Prevalence of Bacteraemia and Septicaemia Among Children Attending Kanti Children Hospital with Special Reference to Salmonella spp.

Abstract

This study was conducted in Kanti Children’s Hospital,Kathmandu, Nepal among the children suspected of bacteraemia and septicaemia from June 2006 toJuly2007. The main aim of this study was to find prevalence of bacteraemia and septicaemia and especially to find the incidence of Salmonella spp.among the children visiting Kanti Children’s Hospital. In this study, a total of1671 blood samples were studied,out of which 10.71%showed positive culture result.The incidence of bacteraemia in indoor patient was found to be14.28% and in outdoor patients was found to be 10.43%.Among the genders slightly high percentage of culture positivitywas seen in female patients with11.5%.However there was nosignificant association between gender and bacteraemia and septicaemia(p>0.05). Gram negative isolates were found to be predominant among the study group (65.93%).Highest percentage of the isolates (31.28%) were obtained from the age group between0 to 45 days and followed by 1 year to 5 years (22.91%). Among the isolates,Salmonella Typhiwas most predominant(39.11%)followed by Staphylococcus aureusand Escherichia coli (29.05% and 13.41% respectively). Salmonella Paratyphi A,Klebsiella spp., Streptococcus viridans and Streptococcus pneumoniae accounted7.82%,2.79%, 2.79% and 2.23 % respectively.Acinetobacter spp.,Enterobacter spp.both with 1.12% and Proteusspp.with 0.56% were isolated. Among common antibiotics used against all gram negative isolates, Ofloxacin was thedrug of choice with susceptibility rate of 89.83% followed by Cephotaxime with81.35%. Cotrimoxazole was found to be resistant among most of the gram negative isolates. Cephotaxime, Amoxicillin and Ofloxacinbeing 100% sensitive were the drug of choice for SalmonellaTyphi.Amoxycillin, Cephotaxime and Chloramphenicol were the drug of choice for Salmonella ParatyphiA. Out of 179 isolates 43 (24.02%) were found to be Multi DrugResistantand18 MDRE scherichia coli was isolated. Among30Nalidixic acid resistant Salmonella Typhi (NARST) tested, 10 were found to moderate sensitive to Ciprofloxacin and among 9nalidixic acid resistant Salmonella Paratyphi A tested,4were found to be moderate sensitive to ciprofloxacin.And it is found that there is significant association between the resistivity pattern of Ciprofloxacin with Nalidixic acid resistant Salmonella spp.statistically at p>0.05 Key words:Bacteraemia, Septicaemia, Salmonellae, MDR, NARST.