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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Jaypee Brothers Medical Publisher
2025-03-01
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| Series: | Pediatric Infectious Disease |
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| Online Access: | https://www.pidjournal.com/doi/PID/pdf/10.5005/jp-journals-10081-1458 |
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| author | Isha Bhagat Rekha Solomon Dhruv Mamtora Garima Mehta Lakshmi Shobhavat |
| author_facet | Isha Bhagat Rekha Solomon Dhruv Mamtora Garima Mehta Lakshmi Shobhavat |
| author_sort | Isha Bhagat |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-11c8222530cb49f4ae57364fd5ab76ad |
| institution | OA Journals |
| issn | 2582-4988 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Jaypee Brothers Medical Publisher |
| record_format | Article |
| series | Pediatric Infectious Disease |
| spelling | doaj-art-11c8222530cb49f4ae57364fd5ab76ad2025-08-20T02:08:31ZengJaypee Brothers Medical PublisherPediatric Infectious Disease2582-49882025-03-0172444910.5005/jp-journals-10081-14582Profile of Positive Cultures in Pediatric Intensive Care Unit: A Retrospective Cohort StudyIsha Bhagat0Rekha Solomon1Dhruv Mamtora2Garima Mehta3Lakshmi Shobhavat4Department of Pediatric Intensive Care Unit, Bai Jerbai Wadia Hospital for Children, Mumbai, Maharashtra, IndiaRekha Solomon, Department of Pediatric Intensive Care Unit, Bai Jerbai Wadia Hospital for Children, Mumbai, Maharashtra, India, Phone: +91 9820957669Department of Microbiology and Infection Control, Bai Jerbai Wadia Hospital for Children, Mumbai, Maharashtra, IndiaDepartment of Pediatric Intensive Care Unit, Bai Jerbai Wadia Hospital for Children, Mumbai, Maharashtra, IndiaDepartment of Pediatric Intensive Care Unit, Bai Jerbai Wadia Hospital for Children, Mumbai, Maharashtra, IndiaInfections 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.https://www.pidjournal.com/doi/PID/pdf/10.5005/jp-journals-10081-1458antibiotic resistanceculture positive inflectionmultidrug resistant organismpediatric intensive care unit |
| spellingShingle | Isha Bhagat Rekha Solomon Dhruv Mamtora Garima Mehta Lakshmi Shobhavat Profile of Positive Cultures in Pediatric Intensive Care Unit: A Retrospective Cohort Study Pediatric Infectious Disease antibiotic resistance culture positive inflection multidrug resistant organism pediatric intensive care unit |
| title | Profile of Positive Cultures in Pediatric Intensive Care Unit: A Retrospective Cohort Study |
| title_full | Profile of Positive Cultures in Pediatric Intensive Care Unit: A Retrospective Cohort Study |
| title_fullStr | Profile of Positive Cultures in Pediatric Intensive Care Unit: A Retrospective Cohort Study |
| title_full_unstemmed | Profile of Positive Cultures in Pediatric Intensive Care Unit: A Retrospective Cohort Study |
| title_short | Profile of Positive Cultures in Pediatric Intensive Care Unit: A Retrospective Cohort Study |
| title_sort | profile of positive cultures in pediatric intensive care unit a retrospective cohort study |
| topic | antibiotic resistance culture positive inflection multidrug resistant organism pediatric intensive care unit |
| url | https://www.pidjournal.com/doi/PID/pdf/10.5005/jp-journals-10081-1458 |
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