Bacteriological Profile and Antimicrobial Sensitivity Pattern of Blood Culture Isolates

BACKGROUND Blood stream infections are the leading cause of morbidity and mortality in children in developing countries. Blood culture remains the golden reference standard for the laboratory diagnosis of bloodstream infections (BSIs) and helps in the prevention of emergence of multidrug resistant bacterial strains which poses a major challenge in the management of bacteraemia. Knowledge about the bacteriological profile and antimicrobial susceptibility patterns in the local unit helps the clinician in rationalizing the empirical treatment protocols and optimizing the duration of therapy. METHODS A hospital based retrospective observational study was carried out by reviewing the records of 318 blood cultures received from children aged 1 month to 12 years admitted with clinically suspected sepsis at Institute of Child Health, Niloufer Hospital for Women and Children, Hyderabad over a 4 month period (April 2019 - August 2019). Blood samples were collected under aseptic conditions, identification of isolates and their antibiotic sensitivity pattern was done by disc diffusion method as per CLSI standards 2019. RESULTS During the study period, among the 318 blood cultures studied, 105 (33 %) samples showed positive cultures. Out of the positive cultures, 57 (54.3 %) samples showed growth of Gram-positive bacteria and 48 (45.7 %) samples showed growth of Gram-negative bacteria. Klebsiella spp [30 (28.5 %)] were the most common bacteria isolated followed by Coagulase negative Staphylococcus 28 (26.7 %), Staphylococcus epidermidis 18 (17.1 %), Pseudomonas aeruginosa 12 (11.4 %), Enterococcus species 6 (5.7 %), Staphylococcus aureus 3 (2.8 %), Acinetobacter species 4 (3.8 %), and each one isolate of E. coli, Citrobacter species and Streptococcus pyogenes. The antibiotic sensitivity patterns have shown a high degree of resistance to the Cephalosporins among the Gram-negative cultures and high sensitivity pattern to Carbapenems and Fluoroquinolones. CONCLUSIONS The present study emphasizes the need for continuous scrutiny and surveillance for the most common pathogens isolated in children with blood stream infections along with antibiotic sensitivity pattern in paediatric units for formulating rationalized antibiotic treatment protocols and infection control strategies for prevention of septicaemia in children.