Causative Organisms Of Septicaemia in Infants and Neonates and thier Antibiotic Sensitivity in Three Hospitals In Khartoum State
Causative Organisms Of Septicaemia in Infants and Neonates and thier Antibiotic Sensitivity in Three Hospitals In Khartoum State
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Date
2005
Authors
Wanasi Hamouda Hamdoon
Journal Title
Journal ISSN
Volume Title
Publisher
University of Khartoum
Abstract
Review of medical literature indicated that neonatal Septicemia
remains a major problem in the field of neonatal medicine . It has been
demonstrated by many investigations that people who have natural or
aquired immunodeficiency are predisposed to infection .
It is also indicated that protein deficiency causes profound changes
in many organs including the immune system. Malnourished people
show an increased incidence of infectious diseases, impaired specific
antibody, and defects in cell –mediated immunity .
The study was carried in the periodbetween June 2001 up to March
2003 . It is a trial toidentify the microorganisms causing septicemia in
neonates and infants below one year of age . The influence of the
levels of immunoglobulin M and immunoglobulin G on the incidence
of septicemia was investigated .
The study included the isolation and identification of 98 bacterial
strains from patients in three hospitals .38 isolates
( 38.8 % ) recovered from cases from patients in Ahmed Gasim
Teaching Hospital , 33 isolates (33.7 % ) from the cases from
patients in Omdurman pediatric Hospital,and (27) isolates (27.5% )
from patients in Maternity Teaching Hospital.
These isolates were identifiedaccording to their cultural
characteristics , microscopical examinations and gram stain in
addition to the biological tests . API 20 identification system was used
for gram negative isolates ,
Gram positive isolates recovered represent 79 % of the isolates
whereas gram negative isolates represent 21 % of the isolates .
The Predominant isolates recovered from these cases were found to
be Staphylococcus aureus 74 isolate ( 76 % ) , followed by
Pseudomonas aeruginosa 12 isolates ( 12 %)
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Escherichia coli 9 isolates (9 %) and Staphylococcus epidermidis 3
isolates ( 3 % ) .
It was found that earlyonset sepsis 53 % ( septicemia for neonates
below 6 days of age ) was more prominent than late onset sepsis
(47 %) (septicemia for neonatesover 6 days of age .
Gram positive bacteria were found to be slightly higher in late
onset sepsis ( 85 %) than early onset sepsis (72 % ) .
Staphylococcus aureus was prominent in both early and late
onset sepsis ( 70 %) & ( 81 % ) respectively , whereas two
isolates of Staphylococcus epidermidis were found in late onset
sepsis (4 % ) and only one isolate in early onset sepsis (2 % ) .
Gram negative bacteria ,were higher in early sepsis ( 28% ) than late
sepsis (15 % ) . Pseudomonas aeruginosa was found in ( 14% ) of
cases in early onset sepsis and ( 11 %) in late onset sepsis .
E.coli was found in ( 14% ) of cases in early onset sepsis and ( 4
% ) of late onset sepsis .
Using Kirby- Bauer method , isolates were examined for their
susceptibility to ten commonly used antimicrobial agents including :
Amoxycillin , Cephalexin , Cephradine ,Ceftriaxone Ciprofloxacin ,
Ceftizoxime , Gentamicin, Kanamycin, and Amoxycillin/ Clavulanic
acid and Penicillin G .
Escherichia coli isolates showed moderate resistance , to most of the
antibiotics used , the percentage of resistance is less than 23 % . On
the other hand 31 % of Staphyllococcus aureus isolates were resistant
to five of the ten antimicrobial agenst used .
Pseudomonas aeruginosa showed a percentage of resistance less than
25 % to six of the ten antimicrobial agents .
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The Staphylococcus epidermidis isolates were the most resistant
isolates , where 33.3% of them were completely resistent to seven of the
antimicrobial agents used .However all the isolates were higley
susceptible to the remaining three antimicrobial agents .
The study also includedthe measurement of the levels of the two
major immunoglobulins in the human blood stream namely
immunoglobulin G and immunoglobulin M for the cases with
positive blood culture . using spectrophotometry
( turbidimetry )
It has been found that most of the I g M levels are within the levels
of controls and the standards .using the latteras reference .
Concerning the levels of the I g G , it has been found that if the
standard levels were taken as a measure , 19 cases will be found to
be substandard , and immunodeficiency will be suspected .
However ,when control levels weretaken as a measure and the
standard levels were neglected , only four cases would be suspected
to be immunodefficient
Description
A Thesis Submitted to the University of Khartoum For The Degree Of Master Of Pharmacy
Keywords
Septicaemia
Infants
Neonates
Antibiotic Sensitivity
Hospital
University of Khartoum
Pharmaceutics
Citation
Wanasi Hamouda Hamdoon, Causative Organisms Of Septicaemia in Infants and Neonates and thier Antibiotic Sensitivity in Three Hospitals In Khartoum State .- Khartoum : University of Khartoum, 2005 .- 124p. : illus., 28cm., M.S