Microbial Profile and Antimicrobial Susceptibility Pattern of Multidrug-resistant Organisms (MDROs) in Bloodstream Infections in Paediatric and Neonatal ICU of a Tertiary Care Hospital, Uttarakhand

Abstract

Healthcare associated infections are the potential cause of morbidity and mortality amongst paediatric population. Widespread antimicrobial use amongst paediatric population leads to the antimicrobial resistance. Bloodstream infections amongst the paediatric population are the leading cause of death. The objective of the study was to determine the general trend of antimicrobial susceptibility pattern in the paediatric and neonatal age group in the ICU setting. Retrospective analysis was done of all the patients of paediatric and neonatal age group who were admitted in ICU including patients on ventilators, and whose blood samples were sent to the lab for culture and sensitivity testing. The sample profile from PICU and NICU shows the total numbers of 3056 samples (including blood, ET secretion, pus, urine, pleural fluid, etc.) were received in the laboratory from paediatric and Neonatal ICU during the study period. Total blood samples received from PICU and NICU were 1310 (sample size). Out of these, blood samples received from PICU were 618 (33.76%), of which 173 (28%) were positive, whereas, 692 (56.52%) blood samples were received from NICU, of which 242 (35%) were positive. The blood samples showed that in PICU, CONS (20.75%), and Staphylococcus aureus (16.98%) were found in maximum numbers. In NICU, Klebsiella pneumoniae were obtained in maximum numbers (30.77%), followed by Acinetobacter baumannii (21.98%). CONS (Methicillin resistant) were found 100% susceptible against Linezolid, followed by Vancomycin and Clindamycin (83% each). Staphylococcus aureus showed 100% sensitivity for Teicoplanin. Klebsiella pneumoniae, were found to be most susceptible to Tigecycline (74.07%) and Colistin (70.37%). Acinetobacter in blood of PICU patients showed high level of resistance with only 37.5% sensitivity for Colistin and Minocycline each, 12.5% sensitivity for Amikacin. To our conclusion, Linezolid was found to be the best Antimicrobial agent against MRCONS, whereas, Linezolid, Teicoplanin, Tetracyclines were found to have good efficacy against Staphylococcus aureus. The best antimicrobial agents against Klebsiella pneumonia and E. coli were Colistin and Tigecycline.

Keywords

• multidrug-resistant organisms
• klebsiella pneumoniae
• mr cons
• health care associated infections
• picu
• nicu