Malaysian Journal of Microbiology (Jan 2008)
Incidence of Bacterial Septicaemia in Ile-Ife Metropolis, Nigeria
Abstract
A retrospective study of septicaemia was conducted in Ile-Ife metropolis with a view to determine its incidence and changes in the predominant aetiological agents. Six hundred and fifty (650) subjects, aged from one day to seventy years and above were examined. They all had clinical features suggestive of septicaemia and were on admission at the Obafemi Awolowo University hospital Complex, Ile-Ife, Nigeria. Their blood specimens were seeded into thioglycolate and glucose broths and incubated at 37 °C for 7 days. Subcultures were performed after 1, 2, 3, 4 and 7 days respectively. Growth (positivity) in the broths was assessed using conventional diagnostic methods namely macroscopy (visualization), Gram filming (microscopy) and culture. The bacterial isolates harvested were subjected to in-vitro antibiotic susceptibility tests using the disc diffusion method. Etiology was established in 204 out of 650 subjects indicating an incidence of 31.4%. This difference in prevalence among different age groups was statistically significant (P 0.01). Monomicrobial septicaemia had a higher prevalence (92.2%) than polymicrobial septicaemia (7.8%). Staphylococcus aureus and Escherichia coli constituted 43.8%. Most of the offensive microbes were facultative anaerobes (91.7%) while very few were strict aerobes (6.8%) and strict anaerobes (1.5%). The isolated anaerobes were Peptostreptococcus sp. (0.5%) and Bacteroides fragilis (1%). The in vitro susceptibility of the bacterial isolates to antibiotics indicated 76.4-95.6% sensitivity to vancomycin, zinnat, peflacin and fortum. However, they were 60 – 90% resistant to penicillin, ampicillin, tetracycline and septrin. This study confirmed the diverse nature of bacterial etiologies of septicaemia in the area; the need for the use of thioglycolate broths, first subcultures on or before 24 h instead of starting off for after 48 h of incubation, complementary application of macroscopy, Gram filming and culture including antibiotic susceptibility test as an integral part of diagnosis and management of septicaemia is hereby advocated, most especially in the developing countries of the world.
