Bacteriologic Profile, Antibiotic Regimen and Clinical Outcome of Neonatal Sepsis in a University Teaching Hospital in North Central Nigeria

Onyedibe, Kenneth I.; Bode‐Thomas, Fidelia; Afolaranmi, Tolulope O; Okolo, Mark Ojogba; Banwat, EB; Egah, DZ

doi:10.9734/bjmmr/2015/16150

Cited by 13 publications

(22 citation statements)

References 18 publications

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“…However, the observed prevalence in our study may be due to other factors such as, (i) pre-medication practice before presentation at the hospital which is a common norm (ii) severity of infection and the level of parasite density and (iii) the competence and skill of the personnel involved in staining and examination of the blood smear could contribute to low prevalence. The severity and outcome of febrile illness is known to be influenced by sociodemographic variables -age, gender and comorbdities Age as predisposing factor of febrile illness, has been well documented [17,18], as observed in our study high numbers of cases were within the aged less than 2 years.…”

Section: Discussionsupporting

confidence: 62%

“…In geographical location with high livestock population and pastoralist activities, zoonotic pathogens like Brucella spp, leptosporosis have been implicated in febrile illness [12,13]. Clinically, association between febrile illness and comorbdities like urinary tract infection, respiratory tract infection, gastroenteritis, age malnutrition, anaemia and HIV/AIDS had been well documented [8,11,12,[15][16][17][18].…”

Section: Discussionmentioning

confidence: 99%

“…Clinical implication of malarial and bacteremia as predisposing risk factor for febrile illness have been well documented [1,10,[11][12][13][14]. However, in malarial endemic region, invasive bacteremia due to Non-typhoidal Salmonella spp predispose to malaria, dependent on the geographical location, seasonal and climatic pattern, socio-demographical variables and comorbdities-urinary tract infection, acute respiratory tract infection, HIV/AIDS, malnutrition and typhoid fever [14,15,16] Wide ranged of bacterial pathogens from enteric gram-negative Enterobactericaea, to gram-positive bacteria has been implicated in febrile episode [6,9,[10][11][12][13][14][15][16][17][18][19][20][21]. Non-malarial agents associated with febrile illness such as brucellosis, leptosporosis, salmonellosis are emerging in region with high livestock population and poor sanitation [12,13].…”

Section: Introductionmentioning

confidence: 99%

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Retrospective Analysis of Malarial Parasitemia and Bacteremia in Febrile Episodes Seen at Tertiary Hospital at Nguru, Nigeria

Okon

Bularafa

Pius

et al. 2018

JAMMR

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Background: Febrile episode remains the common clinical presentation responsible for hospital admission among children aged less than 5 years in sub-Saharan African. The overlapping of clinical signs and symptoms, with diverse aetiological agents implicated in febrile illness, tends to compound effective diagnosis and management approach in a low-resource healthcare setting. Objective: We retrospectively analysed malaria parasitemia and bacteremia results of febrile patients seen at a tertiary hospital in Nguru, Yobe state, Nigeria. Okon et al.; JAMMR, 25(4): 1-9, 2018; Article no.JAMMR.38781 2 Study Design: A retrospective study analysed malarial parasitemia and bacteremia of febrile patients aged less than 12 years. Place and Duration of Study: The study was conducted at the federal Medical center Nguru in the department of Medical Microbiology and Paediatric that spanned between January and December 2014. Methodology: Thick and thin blood smear examination for asexual malarial parasite, blood culture technique for bacterial pathogens isolation, and antibiotic susceptibility testing were employed for the study. Results: Malarial parasitemia was detected in 44(32.6%) cases, bacterial pathogens isolated in 51(37.8%) and co-infection prevalence of 16.3% respectively. Five different bacterial pathogens were isolated, Staphylococcus aureus accounted for 34(66.9%), Salmonella spp 10(19.6%), Escherichia coli 4(7.8%), Coliforms 2(3.9%) and Streprotococcus pneumoniae 1(2.0%) respectively. The significant statistical difference was observed between clinical details and microbiological indices, malarial parasite (P<0.001) and bacterial pathogens (P<0.0001). High malarial parasitemia and bacteremia was observed within the age-group of 1-11 months and >60 months. The bacterial pathogens demonstrated high resistance pattern to ampicillin and cotrimoxazole. Conclusion: These findings presented local epidemiological data of febrile episode that could optimized febrile illness diagnosis and management approach. Original Research Article

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Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Retrospective Analysis of Malarial Parasitemia and Bacteremia in Febrile Episodes Seen at Tertiary Hospital at Nguru, Nigeria

Okon

Bularafa

Pius

et al. 2018

JAMMR

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“…Case ascertainment by physician diagnosis was reported in 44 (54%) of 81 observational studies, 26 of which documented the individual clinical signs used for the diagnosis of neonatal sepsis or meningitis. Only seven studies 36,63,74,[86][87][88][89] reported using the WHO/IMCI clinical algorithm, two studies 90,91 used the French National Agency for Accreditation and Health clinical diagnostic criteria, 92 and one Ugandan study 93 reported using criteria adopted from International Paediatric Sepsis Consensus 94 and Indian Academy of Paediatrics. 95 30 (37%) of these observational studies reported microbiological or laboratory criteria for diagnosis of neonatal infection syndromes (sepsis or meningitis), and 56 studies (69%) described micro biological sample type and sampling strategy (clinical indication vs routine sampling) as well as number of neonates sampled.…”

Section: Resultsmentioning

confidence: 99%

Aetiology of invasive bacterial infection and antimicrobial resistance in neonates in sub-Saharan Africa: a systematic review and meta-analysis in line with the STROBE-NI reporting guidelines

Okomo

Akpalu

Doaré

et al. 2019

The Lancet Infectious Diseases

171

207

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Background Aetiological data for neonatal infections are essential to inform policies and programme strategies, but such data are scarce from sub-Saharan Africa. We therefore completed a systematic review and meta-analysis of available data from the African continent since 1980, with a focus on regional differences in aetiology and antimicrobial resistance (AMR) in the past decade (2008-18). Methods We included data for microbiologically confirmed invasive bacterial infection including meningitis and AMR among neonates in sub-Saharan Africa and assessed the quality of scientific reporting according to Strengthening the Reporting of Observational Studies in Epidemiology for Newborn Infection (STROBE-NI) checklist. We calculated pooled proportions for reported bacterial isolates and AMR. Findings We included 151 studies comprising data from 84 534 neonates from 26 countries, almost all of which were hospital-based. Of the 82 studies published between 2008 and 2018, insufficient details were reported regarding most STROBE-NI items. Regarding culture positive bacteraemia or sepsis, Staphylococcus aureus, Klebsiella spp, and Escherichia coli accounted for 25% (95% CI 21-29), 21% (16-27), and 10% (8-10) respectively. For meningitis, the predominant identified causes were group B streptococcus 25% (16-33), Streptococcus pneumoniae 17% (9-6), and S aureus 12% (3-25). Resistance to WHO recommended β-lactams was reported in 614 (68%) of 904 cases and resistance to aminoglycosides in 317 (27%) of 1176 cases. Interpretation Hospital-acquired neonatal infections and AMR are a major burden in Africa. More population-based neonatal infection studies and improved routine surveillance are needed to improve clinical care, plan health systems approaches, and address AMR. Future studies should be reported according to standardised reporting guidelines, such as STROBE-NI, to aid comparability and reduce research waste.

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“…As observed in adult ICU, S.aureus was recovered from resituating equipment, and E.coli and Kleb.pneumoniae from suction machine. These pathogens, E.coli and Kleb pneumoniae are known ESBL producing pathogens, associated with multidrug resistant pathogens, with potential of rapid dissemination and source of hospital associated infections [32]. Considering the clinical status of patients admitted in NICU, the isolation of S.aureus, CoNs, Streptococcus pneumoniae and Kleb pneumoniae posed a serious clinical concern.…”

Section: Discussionmentioning

confidence: 99%

Bacterial Contamination of Intensive Care Units at a Tertiary Hospital in Bauchi, Northeastern Nigeria

Yusuf¹,

Okwong²,

Mohammed³

et al. 2017

AJIM

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Bacterial contamination of intensive care units is of clinical concern because it is one of the major risk factors of ICU -acquired infections and centre point of multidrug resistant (MDR) pathogens. Periodic surveillance is an early warning signal to non-adherence of basic standard infection control procedures and emergence of MDR pathogens. This study evaluated the bacterial contamination, bacterial pathogens isolated and their antimicrobial susceptibility pattern in the ICU units. The units sampled were adult and neonatal intensive care units, accordingly to previously described methods and analyzed by standard microbiological methods. A total of 113 samples were collected, overall, 71(62.8%) yielded positive bacterial growth, 15(21.1%) detected by open-plate and 14(19.7%) by swabbing in adult intensive care unit and 20(28.2%) and 22(31.0%) in neonatal care unit. Bacillus spp,Staphylococcus aureus and coagulase negative staphylococci spp predominated in both units 24(33.8%), 19(26.8%), 14(19.7%), Other pathogens 19%, clinically relevant pathogens isolated were Eschericia coli (1%), Klebsiella pneumonia(4%) and Streptococcus pneumonia (3%) respectively. High indoor contamination was recorded in both units, 51.7% (n=15) in AICU and 47.6% (n=20) in NICU and inanimate items/equipments. Clinically relevant pathogens were recovered from routinely used equipment and critical sites. High resistance to commonly prescribed and administered agents, cotrimoxazole, amoxicillin and ampicillin was observed. Though the findings has provided a baseline information for furthered surveillance, but the high indoor contamination within both units signify increased traffic, ventilation system problem and inadequate cleaning procedures.

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Bacteriologic Profile, Antibiotic Regimen and Clinical Outcome of Neonatal Sepsis in a University Teaching Hospital in North Central Nigeria

Cited by 13 publications

References 18 publications

Retrospective Analysis of Malarial Parasitemia and Bacteremia in Febrile Episodes Seen at Tertiary Hospital at Nguru, Nigeria

Retrospective Analysis of Malarial Parasitemia and Bacteremia in Febrile Episodes Seen at Tertiary Hospital at Nguru, Nigeria

Aetiology of invasive bacterial infection and antimicrobial resistance in neonates in sub-Saharan Africa: a systematic review and meta-analysis in line with the STROBE-NI reporting guidelines

Bacterial Contamination of Intensive Care Units at a Tertiary Hospital in Bauchi, Northeastern Nigeria

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