Antimicrobial susceptibility patterns of bacteria isolated from sterile sites: cerebral spinal fluid, blood, peritoneal fluid, pleural fluid and synovial fluid at Kenyatta National Hospital

Abstract

Background. Antimicrobial resistance is dramatically increasing worldwide. Much of it due to inappropriate overuse and is causing significant morbidity and mortality. Diagnosis of sterile site infections is based on culture of properly collected and processed samples. Since definitive diagnosis is based on quantitative cultures, the course of antibiotic therapy should be determined after the culture results have been confirmed. Unfortunately in most instances empiric treatment is commenced because it is not possible to wait for culture reports or laboratory facilities are unavailable. Infections caused by drug resistant organisms are difficult to eradicate because of limited therapeutic options. With growing antimicrobial resistance in Kenya, reliance on international guidelines is insufficient and hence a study such as this one is needed to get our local patterns to help formulate local policies. Objectives. The general objective of this study was to determine the bacterial isolates identified from sterile body sites and their antibiotic susceptibility patterns from both inpatients and outpatients at the Kenyatta National Hospital (KNH) microbiology laboratory, in the period January to December 2013. Study design and Methodology. This was a retrospective descriptive study done over three months using previously available data from the patients’ laboratory files. After obtaining ethical approval from the KNH/UON- ERC, abstraction of data of samples collected from sterile sites was done from the existing laboratory database using a coded form, which was then recorded on a tally sheet .The outcomes that were considered were bacterial isolates from the respective sterile sites i.e. Cerebral Spinal Fluid (CSF), blood, peritoneal, pleural and synovial fluid; and their antibiotic susceptibility patterns. Demographic