RELEVANCE OF BLOOD CULTURE TO THE DIAGNOSIS AND TREATMENT OF SEPTICAEMIA
ABSTRACT
Septicemia refers to the presence of bacteria in the blood and is often associated with severe infections, the alternative names. It is a common cause of morbidity and mortality among children in the developing world. The study was carried out to determine the Relevance of Blood Culture to the Diagnosis and Treatment of Septicaemia. In achieving this aim, the following specific objectives were laid out to determine the Relevance of Blood Culture to the Diagnosis and Treatment of Septicaemia and compare the occurrence of Gram positive and Gram-negative bacteria in the subjects with culture – proven septicaemia.
Blood culture remains the best approach to identify the incriminated microorganisms when a bloodstream infection (BSI) is suspected, and to guarantee that the antimicrobial treatment is adequate. This report highlights the pattern of bacterial isolates in our environment from a retrospective study of our patients' records.One thousand, two hundred and one blood samples were analysed from children aged 0–15 years, admitted into the children's wards of the University of Calabar Teaching Hospital, Calabar, Nigeria with features suggesting septicaemia.
Samples were collected under aseptic conditions and cultured for aerobic and anaerobic organisms. Isolates were identified using bacteriologic and biochemical methods and antibiotic sensitivity determined by agar diffusion method using standard antibiotic discs. Bacteria was isolated in 552 (48.9%) of samples with highest rates among newborns (27150.8). The most frequent isolates were Staphylococcal aureus (48.7%) and Coliforms (23.4%). Results showed high susceptibilities to the Cephalosporins (Ceftriazone100%:83.2%, Cefuroxime100%:76.5%) and Macrolides (Azithromycin-100%:92.9%) for S. aureus and coliforms respectively.
This study underscores the importance of septicaemia as a common cause of febrile illness in children and provides information on common prevalent aetiologic agents and drug susceptibilities of the commonest pathogens.Together with traditional antimicrobial susceptibility testing (AST), new rapid methods for the detection of resistance mechanisms respond to major epidemiological concern such as Methicillin-resistant Staphylococcus aureus (MRSA), Extended-spectrum beta-lactamase (ESBL) or carbapenemases. This review present and discuss the recent development for the microbial diagnosis of BSI based on blood cultures.
CHAPTER ONE
1.1 Introduction
Septicemia is defined as the presence of bacteria in the blood and is often associated with severe infections, the alternative names (Enrione et al., 2007). It is a common condition in children with a resultant high morbidity and mortality (Nwadioha et al., 2010). Septicaemia also known as Sepsis is a condition that arises when the body’s response to infection injures its own tissues and organs (Deutschman and Tracey, 2014). Children with septicemia present with poor activity, fever, vomiting, chills, difficulty in breathing, tachycardia, malaise, refusal of feeds or lethargy hypothermia, respiratory distress, abdominal distension, jaundice, toxicity and eventually the extreme form being-shock (Iregbu et al., 2006).
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research questions, Limitations of the Study and Definition of technical terms.
1.2 Background of Study
Septicemia is a common condition in children with a resultant high morbidity and mortality (Nwadioha et al., 2010). It’s defined as the presence of bacteria in the blood and is often associated with severe infections; the alternative names (Enrione et al., 2007). Severe sepsis is sepsis causing poor organ function or insufficient blood flow. Insufficient blood flow may be evident by low blood pressure, high blood lactate, or low urine output. Septic shock is low blood pressure due to sepsis that does not improve after reasonable amounts of intravenous fluids are given (Dellinger et al., 2013). Sepsis is caused by an immune response triggered by an infection (Jui, 2011; Deutschman and Tracey, 2014).
The infection is most commonly bacterial, but it can also be from fungi, viruses, or parasites (Jui, 2011) Common locations for the primary infection include: lungs, brain, urinary tract, skin, and abdominal organs. Risk factors include young or old age, a weakened immune system from conditions such as cancer or diabetes, and major trauma or burns (CDC, 2014). Diagnosis is based on meeting at least two systemic inflammatory response syndrome (SIRS) criteria due to a presumed infection. Blood cultures are recommended preferably before antibiotics are started; however, infection of the blood is not required for the diagnosis (Jui, 2011). Medical imaging should be done to look for the possible location of infection (Patel and Balk, 2012). Other potential causes of similar signs and symptoms include: anaphylaxis, adrenal insufficiency, low blood volume, heart failure, and pulmonary embolism among others (Jui, 2011).
Bacteria can be introduced in to the blood stream during tooth brushing (Lockhart et al., 2008). This form of bacteria almost never causes problems in normal individuals. However, bacteremia associated with certain dental procedures can cause bacterial infection of the heart valves known as endocarditis in high risk patients (Wilson et al., 2007). The therapy of sepsis rests on antibiotics, surgical drainage of infected fluid collections, fluid replacement and appropriate support for organ dysfunction, this may include hemodialysis in kidney failure, mechanical ventilation in pulmonary dysfunction, transfusion of blood products and drug and fluid therapy for circulating failure. Ensuring adequate nutrition-preferably by central feeding, but if necessary by parenteral nutrition-is important during prolonged illness (Dellinger et al., 2008).
The term septicaemia is often used in describing severebacteraemic infections or a condition in which the blood serves as a site of bacteria multiplication as well as a means of transfer of the infectious agent from one site to the other. The clinical picture frequently present in septicaemia is that of septic shock which is recognized by a severe febrile episode with chills, fever, malaise, tachycardia mental confusion, hyperventilation and toxicity, a hypotension (drop in blood pressure) and prostration which results when circulating bacteria multiply at a rate that exceeds their removal by phagocytes. Complications include disseminated intravascular coagulation (DIC) and acute renal failure (Shanson, 1999). Thus, in presence of high risk factors; early clinical suspicion, combined with sepsis screen will detect neonatal septicemia earlier which will enable the paediatricians to treat the infection timely and thus reduce neonatal morbidity and mortality (Jeevasankar et al., 2008; Stoll et al., 2007).
Therefore, in Nigeria where the research was carried out, the activities that was conducted is to know the Relevance of Blood Culture to the Diagnosis and Treatment of Septicaemia.
1.3 Statement of Problems
Investigation revealed that despite early intervention, death occurs in 13% of children who develop septic shock, with the risk partly based on other health problems. Those without multiple organ system failure or who require only one inotropic agent mortality is low. During critical illness, a state of adrenal insufficiency and tissue resistance to corticosteroids may occur. This has been termed critical illness–related corticosteroid insufficiency. Treatment with corticosteroids might be most beneficial in those with septic shock and early severe ARDS, whereas its role in others such as those with pancreatitis or severe pneumonia is unclear. However, the exact way of determining corticosteroid insufficiency remains problematic.
1.4 Aim and Objectives of Study
The aim of the study is to determine the Relevance of Blood Culture to the Diagnosis and Treatment of Septicaemia. In achieving this aim, the following specific objectives were laid out as follows:
- To determine the relevance of blood culture to the diagnosis and treatment of septicaemia;
- To determine which gender (male or female) is more prone to septicaemia; and
- To compare the occurrence of Gram positive and Gram-negative bacteria in the subjects with culture – proven septicaemia.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- What is the relevance of blood culture to the diagnosis and treatment of septicaemia?
- Which gender (male or female) is more prone to septicaemia?
- What is the occurrence of Gram positive and Gram-negative bacteria in the subjects with culture – proven septicaemia?
1.6 Justification of Study
It is important to ensure that bloodstream infections are diagnosed accurately and that infecting pathogens, their antimicrobial susceptibilities, and the possible primary sources of infection are evaluated thoroughly, to enable optimal targeted antimicrobial therapy. Blood cultures and their microbiological analysis are highly essential and important for the diagnosis and treatment of septicaemia (sepsis). Blood culture is important for early diagnosis and treatment of patients with septicaemia as survival depends on early detection and administration of adequate empirical antimicrobial therapy.
1.7 Scope of Study
The scope of the research is focused on the Relevance of Blood Culture to the Diagnosis and Treatment of Septicaemia.
1.8 Limitations of the Study
During the course of this study, many things militated against its completion, some of which are:
- Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
- Research material: availability of research material is a major setback to the scope of the study.
- Frequent power failure: This made the researcher append more money on fuel to ensure sustainable power.
- Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet).
1.9 Definition of Terms
Septicemia: It is also known as Sepsis which is defined as the presence of bacteria in the blood and is often associated with severe infections (Enrione et al., 2007).
CHAPTER TWO
2.0 Literature Review
2.1 Introduction
The review of relevant literature is the main topic of this chapter. A literature review covers theoretical and methodological contributions to a certain issue in addition to the state of knowledge at the time of writing. It provides information about the state of the art in relation to the subject you are writing about. It examines the body of work on the chosen subject. The literature evaluation in this study comprises the …
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TABLE OF CONTENTSPRELIMINARY PAGES
- Title page
- Approval page
- Dedication
- Acknowledgement
- Table of Contents
- Abstract
INTRODUCTION
- 1.1 Introduction
- 1.2 Background of Study
- 1.3 Statement of Problems
- 1.4 Aim and Objectives of Study
- 1.5 Research Questions
- 1.6 Justification of Study
- 1.7 Scope of Study
- 1.8 Limitations of the Study
- 1.9 Definition of Terms
LITERATURE REVIEW
- 2.1 Introduction
- 2.2 Conceptual Review of Septicaemia
- 2.3 Signs and Symptoms of Septicaemia
- 2.4 Cause of Septicaemia among Children
- 2.5 Diagnosis of Septicaemia
- 2.6 Pathophysiology of Septicaemia
- 2.7 Management of Septicaemia
- 2.8 Theoretical Framework of Blood Culture
- 2.9 Principles of Blood Culture Collection
- 2.9.1 Timing
- 2.9.2 Site
- 2.9.3 Skin Antisepsis
- 2.9.4 Volume and Number of Cultures
REFERENCES
MATERIALS AND METHODS
- 3.1 Introduction
- 3.2 Study Area
- 3.3 Collection of Samples
- 3.4 Preparation of Samples
- 3.5 Methods of Specimen Preparation
- 3.6 Analysis of Samples
RESULTS AND DISCUSSION
- 4.1 Introduction
- 4.2 Results
- 4.3 Analysis of Research Questions
- 4.4 Discussion of Findings
SUMMARY, CONCLUSION AND RECOMMENDATION
- 5.1 Introduction
- 5.2 Summary of Findings
- 5.3 Conclusion
- 5.4 Recommendation
REFERENCES
Disclaimer for Complete Material Utilization
The displayed research work titled "Relevance of Blood Culture to the Diagnosis and Treatment of Septicaemia" is stated as a research guideline towards accomplishing your assigned project / seminar research work. All the research materials on this website are ONLY for research purposes and should be used as a guideline in developing your research work. For no reason should you copy word for word as projectlist.com.ng will not be liable for any who copied the material. By ordering the complete research guideline, it signifies that you've accepted our terms of service.
PRELIMINARY PAGES
- Title page
- Approval page
- Dedication
- Acknowledgement
- Table of Contents
- Abstract
INTRODUCTION
- 1.1 Introduction
- 1.2 Background of Study
- 1.3 Statement of Problems
- 1.4 Aim and Objectives of Study
- 1.5 Research Questions
- 1.6 Justification of Study
- 1.7 Scope of Study
- 1.8 Limitations of the Study
- 1.9 Definition of Terms
LITERATURE REVIEW
- 2.1 Introduction
- 2.2 Conceptual Review of Septicaemia
- 2.3 Signs and Symptoms of Septicaemia
- 2.4 Cause of Septicaemia among Children
- 2.5 Diagnosis of Septicaemia
- 2.6 Pathophysiology of Septicaemia
- 2.7 Management of Septicaemia
- 2.8 Theoretical Framework of Blood Culture
- 2.9 Principles of Blood Culture Collection
- 2.9.1 Timing
- 2.9.2 Site
- 2.9.3 Skin Antisepsis
- 2.9.4 Volume and Number of Cultures
REFERENCES
MATERIALS AND METHODS
- 3.1 Introduction
- 3.2 Study Area
- 3.3 Collection of Samples
- 3.4 Preparation of Samples
- 3.5 Methods of Specimen Preparation
- 3.6 Analysis of Samples
RESULTS AND DISCUSSION
- 4.1 Introduction
- 4.2 Results
- 4.3 Analysis of Research Questions
- 4.4 Discussion of Findings
SUMMARY, CONCLUSION AND RECOMMENDATION
- 5.1 Introduction
- 5.2 Summary of Findings
- 5.3 Conclusion
- 5.4 Recommendation
REFERENCES
Disclaimer for Complete Material Utilization
The displayed research work titled "Relevance of Blood Culture to the Diagnosis and Treatment of Septicaemia" is stated as a research guideline towards accomplishing your assigned project / seminar research work. All the research materials on this website are ONLY for research purposes and should be used as a guideline in developing your research work. For no reason should you copy word for word as projectlist.com.ng will not be liable for any who copied the material. By ordering the complete research guideline, it signifies that you've accepted our terms of service.
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