (44.6%) and 11,630 (55.4%) in the Manual and Bactec
blood culture era respectively. Blood cultures were done in 5271 in the manual culture
era and 1077 in the Bactec culture era; of these
cultures, 514 (9.7%) and 461 (42.8%) were positive for isolates in the respective era (p = 0.01). There were no statistically significant
differences in trend between positive and negative blood cultures in males
and females. Newborns, followed by children 1 - 5 years had more blood culture performed on them than other age categories.
In general, there is no significant relationship in blood culture outcomes
between the age categories and sex of the patients. The isolation of Staph aureus, Citrobacter and Alkaligenes increased two-fold with Bactec automated system. Resistance to the quinolones and
the penicillin was high. Resistance trend to Genticin, an aminoglycoside was less than 40%. Resistance
to Ceftazidime was high. Conclusion: Antimicrobial resistance surveillance is critical to reduce AMR related morbidity and mortality.