Bacterial infections, sensitivity patterns, and chemotherapy among hospital patients in the tropics

A prospective clinical and bacteriological review of the pattern of bacterial infections and chemotherapy among 1931 patients admitted to University College Hospital, Ibadan, between July and September, 1976, showed that 394 patients (20%) had bacterial infections, but 940 patients (49%) received antimicrobial chemotherapy. Thus 58% of the patients were treated either prophylactically or without bacteriological confirmation of infection. Infections of the respiratory tract were commonest (28%), followed closely by wound infections (26%). Septicaemia accounted for 20% of all infections and this was particularly common among children. There was a preponderance of infections due to gram-negative bacteria (69%), with Klebsiella spp. being the most frequently encountered. Among the gram-positive organisms, Staphylococcus aureus accounted for the majority of the infections, particularly infections of wounds, while Salmonellae were responsible for the majority of septicaemias, except among young children, where Klebsiella spp. were predominant. Approximately 90% of urinary tract infections were caused by Klebsiella, Escherichia coli and Proteus spp. Almost all the patients with meningitis were children (93%) and the commonest infecting organisms were Haemophilus influenzae and Streptococcus pneumoniae. The most commonly used antibiotics (penicillin, streptomycin and ampicillin) did not bear a close relationship to the sensitivity patterns of bacteria causing infections in the hospital. Comparison of the bacterial sensitivity patterns for 1963, 1967, 1974 and 1976 showed that the current usage of antibiotics had led over the years to increasing proportions of resistant organisms.