Microbiological profile of Pediatric sepsis in a tertiary care teaching hospital of Central India

A. Mehta, Rajesh K. Gupta, M. Ajmariya
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Abstract

: Background : As per World Health Organization (WHO), sepsis is a leading cause of hospitalization and death in children in developing countries.The rapidly changing bacteriologic profile of childhood sepsis warrants the need for an ongoing review of the etiopathogenesis and drug susceptibility pattern of causative agents. Objectives: To find out the etiological profile and antibiotic sensitivity pattern of the pathogens causing pediatric sepsis in a tertiary care teaching hospital of Central India. Materials and Methods : This is a cross-sectional study. 194 clinical samples were collected from inpatients ranging in age from >1 month to 15 years. Isolation and identification of pathogens were done using Standard microbiological techniques. Antimicrobial susceptibility testing was performed by the standard Kirby Bauer disc diffusion method and interpreted as per CLSI guidelines. Results :Out of the total 87 blood culture isolates majority were Gram Positive cocci (70%); with Staphylococcus aureus (53%) being the most predominant organism. The GPC isolates showed high susceptibility towards Vancomycin, Linezolid, Piperacillin tazobactam, and Tetracyclines. Methicillin resistance was reported in 38% of Staphylococcus aureus isolates. 40% of Enterococcus isolates exhibited High-level Aminoglycoside resistance.Enterobacteriaceae isolates exhibited high susceptibility towards Carbapenems, Colistin, Piperacillin tazobactum& Ceftazidime clavulanate. 40% of E.coli isolates & 50% of K.pneumoniae isolates were found to be Extended- spectrum β lactamase ( ESBL) producers. Non-fermenters exhibited high sensitivity towards Meropenem, Colistin, Piperacillin tazobactam, Amikacin. Conclusions : The present study has provided much-needed information on the local antimicrobial profile of the prevailing pathogens causing pediatric sepsis which will be helpful in guiding their management.
小儿败血症的微生物谱在印度中部的三级护理教学医院
背景:根据世界卫生组织(世卫组织)的资料,败血症是发展中国家儿童住院和死亡的主要原因。儿童败血症快速变化的细菌学特征证明有必要对病原体的发病机制和药物敏感性模式进行持续审查。目的:了解印度中部某三级教学医院致儿童败血症病原菌的病原学特征及抗生素敏感性。材料与方法:这是一项横断面研究。收集194例住院患者临床样本,年龄从>1个月到15岁不等。病原分离鉴定采用标准微生物学技术。抗菌药敏试验采用标准Kirby Bauer圆盘扩散法进行,并按照CLSI指南进行解释。结果:87株血培养分离株中以革兰氏阳性球菌居多(70%);其中,金黄色葡萄球菌(53%)是最主要的细菌。GPC对万古霉素、利奈唑胺、哌拉西林、他唑巴坦和四环素类药物均有较高的敏感性。据报道,38%的金黄色葡萄球菌对甲氧西林耐药。40%的分离肠球菌表现出高水平的氨基糖苷耐药性。肠杆菌科分离株对碳青霉烯类、粘菌素、哌拉西林、他唑巴肟和克拉维酸头孢他啶具有高敏感性。40%的大肠杆菌分离株和50%的肺炎克雷伯菌分离株被发现是扩展谱β内酰胺酶(ESBL)的产生者。非发酵菌对美罗培南、粘菌素、哌拉西林、他唑巴坦、阿米卡星均有较高的敏感性。结论:本研究为儿童脓毒症主要病原菌的局部抗菌特征提供了急需的信息,有助于指导其治疗。
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