Spectrum of World Health Organization global priority pathogens in hospitalized children - A single center experience

Samrin Sheikh, Swati Joshi Mulye
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Abstract

Objectives: To study the spectrum of World Health Organization (WHO) global priority pathogens in hospitalized children at our center. Material and Methods: This cross-sectional study was conducted between April 2021 to September 2022 in the Department of Pediatrics at Sri Aurobindo Institute of Medical Sciences and Post Graduate Institute (SAMC), Indore. All children admitted to the Pediatric and Adolescent Medicine Department; Ward, Pediatric Intensive Care Unit, Neonatal Intensive Care Unit, and Pediatric Surgical intensive Care Unit and with culture (Blood, urine, cerebrospinal fluid, and other body fluids/tissue) having grown at least one of the WHO priority pathogens, were studied. Results: In this study period, 100 children had positive cultures. We found that urine specimens had the most bacterial isolations 35 (35%), followed by blood 24 (24%). Escherichia coli was the most often isolated organism [25 (25%)], followed by Staphylococcus aureus [18 (18%)]. About 80% of E. coli and 70.59% of Klebsiella spp. were resistant to third-generation cephalosporins due to extended-spectrum beta-lactamase (ESBL), while 50% of S. aureus were Methicillin-resistant. In all, over half of the Enterobacteriaceae were resistant to carbapenem (49.21%) or third generation cephalosporins (55.56%) due to ESBL. Pseudomonas aeruginosa carbapenem resistance was found in 11.11% cases. Conclusion: In this study, WHO priority list pathogens, Enterobacteriaceae, methicillin-resistant S. aureus, Klebsiella species, and E. coli all show significant antimicrobial resistance (AMR). On the other hand, AMR trends for Acinetobacter baumanni, P. aeruginosa , and S. aureus (vancomycin resistant) are lower than the estimations provided by the WHO globally.
世界卫生组织住院儿童全球优先病原体谱-单一中心经验
目的:了解我院住院儿童世界卫生组织(WHO)全球重点病原菌谱。材料和方法:本横断面研究于2021年4月至2022年9月在印多尔室利·阿罗宾多医学科学研究所和研究生院(SAMC)儿科进行。所有进入儿科和青少年医学部的儿童;对病房、儿科重症监护病房、新生儿重症监护病房和儿科外科重症监护病房以及培养物(血液、尿液、脑脊液和其他体液/组织)至少生长了一种世卫组织重点病原体进行了研究。结果:在本研究期间,100名儿童培养阳性。我们发现尿液标本中细菌分离率最高,为35(35%),其次是血液标本24(24%)。大肠杆菌是最常见的分离菌[25(25%)],其次是金黄色葡萄球菌[18(18%)]。约80%的大肠杆菌和70.59%的克雷伯菌因广谱β -内酰胺酶(ESBL)对第三代头孢菌素耐药,50%的金黄色葡萄球菌对甲氧西林耐药。总的来说,超过一半的肠杆菌科细菌因ESBL对碳青霉烯类(49.21%)或第三代头孢菌素(55.56%)耐药。铜绿假单胞菌耐碳青霉烯类药物占11.11%。结论:在本研究中,WHO重点列出的病原菌,肠杆菌科、耐甲氧西林金黄色葡萄球菌、克雷伯氏菌和大肠杆菌均表现出显著的抗微生物药物耐药性。另一方面,鲍曼不动杆菌、铜绿假单胞菌和金黄色葡萄球菌(耐万古霉素)的耐药性趋势低于世界卫生组织提供的全球估计。
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