Etiology, antibiotic susceptibility and prognostic factors of pediatric community-acquired sepsis in Addis Ababa, Ethiopia

  • Abel Abera Negash Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia
  • Daniel Asrat Department of Microbiology, Immunology and Parasitology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
  • Workeabeba Abebe Department of Pediatrics and Child Health, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
  • Tewodros Hailemariam Department of Pediatrics and Child Health, Yekatit 12 Medical College, Addis Ababa, Ethiopia
  • Andualem Wubete Department of Emergency Medicine and Critical Care, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
  • Abraham Aseffa Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia
  • Mario Vaneechoutte Laboratory Bacteriology Research, Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
Keywords: Antibiotic resistance, community-acquired sepsis, Klebsiella pneumoniae, Streptococcus pneumoniae, Ethiopia

Abstract

Introduction: There is a scarcity of data on pediatric community-acquired sepsis (CAS) in Ethiopia. We sought to determine the etiology, role of Streptococcus pneumoniae, antibiotic susceptibility pattern, and prognostic factors in children with CAS in Addis Ababa, Ethiopia.

Methodology: A prospective cross-sectional study of 101 children aged 0-15 years with suspected CAS was performed at two major hospitals in Addis Ababa, Ethiopia. Blood culture, antibiotic susceptibility testing, amplification of the autolysin (lytA) gene and typing S. pneumoniae by sequencing and Quellung reaction were performed. Data were analyzed using descriptive statistics and logistic regression.

Results: The prevalence of culture-positive CAS was 18.81% (19/101). S. pneumoniae (21.1%) (Serotypes 19A (n = 2), 33C and 12F) and Klebsiella pneumoniae (21.1%) were the most common causes of CAS. Half of K. pneumoniae isolates were resistant to gentamicin and ceftriaxone. The most common antibiotics used for treatment were a combination of ampicillin with gentamicin (47.5%). The presence of lower respiratory tract infections (LRTIs) in the preceding 3 months was an independent predictor associated with culture-proven sepsis (adjusted odds ratio (AOR), 7.02; 95% confidence interval (CI), 1.42 - 34.64; P = 0.02). The case-fatality rate was 11.9% (12/101). Presence of underlying comorbidity (AOR, 6.8; 95% CI, 1.59-28.7; P = 0.009) was an independent predictor of mortality.

Conclusions: S. pneumoniae and K. pneumoniae were the major causes of CAS and there was a substantial level of antibiotic resistance. Presence of LRTIs in the preceding 3 months was a predictor of culture-proven CAS whereas underlying comorbidity was a predictor of mortality.

Published
2021-01-31
How to Cite
1.
Negash AA, Asrat D, Abebe W, Hailemariam T, Wubete A, Aseffa A, Vaneechoutte M (2021) Etiology, antibiotic susceptibility and prognostic factors of pediatric community-acquired sepsis in Addis Ababa, Ethiopia. J Infect Dev Ctries 15:113-122. doi: 10.3855/jidc.12674
Section
Original Articles