Abstract
Introduction: Nowadays, antimicrobial resistance is a challenge faced by physicians globally. Infections due to Multidrug Resistant Organisms (MDROs) is a significant problem in Paediatric Intensive Care Unit (PICU).
Aim: To identify the burden of antimicrobial resistance in hospital isolates from paediatric patients and elucidate the resistance pattern of MDROs.
Material and Methods: All the clinical specimen received from pediatric outpatient and inpatient were included in the study and data were collected and processed on blood agar, chocolate agar and MacConkey agar. Cled agar from those yielding growth on urine culture. The bacterial isolates were identified with standard bio-chemical tests. Antibiotic susceptibility testing was done according to CLSI guidelines 2019 by Kirby Bauer disk diffusion method.
Results: A total of 100 (39.07%) bacteria were isolated from 256 clinical samples, 65 bisolates were from urine followed by blood (22), exudates (9) and respiratory (4) samples. 22 were MDROs,14 were from urine, blood(5), exudates(2) and respiratory(1) samples respectively. Isolates of E. coli (54%), Klebsiella spp (36%). and Enterococcus (0.9%) spp. were the common MDROs. The most sensitive antibiotic for gram negative bacteria was polymyxin-B (100%) followed by imipenem (98%) and meropenem (90%). And the most sensitive antibiotic for gram positive bacteria was Linezolid (100%) Vancomycin (97%) followed by Teicoplanin (94%).
Conclusion: This study reveals significant prevalence of MDR pathogens among paediatric population. E. coli, Klebsiella spp. and Enterococcus spp. were the common MDROs encountered in the study, mostly isolated from urine culture.
Keywords: Bacterial, Drug resistance, Escherichia coli, Urinary tract infection.
References
- Gajul SV, Mohite ST, Mangalgi SS, Wavare SM, Kakade SV. Klebsiella pneumoniae in septicemic neonates with special reference to extended spectrum β-lactamase, Amp C, metallo β-lactamase production and multiple drug resistance in tertiary care J Lab Physicians. 2015;7(1):32-37
- Muley VA, Ghadage DP, Bhore AV. Bacteriological profile of neonatal septicemia in a tertiary care hospital from Western J Global Infect Dis. 2015;7(2):75-77.
- De Oliveira Costa P, Atta EH, da Silva AR. Infect with multidrug-resistant gram- negative bacteria in a pediatric oncology intensive care unit: risk factors and J Pediatr (Rio J). 2015;91 (5):435-41
- Arnold, J.C.; Bradley, J.S. Osteoarticular Infections in Children. Infect. Dis. Clin. 2015, 29, 557–574.
- Folgori L, Livadiotti S, Carletti M, Bielicki J, Pontrelli G, DegliAtti ML, et al. Epidemiology and clinical outcomes of multidrug-resistant Gram-negative bloodstream infections in a European tertiary pediatric hospital during a 12 month Pediatr Infect Dis J. 2014;33(9):929-32
- Siddiqui N, Qamar FN, Jurair H, Haque A. Multi-drug resistant gram-negative infections and use of intravenous polymyxin B in critically ill children of developing country: retrospective cohort BMC Infectious Diseases. 2014;14:626
- Benner KW, Parbhakaran P, Lowros Epidemiology of infections due to extended spectrum beta-lactamase-producing bacteria in a pediatric intensive care unit. J Pediatr Pharmacol Ther. 2014;19(2):83-90
- Gyawali N, Sanjana Bacteriological profile and antibiogram of neonatal septicemia. Indian J Pediatr. 2013;80(5):371-74.
- Patel G, Bonomo “Stormy waters ahead”: global emergence of carbapenemases. Front Microbiol 2013; 4:1–17.
- Cornaglia G, Giamarellou H, Rossolini GM. Metallo- β-lactamases: a last frontier for β-lactams? Lancet Infect Dis 2011; 11:381–93.
- Taneja N, Chatterjee SS, Singh M, Singh S, Sharma M. Pediatric urinary tract infections in a tertary care center from North Indian J Med Res. 2010;131:101-05.
- DeLeo, F.R.; Otto, M.; Kreiswirth, B.N.; Chambers, H.F. Community- associated Methicillin-resistant Staphylococcus-aureus. Lancet 2010, 375, 1557–1568.
- Yolbas, R. Tekin1, S. Kelekci, A. Tekin, M.H. Okur, A. Ece, A. Gunes, V. Sen. Community-acquired urinary tract infections in children: pathogens, antibiotic susceptibility and seasonal changes. European Rev Med Pharmacol Sci 2013;17:971-976.
- Durgesh D. Wasnik, P. M. Tumane. Prevalence and antibacterial susceptibility pattern of Urinary Tract Infection Causing Human Pathogenic Bacteria. Asian J Biomed Pharmaceutical Sci 2012;2:1-3.
- Mostafa Sharifi an, Abdollah Karimi, Sedigheh Rafi ee, Tabatabaei and Navid Microbial Sensitivity Pattern in Urinary Tract Infections in Children: A Single Centre Experience of 1,177 Urine Cultures. J Infect Dis 2006;59:380- 382.
- RehamIssa Al-Mardeni, Adel Batarseh, Lina Omanish, Majdolin Shraideh, Basma Batarseh, Nidal Unis. Emprical Treatment for Pediatric Urinary Tract Infection and Resistance Patterns of Uropathogens, in Queen Alia Hospital and Prince A’Isha Military Centre – Jordan. Saudi J Kidney Dis Transplant 2009;20(1):135-139.
- CW Kwan, H Community-acquired urinary tract pathogens and their resistance patterns in hospitalized children in south-eastern Ontario between 2002 and 2006. Paediatr Child Health 2008;13:759-762.
- Haller M, Brandis M, Berner Antibiotic resistance of urinary tract pathogens and rationale for empirical intravenous therapy. Pediatr Nephrol 2004;19:982- 986.
- Prais D, Straussberg R, Avitzur Y, Nussinovitch M, Harel L, Amir J. Bacterial susceptibility to oral antibiotics in community acquired urinary tract Arch Dis Child 2003;88:215-218.
- Hoberman A, Wald ER, Hickey RW, et al. Febrile children oral versus initial intravenous therapy for urinary tract infections in young. Pediatrics. 1999;104;79-
- Stephanie A. Lutter, MD; Melissa L. Currie, MD; Lindsay B. Mitz, BA; Larry A. Greenbaum, MD, PhD. Antibiotic Resistance Patterns in Children Hospitalized for Urinary Tract Arch Pediatr Adolesc Med. 2005;159:924-928.
- Rasoul Yousefi Mashouf, Hooshang Babalhavaeji and Javad Urinary Tract Infections: Bacteriology and Antibiotic Resistance Patterns. Indian Pediatrics. 2009;46: 617-620.
Corresponding Author
Prof. Dr Dolly Rastogi
Head of Department Physiology GMC Kannauj
DOI: https://dx.doi.org/10.18535/jmscr/v9i7.14
