Relevance Of Blood Culture To The Diagnosis And Treatment Of Septicemia
Need help with a related project topic or New topic? Send Us Your Topic
DOWNLOAD THE COMPLETE PROJECT MATERIAL
Relevance Of Blood Culture To The Diagnosis And Treatment Of Septicemia
ABSTRACT
A septicaemia study was carried out in Enugu metropolis to assess the role of blood culture in the diagnosis and management of this disease. The study included 350 children and adults of both sexes aged one day to 70 years with clinical characteristics suggestive of septicaemia who were admitted to the University of Nigeria Teaching Hospitals (UNTH) in Enugu.
Their blood samples were planted into thioglycolate and glucose broths and incubated at 37 degrees Celsius for 7 days. Subcultures were performed at 1, 2, 3, 4, and 7 days intervals.
Growth (positivity) in the broths was determined using standard diagnostic methods such as macroscopy (visualisation), Gramme filming (microscopy), and culture.
The collected bacterial isolates were tested for antibiotic susceptibility in vitro using the disc diffusion method. The aetiology was determined in 104 out of 350 individuals, giving a 29.7% incidence.
The difference in prevalence between age groups was statistically significant (P < 0.01). Males (59/350, 16.86%) appeared to be more prone to septicaemia than females (45/350, 12.9%) across all age categories.
This variance was not statistically significant (P > 0.01). Monomicrobial septicaemia was more prevalent (91.3%) than polymicrobial septicaemia (8.65%). Staphylococcus aureus and Escherichia coli accounted for 33.3%.
The majority of the offensive microorganisms (93.3%) were facultative anaerobes, with only a few being stringent aerobes (7.69%) and strict anaerobes (1.92%).
The identified anaerobes were Peptostreptococcus sp. (1%) and Bacteroidesfragilis (1%). The bacterial isolates’ in vitro antibiotic susceptibility ranged between 78.9 and 92.9% for vancomycin, zinnat, peflacin, and fortum.
However, they were resistant to penicillin, ampicillin, tetracycline, and septrin to the extent of 60-90 percent. This study confirmed the diverse nature of bacterial aetiologies of septicaemia in Enugu metropolis; the need for the use of thioglycolate broths, first subcultures on or before 24 h instead of starting off after 48 h of incubation, complementary application of macroscopy
Gramme 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
Chapter one
1.0 Introduction
Blood is typically sterile in healthy people. It is the primary transport mechanism that connects all sections of the body. It can transport bacteria as well as oxygen, food items, waste products, and other substances throughout the body.
However, it lacks a normal flora, and the presence of microorganisms suggests a failure of the defence systems to keep it sterile. In many circumstances, such a failure is temporary and has no clinical significance, but in others, it is severe and life-threatening.
Lymphoid tissue is an important aspect of the defence system since it acts as a filter to capture potentially invasive diseases and is home to lymphocytes, on which immunity is strongly dependent.
This filter system, however, is susceptible to clinically severe infections caused by captured pathogens and serves as the principal target for several infection factors (Douglas et al., 1981). Many illnesses involve the blood, lymphatic system, and heart, allowing us to detect the presence of bacteria in the bloodstream.
Several authors have described bacteraemia following abscess incision, tonsillectomy, and tooth extraction (Fischer et al., 1941, Murry et al., 1941). According to Robert et al. (1997), bacteraemia is a transitory condition in which bacteria in the blood are normally removed from the vascular system by the reticuloendothelial system with no detrimental consequence, but septicaemia occurs in hosts with low immunity.
The word septicaemia is commonly used to describe severe bacteraemic infections or a state in which the blood acts as both a site of bacteria multiplication and a way of transporting the infectious agent from one location to another.
Septic shock is a severe febrile episode characterised by chills, fever, malaise, tachycardia, mental confusion, hyperventilation and toxicity, hypotension (drop in blood pressure), and prostration caused by circulating bacteria multiplying faster than phagocytes can remove them. Complications include DIC and acute renal failure (Shanson, 1999).
The death rate ranges from 15% to 35%, depending on age, underlying condition, and treatment (Shamson, 1998). It is critical to detect septicaemia quickly and treat it as soon as possible based on the identification of the most likely causing pathogen.
Bacterial septicaemias are caused by a diverse range of bacteria that vary by location. Many studies on septicaemia in Nigeria have been conducted on neonates and children, as well as retrospectively (Dawodu et al., 1980), and there is thus a scarcity of information on prospective studies on septiceamia in various strata of Nigeria society.
1.1 Blood Culture.
This is a microbiologic blood culture used to detect infections as they spread through the bloodstream. One of these diseases is septicaemia. This blood culture is achievable because the bloodstream is often a sterile environment, and it is performed as part of a laboratory test to detect bacteria or other microbes in a blood sample. Most cultures test for bacteria. A culture can be performed on a sample of blood, tissue, stool, urine, or other bodily fluid.
When a patient exhibits signs or symptoms of a systemic infection, blood culture findings can confirm the presence of an infection and identify the type(s) of microorganism responsible for the infection.
A excellent example is when blood tests reveal the causative organisms in neonatal epiglottitis, sepsis, severe pneumonia, puerperal fever, and fever of unclear origin. However, negative growths do not rule out infection.
The usual dangers of venipuncture, as well as the occurrence of false positive results in around 3% of cases, can result in incorrect therapy (Madeo et al., 2003).
1.2 SEPTICAEMIA
Septicaemia is also known as blood poisoning, bacteremia, or sepsis, and while each of these phrases may not be totally correct, scientists frequently use them interchangeably. Sepsis is not restricted to the bloodstream; it can affect the entire body, including the organs.
Septicaemia (also known as blood poisoning) is a bacterial infection of the blood, although sepsis can be caused by viral or fungal infections.
Septicaemia, often known as Sepsis, is a disorder in which the body’s response to infection damages its own tissues and organs (Deutschman and Tracey, 2014).Fever, increased heart rate, increased breathing rate, and confusion are some of the most common signs and symptoms.
There may also be infection-specific symptoms, such as a cough with pneumonia or painful urination with a kidney infection. According to Martí-Carvajal et al. (2012), individuals with a weaker immune system, the very young, elderly, or those with a weakened immune system may not experience symptoms of an illness and may have a normal or low body temperature.
Severe sepsis is defined as sepsis resulting in impaired organ function or inadequate blood flow. limited blood pressure, high blood lactate levels, or limited urine output might all indicate insufficient blood flow.
Septic shock is defined as low blood pressure caused by sepsis that persists despite receiving enough intravenous fluids (Dellinger et al., 2013).
Sepsis is caused by an immunological response to an infection (Jui, 2011; Deutschman and Tracey, 2014). The infection is most usually bacterial, although it can also come from fungi, viruses, or parasites (Jui, 2011). Primary infections are commonly found in the lungs, brain, urinary tract, skin, and abdominal organs.
Young or old age, a compromised immune system caused by cancer or diabetes, and serious trauma or burns are also risk factors (CDC, 2014). The diagnosis is based on the presence of at least two systemic inflammatory response syndrome (SIRS) criteria associated with a suspected infection.
Blood cultures are encouraged before starting antibiotics; however, blood infection is not required for diagnosis (Jui, 2011). Medical imaging should be performed to determine the possible site of infection (Patel and Baulk, 2012).
Other possible causes of similar signs and symptoms include allergy, adrenal insufficiency, low blood volume, heart failure, and pulmonary embolism (Jui, 2011).
1.3 Objectives of the Research
The objectives of this study are to:
Determine the role of blood culture in the diagnosis and management of septicaemia.
Compare the prevalence of Gramme positive and Gramme negative microorganisms in people with culture-proven septicaemia.
Determine whether males or females are more prone to septicaemia.
1.4 Justification.
To allow for optimal targeted antimicrobial therapy, it is critical to accurately diagnose bloodstream infections and thoroughly examine infecting microorganisms, their antimicrobial susceptibilities, and potential primary sources of infection.
Blood cultures and microbiological analysis are critical for the diagnosis and management of septicaemia.Blood culture is critical for the early diagnosis and treatment of patients with septicaemia, as survival is dependent on early detection and adequate empirical antimicrobial therapy.
Need help with a related project topic or New topic? Send Us Your Topic