Isolation and Identification of Bacteria by Blood Culture and their Drug Susceptibility Pattern in Children to Establish the Correlation Between Cidldhood Septicemia with C-Reactive Protein (Crp) levels.

Abstract

Septicemia is clinical state in which bacteria or their products such as toxins are present in blood stream and gives rise to serious systemic symptoms. Microbial invasion of blood stream causes high rate of morbidity and mortality. C-reactive protein (CRP) is an acute phase reactant of hepatic origin synthesized, regulated and secreted under the influence of interleukin-6. CRP levels are useful marker in the diagnostic evaluation of neonates with suspected bacterial infection as well as monitoring the response of therapy. Suspected septicemic children of O day-15 years enrolled in United Hospital, Dhaka were considered for this study. Patients were grouped according to age. Out of 233 cases studied 39 were blood culture positive (22 male & 17 female). Culture proven septicemia was noted in 39 (16.74%) cases, probable septicemia were 136 (58.37%) and non-septicemic febrile patients were 58 (24.90%). Organisms isolated from blood were S. typhi 16 (41.03%), S. paratyphi A 7 (17.95%), K. pneumoniae & A. baumannii 4 (10.26%), Pseudomonas spp. 3 (7.69%), S. marcescens 2 (5.13%). S. aureus 1 (2.56%), E. coli 1(2.56%) and Enterococcus spp.l (2.56%). Blood culture positivity was significantly higher (23.74%, p <0.001) among patients without antimicrobial therapy than with antimicrobial therapy (6.38%). Multidrug resistant S. typhi was found in 43.75% cases. S. typhi were 75% sensitive to ceftriaxone. E. coli and K. pneumoniae were highly sensitive to imipenem (100%) but was resistant to amikacin, (100%) amoxyclavonic acid, ciprofloxacin, gentamicin and cefepime. Resistance to gentamicin was observed in K. pneumoniae (100%). A. baumannii were 75% sensitive to ciprofloxacin & imipenem but resistant (100%) against amoxyclavonic acid. S. aureus & Enterococcus sp. sensitive (100%) to vancomycin but resistant (100%) to ampicillin, doxycycline. Pseudomonas spp. was resistant (100%) to ceftriaxone, cefixime and imipenem.