尼日利亚东北部包奇市儿科患者血流感染的病因

Torkwase Janet Aondofa, Ahmed Faruk Umar, Yusuf Alhaji Suleiman
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摘要

背景:儿童细菌感染的发病率与日俱增,这引起了人们对发展中国家高血流感染(BSI)率和相关死亡率的担忧。体征和症状可能有用,但特异性有限,这需要通过细菌血液培养来解决。本研究旨在确定菌血症的病原体以及 0-5 岁儿童患者的发病率。研究方法分析了 262 份血液样本,这些样本来自包奇市内各医院就诊的 0-5 岁儿童,其特征表明这些儿童患有败血症。样本在无菌条件下采集,并使用德国Biomerieux公司的BacT/ALERT 3D进行自动血液培养。阳性血培养物在血琼脂和麦康凯琼脂上进行亚培养,并在革兰氏染色后用 Vitek2(法国 bioMѐrieux)自动系统进行鉴定。病原体分布在年龄和性别上的变化通过卡方检验确定,如果双尾 p 值不超过 0.01,则具有统计学意义。结果119(45.4)份样本中分离出了细菌,其中新生儿的细菌分离率最高,为 54(45.3)。金黄色葡萄球菌(21(17.6))是所有年龄组中分离出的最主要菌种,在 1 岁以下的患者中发生率较高。培养阳性率与年龄/性别的独立性的卡方检验(P<.01)不显著:在这项研究中,革兰氏阳性菌和革兰氏阴性菌都与小儿血流感染有关。金黄色葡萄球菌是最主要的细菌,其次是肠杆菌科细菌(肠杆菌属、克雷伯氏菌属和大肠埃希氏菌)。
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Etiology of bloodstream infections among pediatric patients in Bauchi metropolis, north-east Nigeria
Background: The prevalence of bacterial infections in children is increasing by the day, this gives a cause for concern regarding the high rate of bloodstream infection (BSI) and associated mortality in developing countries. Physical signs and symptoms may be useful but have limited specificity which would be addressed with bacteriologic blood culture. This study was aimed at determining the etiologic agents of bacteremia and the prevalence in pediatric patients aged 0-5years. Methods: Two hundred and sixty- two (262) blood samples were analyzed from children aged 0-5years, attending hospitals within Bauchi metropolis with features suggestive of septicemia. Samples were collected under aseptic conditions and automated blood culture was done on BacT/ALERT 3D Biomerieux, Germany. Positive blood culture was sub-cultured on blood agar and MacConkey agar and identified on Vitek2 (bioMѐrieux, France) automated system after gram staining. Changes in pathogen distribution according to age and gender were determined by the chi-square test and statistical significance confirmed if a two-tailed p-value was not more than 0.01. Results: Bacteria was isolated in 119 (45.4) of samples with highest rate among neonates 54(45.3). Staphylococcus aureus 21 (17.6) was the most predominant organism isolated across all age groups with a higher occurrence in patients<1year old. A chi-square test of independence for culture positivity and age/gender at p<.01 was not significant Conclusion: In this study both Gram-positive and Gram-negative bacteria are implicated in pediatric bloodstream infections. Staphylococcus aureus was the most predominant organism followed by members of the Enterobacterales (Enterobacter spp, Klebsiella spp and Escherichia coli).
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