• Relevance Of Blood Culture To The Diagnosis And Treatment Of Septicemia

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    • A study of septicaemia was conducted in Enugu metropolis with a view to determine the relevance of blood culture to the diagnosis and treatment of this disease. The subjects comprised of  three hundred and fifty (350) children and adults of both sexes aged between one day to 70 years having clinical features suggestive of septicaemia, who were on admission at University Of Nigeria Teaching Hospitals (UNTH), Enugu.  Their blood specimens were seeded into thioglycolateand 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-vitroantibiotic susceptibility tests using the disc diffusion method. Etiology was established in 104 out of 350 subjects indicating an incidence of 29.7%.
      This difference in prevalence among different age groups was statistically significant(P < 0.01). The males (59/350, 16.86%) appeared to be more susceptible to septicaemia than the females (45/350, 12.9%) in all the age groups.
      This variation had no statistical significance (P > 0.01). Monomicrobialsepticaemia had ahigher prevalence (91.3%) than polymicrobialsepticaemia (8.65%). Staphylococcus aureusand Escherichia coliconstituted 33.3%. Most of the offensive microbes were facultative anaerobes (93.3%) while very few were strict aerobes (7.69%) and strict anaerobes (1.92%). The isolated anaerobes were Peptostreptococcussp. (1%) and Bacteroidesfragilis(1%). The in vitro susceptibility of the bacterial isolates to antibiotics indicated 78.9-92.9% 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 Enugu metropolis; the need for the use ofthioglycolate 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 treatment of septicaemia is hereby advocated, most especially in the developing countries of the world.
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    • CHAPTER ONE - [ Total Page(s): 3 ]CHAPTER ONE1.0   INTRODUCTIONBlood is normally sterile in healthy individuals. It is the main transport mechanism connecting all different parts of the body. As it serves as a transport system for oxygen, food materials, waste products and others round the body, it can also carry microbes (Eugene et al., 1998).   However, it has no normal flora and the presence of microorganism in it indicates failure of the defence mechanisms to maintain its sterility. In many cases such a failure is transi ... Continue reading---