Anti-bacterial susceptibility patterns of blood culture isolates at a referral hospital in Eldoret

Abstract

Background: Hospital treatment guidelines are often guided by scientific evidence of efficacy of the anti-microbial agents. In developing countries, most of the treatment guidelines are adopted from the World Health Organisation (WHO). However, local data is often needed to confirm or adjust these guidelines to suit a local situation. In resource limited settings there is scarce data on blood culture isolates and their anti- microbial sensitivity patterns to guide anti-biotic prescription in these settings. Objectives: To assess the bloodstream bacterial isolates and their anti-biotic sensitivity patterns in patients admitted at a tertiary teaching and referral hospital. Design: Hospital based laboratory retrospective study Setting: Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya. Subjects: All blood culture specimens received from inpatients at MTRH over a 12 year period from 2002 to 2013. Results: The median age was 13.4yrs (IQR 0.7-29).Most of the blood samples were from female patients (51.8%). A total of 4046 blood culture samples were analysed of which 29.9% (n=1356) yielded positive growths. Majority of the positive blood cultures were from the New Born Unit (62.4%). Staph epidermidis was the most common organism isolated (43.1% n=531) followed by Klebsiella pneumoniae (22.8% n=281). Resistance to commonly used anti-biotics (penicillin, cephalosporin) was high among gram positive as well as gram negative organisms. No trend in bacterial isolates was observed over the study period. Conclusions: Staph epidermidis and Klebsiella pneumoniae were the most common organisms isolated with higher growth rates occurring in the neonatal and paediatric age groups than in adults. There was no trend in bacterial isolates over the study period. Resistance to commonly used anti-biotics was prevalent.