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International Journal of Clinical and Experimental Medicine Research

ISSN Online: 2575-7970 ISSN Print: 2575-7989 CODEN: IJCEMH
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ArticleOpen Access http://dx.doi.org/10.26855/ijcemr.2023.07.003

Septicaemia among Children on Chronic Haemodialysis in a Renal Paediatric Setting in South Africa

Nneka Chioma Okoronkwo1,*, Cecil Levy2

1Department of Paediatrics, Abia State University Teaching Hospital, Aba, Abia State, Nigeria.

2Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, Gauteng, South Africa.

*Corresponding author: Nneka Chioma Okoronkwo

Published: August 7,2023

Abstract

Introduction: Infection contributes significantly to morbidity and mortality in children on haemodialysis (HD). It is second to only cardiovascular disorders as a cause of death among this cohort of patients. Majority of these infection related deaths are due to septicaemia. A regular review of septicaemia in children undergoing long term HD is a very crucial step in targeting a reduction in mortality. Aim and Objectives: This study aimed to review the pattern of septicaemia among our patients on chronic HD and to determine the bacteriological profile and antimicrobial sensitivity patterns of the infections. Methodology: This was a retrospective descriptive study over a 5-year period. The study population comprised of all patients with symptomatic septicaemia, undergoing chronic HD, at the Division of Paediatric Nephrology of the Charlotte Maxeke Johannesburg Academic Hospital, South Africa. Results: A total of 129 patients were enrolled into our chronic HD program over the 5-year study period. 79/129 was on HD for at least 6 months. Septicaemia was diagnosed on clinical grounds in 50/79 patients (63%). There were 66 episodes of infections overall. Blood cultures results were available for 60 of these episodes of clinical septicaemia. 35/60 blood culture results were positive for organisms and 25/60 were negative (sterile). Coagulase negative staphylococcus (CNS) was the commonest bacteria isolated (10/35) and all CNS were susceptible to cloxacillin. Conclusion: The high rates of bacteraemic sepsis are of concern in our cohort of patients. Poor sterile technique, low nurse: patient ratios and long periods of time on HD are all possible contributing factors in our setting. Cost effective antimicrobials like cloxacillin should still be used as first line drugs in centres where their sensitivity pattern against causative organisms is still high.

Keywords

Septicaemia, Children, Chronic Haemodialysis, South Africa

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How to cite this paper

Septicaemia among Children on Chronic Haemodialysis in a Renal Paediatric Setting in South Africa

How to cite this paper:  Nneka Chioma Okoronkwo, Cecil Levy. (2023) Septicaemia among Children on Chronic Haemodialysis in a Renal Paediatric Setting in South Africa. International Journal of Clinical and Experimental Medicine Research7(3), 316-321.

DOI: http://dx.doi.org/10.26855/ijcemr.2023.07.003