RESUMO
Introduction: Sodium fluoride/potassium oxalate (NaF/KOx) tubes has been regarded as the gold-standard tubes for glucose analysis. Even though their ineffectiveness in immediately inhibiting glycolysis has been reported in several studies especially in the first 1-4h, they are still used in our clinical biochemistry laboratory for glucose measurement. However, in its absence, only serum separator tubes are employed for glucose measurement. We aim to determine whether serum separator tubes (SSTs) can replace NaF/KOx tubes for laboratory measurement of blood glucose and to assess the stability of glucose concentrations for 3 days period. Methods and findings: NaF/KOx tube type was the reference method while SSTs type was the candidate method for glucose measurement. A total of 50 paired samples collected separately in NaF/KOx tubes and SSTs from healthy adult participants in the Gambia Adults Reference Intervals Study (GARIS) project were used as the project sample size. Following blood collection and separation, the glucose concentration was measured within 2 h, and at 24h, 42h and 72h time-points. Our data analysis showed no significant difference in the mean glucose concentrations between the reference tube and candidate tube types (Mean difference = 0.06 mmol/L; P = 0.38) recorded in the different timepoints. Using growth trajectory and mixed effects model, the study data further showed no significant change in the glucose concentrations (p = 0.25) for three days period. Conclusions: The study confirms that SSTs can produce similar glucose results when employed in the absence of NaF/KOx tubes. Besides, the glucose concentrations were stable in both tubes for three days when the samples were separated within 2 h and refrigerated in 2-8°C.
RESUMO
BACKGROUND: The aim of this study was to determine the prevalence of invasive bacterial infections and their antimicrobial resistance patterns in sickle cell disease (SCD) patients admitted at the Medical Research Council the Gambia (MRCG) Ward in the era of PCV and Hib vaccination in the Gambia. METHODS AND RESULTS: This study was conducted in the clinical laboratory department of MRCG. We retrospectively generated haematological, and blood culture data from our electronic medical records from 2015 to 2022 of SCD patients admitted to MRCG Ward. Of 380 SCD patients, blood culture was requested only for 159. Of the 159 admitted SCD, 11 patients had qualified positive blood cultures. Five different types of bacterial pathogens were isolated from these positive blood cultures: 4 Staphylococcus aureus, 3 Streptococcus pneumoniae, 2 Salmonella species, 1 Enterococcus species, and 1 Shigella boydii. No episode of bacteremia caused by Haemophilus influenzae type b was identified. The molecular serotyping of the Streptococcus pneumoniae isolates revealed non-vaccine serotypes 10 A, 12 F and 12 F. Penicillin resistance was recorded in two of the three Streptococcus pneumoniae. The Staphylococcus aureus isolates were penicillin resistant but cefoxitin sensitive, hence no methicillin (oxacillin) resistant Staphylococcus aureus was reported. Generally, the isolated pathogens were all sensitive to chloramphenicol, and vancomycin. The haematological indices were not significantly varied between SCD patients with and without microbiologically confirmed bacterial infection. CONCLUSION: Streptococcus pneumoniae and Staphylococcus aureus were the most common cause of bacteremia in these admitted SCD patients. The presence of non-typhoidal Salmonella and Shigella infection coupled with penicillin resistance should be considered during penicillin prophylaxis and empirical treatment regimens for SCD patients and future SCD management policies in the Gambia. The haematological parameters may not be reliable biomarkers in differentiating bacterial from non-bacterial infections in SCD patients.
