Profile of Positive Cultures in Pediatric Intensive Care Unit: A Retrospective Cohort Study
Infections are an important cause of morbidity and mortality in the pediatric intensive care unit (PICU). Aims and objectives: To study the demographic profile, describe the spectrum and resistance pattern of organisms isolated from blood and respiratory cultures, and study the outcome. Materials an...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Jaypee Brothers Medical Publisher
2025-03-01
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| Series: | Pediatric Infectious Disease |
| Subjects: | |
| Online Access: | https://www.pidjournal.com/doi/PID/pdf/10.5005/jp-journals-10081-1458 |
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| Summary: | Infections are an important cause of morbidity and mortality in the pediatric intensive care unit (PICU).
Aims and objectives: To study the demographic profile, describe the spectrum and resistance pattern of organisms isolated from blood and respiratory cultures, and study the outcome.
Materials and methods: This retrospective observational study, conducted from January 1 to December 31, 2021, was performed on children with positive blood and respiratory cultures admitted to the PICU of a tertiary care multispecialty hospital. Demographic profile and outcome measures were recorded. Positive cultures and resistance patterns were noted.
Results: There were 139 children with positive cultures, with a median age of 12 months. The majority of children had comorbidities (62.6%), previous hospital admissions (83.5%), and/or antibiotic exposure (85.4%). Gram-negative bacilli (GNB) comprised 99% of positive respiratory cultures in hospital-acquired infections (HAI), and the most common organisms grown were <italic>Acinetobacter</italic> species, <italic>Klebsiella</italic> species, and <italic>Pseudomonas</italic> species. On antibiotic sensitivity testing, approximately three-fourths of the organisms showed multidrug resistance. High levels of carbapenem resistance were seen in isolates of <italic>Acinetobacter baumannii</italic> (40/48), <italic>Klebsiella pneumoniae</italic> (25/29), and <italic>Pseudomonas aeruginosa</italic> (22/37). Out of the 139 patients included in the study, 86 (61.9%) survived. On multivariate analysis, multidrug resistant organisms (MDRO) were significantly associated with mortality (<italic>p</italic> = 0.02).
Conclusion: Infections in critically ill children were predominantly due to gram-negative organisms. There is a trend toward increasing antibiotic resistance over time. Infection with MDRO is associated with mortality.
Highlights: Infections represent a major burden in developing countries, especially in critically ill children. Our study shows high levels of multidrug resistance and increasing carbapenem resistance over time. We have demonstrated a higher risk of mortality in children with MDRO. |
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| ISSN: | 2582-4988 |