Microbial Isolates and their Antibiotic Resistance Pattern; Pediatric Intensive Care Unit Experience

Abstract

Objective:  This study was conducted to assess the frequency of different microbial isolates and their antibiotic resistance pattern in patients admitted to Pediatric Intensive Care Units of Holy Family Hospital (HFH), Rawalpindi and Benazir Bhutto Hospital (BBH), Rawalpindi.

Methods: In this descriptive cross-sectional study, samples drawn from 253 pediatric patients of Intensive Care Units were included. Data was taken from records of the Pathology Department of the concerned hospitals, from September 2016 to July 2017. Data was collected about the types of specimens, culture positive microbes, and the antibiotic sensitivity of the bacterial isolates.

Results: Amongst the cultures included, 64.8% showed no growth while 32% showed bacterial growth and 3.2% showed fungal growth. Most frequently isolated organism was Escherichia Coli (22.7%) followed by Klebsiella pneumoniae (18.8%), Acinetobacter baumannii (16.8%), Staphylococcus Aureus (10.9%), Pseudomonas (9.9%), Candida (7.9%). The most common pathogen isolated from the respiratory tract was Klebsiella (38.7%); from urinary tract, E.coli (63.2%); from blood, Staphylococcus Aureus (30%). Antibiotic sensitivity showed that the isolated pathogens were most susceptible to Meropenem. It was however less effective against Acinetobacter. Vancomycin was also effective against majority of microbes isolated except for Klebsiella. Fosfomycin showed mixed results.

Conclusion: In Paediatric ICU most commonly isolated pathogens are E.coli, Klebsiella, Acinetobacter and S.aureus. Meropenam and Vancomycin combination is the best guess empiric antibiotic keeping in mind antibiotic sensitivity patteren of these microrganisms.