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Aetiology and antimicrobial drug resistance of bacterial pathogens associated with cases of septicemia in children from Mulago hospital, Kampala Uganda




Septicemia caused by various species of bacteria is associated with significant morbidity and mortality among children in developing nations. Isolating the offending bacteria and understanding their susceptibility patterns is crucial if appropriate treatment is to be instituted in light of the emerging drug resistance. Therefore this study conducted at Mulago Hospital in Uganda identified the bacteria associated with childhood septicemia and also determined their antibiograms. The study involved 100 children admitted at Pediatric Wards in Mulago hospital between January and March 2009. Clinical notes were taken. Blood culture was carried out in an automated BD bactec machine and positive blood cultures were sub-cultured on blood agar, MacConkey agar and chocolate agar. Bacteria were identified by Gram staining and biochemical tests. Antimicrobial susceptibility of the cultures was determined by disc diffusion method.  Seventy one percent of the children sampled with clinical septicemia were older than one year.  Blood positive cultures were obtained from 18% of the children, of which 61% were above 1 year old. The common bacterial isolates were Staphylococcal aureus (39%), Salmonella species (22%) and Streptococcal pneumoniae (11%).  More than 50% of S. aureus were resistant to 7 out of 8 antimicrobial drugs, including resistance to oxacillin, cotrimoxazole, gentamicin and Ceftazidime.  Salmonella species were resistant to chloramphenicol, co-trimoxazole and erythromycin, while Alcaligenes species, Escherichia coli and Klebsiella species were sensitive to all antimicrobial drugs, although, all Gram negative isolates were susceptible to ciprofloxacin. It was concluded that childhood septicemia in Uganda could become a public health problem in the near future due to emergence of pathogens resistant to most readily available drugs.