Baiye William Abange
Yaounde University Teaching Hospital Cameroon
Biography:
Abstract:
Background: Rapid and accurate diagnosis of bacterial bloodstream infection is strategic for the survival of the patient.
Methods: We carried out a cross sectional study on hospitalised patients suspected of bloodstream infections from May to June 2017 in the Yaounde University Teaching Hospital. Blood blood culture were collected from 154 patients in four different units; neonatal unit (58), pediatric ward (56), surgical ward (22) and emergency ward (18). We used the conventional classical gallery to identify the different positive culture/isolates then later using the Kirby-Bauer disc diffusion method for antimicrobial susceptibility testing.
Results: Out of the 154 patients enrolled, 45(29.22%) were positive for blood culture. 37 (82.22%) of these bloodstream infections were hospital acquired, with higher prevalence at neonatal unit 19/45 (42.22%). We identified more Gram positive cocci in clusters 30(66.67%), coagulase negative Staphylococcus 18(40%), and Staphylococcus aureus 12(26.67%) than Gram negative bacilli 15(33.33%); Klebsiella pneumonia 7(15.56%), Enterobacter spp. 6(13.33%), Escherichia coli 1(2.22%) and Citrobacter spp. 1(2.22%). The Staphylococci spp. were resistant to cefoxitine 53.33%, amoxicillin (50%), tobramycine (33.33%), gentamycin (26.67%), vancomycin (23.33%), erythromycin (20%), clindamycine (20%), and lincomycine (20%), amox + clav (16.67%). No D-zone observe for the resistant induced to clindamycin by erythromycin. Our study registered 53.33% MRSA and 33.33% VRSA and low resistance to aminoglycosides. Gram negative bacilli-enterobacteriaceae were more commonly resistant to the fluoroquinolones (ofloxacine (53.33%), ciprofloxacine (40%), nalidixic acid (33.33%)), the beta lactamines (Cefotaxime (40%), amox + clav (33.33%), cefuroxime (26.67%) and imipenem (6.67%)) and the aminoglycosides (gentamicine 20%).
Conclusion: The study therefore revealed that bloodstream infection was hospital acquired, and caused by Gram positive bacteria. Neonatal unit was mostly implicated. MRSA remain a big problem in our context. No D-zone observed and emergence of VRSA. Enterobacteriaceae produced increased resistant rate to fluroquinolones and beta lactamines (beta lactamases producing strains) and one registered strain producing carbapenemases.