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Abstract：
BACKGROUND: Sepsis is one of the major causes of morbidity and mortality among pediatric patients throughout the world. The varying microbiological pattern of sepsis warrants the need for researches on the causative organisms and their antimicrobial susceptibility pattern. The epidemiology of neonatal and pediatric sepsis in Ethiopia is under-research. The objective of this study was to evaluate the burden of bacterial pathogens and their antimicrobial susceptibility patterns among children suspected of sepsis.
METHODS: An institutional-based prospective cross-sectional study was conducted on 370 pediatric(age birth-15 years) patients suspected of sepsis at the University of Gondar Comprehensive Specialized hospital from December 2020 to November 2021. Blood samples were collected aseptically and inoculated into Tryptone Soya Broth for culture. The organisms grown were identified by standard microbiological methods and subjected to antibiotic susceptibility testing by modified Kirby-Bauer disk diffusion method recommended by Clinical laboratory and standard institute. Methicillin resistance was confirmed using Cefoxitin disk diffusion method. Data entry and analysis were done using Statistical Package for Social Sciences (SPSS) version 26 software. A p-value less than 0.05 at 95% confidence interval was considered statically significant.
RESULTS: Out of the total 370 study subjects, 21.6% (80/370) of them were culture positive. Of these, 43 (53.8%) and 37 (46.3%) were Gram-positive and Gram-negative bacterial pathogens, respectively. The most prevalent Gram-positive bacterial isolate was Staphylococcus aureus (n = 24; 30%) and coagulase negative staphylococci (n = 7; 8.8%). Among the Gram-negative bacterial isolates, the leading bacteria was Klebsiella pneumoniae (n = 20; 25%) followed by Escherichia coli (n = 7; 8.8%). Clindamycin, Chloramphenicol, Gentamicin and Ciprofloxacin were the most effective antibiotics against Gram-positive bacterial isolates while Amikacin, Meropenem and Chloramphenicol were effective against Gram-negative pathogens. Methicillin resistance was detected in 45.8% of Staphylococcus aureus. Multi-drug resistance (MDR) antimicrobial susceptibility pattern was observed in 76% of the bacterial isolates.
CONCLUSIONS: Gram positive bacteria were the predominant isolates among pediatric sepsis cases and most of the bacterial isolates showed MDR. Staphylococcus aureus and Klebsiella pneumoniae were frequently isolated bacteria. The high prevalence of drug resistance warrants rational use of antibiotics and the need for regular antibiotic susceptibility surveillance studies.
METHODS: An institutional-based prospective cross-sectional study was conducted on 370 pediatric(age birth-15 years) patients suspected of sepsis at the University of Gondar Comprehensive Specialized hospital from December 2020 to November 2021. Blood samples were collected aseptically and inoculated into Tryptone Soya Broth for culture. The organisms grown were identified by standard microbiological methods and subjected to antibiotic susceptibility testing by modified Kirby-Bauer disk diffusion method recommended by Clinical laboratory and standard institute. Methicillin resistance was confirmed using Cefoxitin disk diffusion method. Data entry and analysis were done using Statistical Package for Social Sciences (SPSS) version 26 software. A p-value less than 0.05 at 95% confidence interval was considered statically significant.
RESULTS: Out of the total 370 study subjects, 21.6% (80/370) of them were culture positive. Of these, 43 (53.8%) and 37 (46.3%) were Gram-positive and Gram-negative bacterial pathogens, respectively. The most prevalent Gram-positive bacterial isolate was Staphylococcus aureus (n = 24; 30%) and coagulase negative staphylococci (n = 7; 8.8%). Among the Gram-negative bacterial isolates, the leading bacteria was Klebsiella pneumoniae (n = 20; 25%) followed by Escherichia coli (n = 7; 8.8%). Clindamycin, Chloramphenicol, Gentamicin and Ciprofloxacin were the most effective antibiotics against Gram-positive bacterial isolates while Amikacin, Meropenem and Chloramphenicol were effective against Gram-negative pathogens. Methicillin resistance was detected in 45.8% of Staphylococcus aureus. Multi-drug resistance (MDR) antimicrobial susceptibility pattern was observed in 76% of the bacterial isolates.
CONCLUSIONS: Gram positive bacteria were the predominant isolates among pediatric sepsis cases and most of the bacterial isolates showed MDR. Staphylococcus aureus and Klebsiella pneumoniae were frequently isolated bacteria. The high prevalence of drug resistance warrants rational use of antibiotics and the need for regular antibiotic susceptibility surveillance studies.
摘要：
背景：脓毒症是全世界儿科患者发病和死亡的主要原因之一。脓毒症的微生物学模式各不相同，因此有必要对致病生物及其抗菌敏感性模式进行研究。埃塞俄比亚新生儿和小儿败血症的流行病学正在研究中。这项研究的目的是评估怀疑败血症的儿童中细菌病原体的负担及其抗菌药物敏感性模式。
方法：一项基于机构的前瞻性横断面研究于2020年12月至2021年11月在冈达尔大学综合专科医院对370名疑似脓毒症的儿科（年龄-15岁）患者进行。无菌收集血液样品并接种到胰蛋白内酯大豆肉汤中进行培养。通过标准微生物学方法鉴定生长的生物，并通过临床实验室和标准研究所推荐的改良Kirby-Bauer圆盘扩散方法进行抗生素敏感性测试。使用头孢西丁纸片扩散法确认甲氧西林抗性。使用社会科学统计软件包（SPSS）版本26软件进行数据输入和分析。在95%置信区间小于0.05的p值被认为是静态显著的。
结果：在总共370个研究对象中，其中21.6%(80/370)为培养阳性。其中,革兰阳性和革兰阴性病原菌43例(53.8%)和37例(46.3%),分别。最普遍的革兰氏阳性细菌分离物是金黄色葡萄球菌(n=24;30%)和凝固酶阴性葡萄球菌(n=7;8.8%)。在革兰氏阴性细菌分离物中，主要细菌是肺炎克雷伯菌（n=20;25％），其次是大肠杆菌（n=7;8.8％）。克林霉素,氯霉素,庆大霉素和环丙沙星是针对革兰氏阳性菌分离株最有效的抗生素，而阿米卡星，美罗培南和氯霉素对革兰氏阴性病原体有效。金黄色葡萄球菌对甲氧西林耐药率为45.8%。在76％的细菌分离物中观察到多药耐药（MDR）抗菌药物敏感性模式。
结论：在小儿脓毒症病例中，革兰阳性菌是主要分离菌，大多数分离菌表现为MDR。金黄色葡萄球菌和肺炎克雷伯菌是常见的分离细菌。耐药性的高患病率保证了合理使用抗生素和需要定期进行抗生素敏感性监测研究。
方法：一项基于机构的前瞻性横断面研究于2020年12月至2021年11月在冈达尔大学综合专科医院对370名疑似脓毒症的儿科（年龄-15岁）患者进行。无菌收集血液样品并接种到胰蛋白内酯大豆肉汤中进行培养。通过标准微生物学方法鉴定生长的生物，并通过临床实验室和标准研究所推荐的改良Kirby-Bauer圆盘扩散方法进行抗生素敏感性测试。使用头孢西丁纸片扩散法确认甲氧西林抗性。使用社会科学统计软件包（SPSS）版本26软件进行数据输入和分析。在95%置信区间小于0.05的p值被认为是静态显著的。
结果：在总共370个研究对象中，其中21.6%(80/370)为培养阳性。其中,革兰阳性和革兰阴性病原菌43例(53.8%)和37例(46.3%),分别。最普遍的革兰氏阳性细菌分离物是金黄色葡萄球菌(n=24;30%)和凝固酶阴性葡萄球菌(n=7;8.8%)。在革兰氏阴性细菌分离物中，主要细菌是肺炎克雷伯菌（n=20;25％），其次是大肠杆菌（n=7;8.8％）。克林霉素,氯霉素,庆大霉素和环丙沙星是针对革兰氏阳性菌分离株最有效的抗生素，而阿米卡星，美罗培南和氯霉素对革兰氏阴性病原体有效。金黄色葡萄球菌对甲氧西林耐药率为45.8%。在76％的细菌分离物中观察到多药耐药（MDR）抗菌药物敏感性模式。
结论：在小儿脓毒症病例中，革兰阳性菌是主要分离菌，大多数分离菌表现为MDR。金黄色葡萄球菌和肺炎克雷伯菌是常见的分离细菌。耐药性的高患病率保证了合理使用抗生素和需要定期进行抗生素敏感性监测研究。
