Chinese Medical Sciences Journal ›› 2020, Vol. 35 ›› Issue (4): 315-322.doi: 10.24920/003675
• Original Article • Previous Articles Next Articles
Anees Muhammad1, 4, Sadiq Noor Khan1, Tahir Jamal2, Irshad Ul Haq3, Abdul Jabbar1, Ihsan Ali5, *()
Received:
2019-10-29
Accepted:
2020-04-30
Published:
2020-12-31
Online:
2020-10-28
Contact:
Ihsan Ali
E-mail:ihsanmicro@gmail.com
Anees Muhammad, Sadiq Noor Khan, Tahir Jamal, Irshad Ul Haq, Abdul Jabbar, Ihsan Ali. Bacterial Spectrum and Antimicrobial Profile of Pediatric Blood Stream Infection at a Tertiary Care Hospital in Pakistan[J].Chinese Medical Sciences Journal, 2020, 35(4): 315-322.
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Table 1
Prevalence of bacterial isolates of blood stream infections (BSI) in children (n=111)"
Bacterial isolates | n | % |
---|---|---|
Gram-positive isolates | 32 | 28.8 |
Methicillin resistant Staphylococcus aureus (MRSA) | 11 | 9.9 |
Staphylococcus aureus | 7 | 6.3 |
Enterococcus spp | 7 | 6.3 |
Streptococcus spp | 6 | 5.4 |
Coagulase negative Staphylococcus spp (CONS) | 1 | 0.9 |
Gram-negative isolates | 79 | 71.2 |
Salmonella typhi | 35 | 31.5 |
Escherichia coli | 19 | 17.1 |
Klebsiella pneumonia | 12 | 10.8 |
Pseudomonas aeruginosa | 6 | 5.5 |
Salmonella paratyphi | 4 | 3.6 |
Enterobacter aeruginosa | 2 | 1.8 |
Citrobacter spp | 1 | 0.9 |
Table 2
Antibiotic resistance patterns of Gram-negative bacterial isolates from children with blood stream infections in Pakistan [n(%)]"
Bacteria | Ampi- cillin | Aztreo- nam | Azithromycin | Amikacin | Chloramphenicol | Ciproflo- xacin | Co-Trimo- xazole | Ceftria- xone | Cefota- xime | Ceftazidime | Imipenam | Cefepime | Colistin/Polymyxin B | Tazocin | Gentamicin |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
S. typhi (n=35) | 11 (31.4) | 11 (31.4) | 10 (28.6) | NT | 11 (31.4) | 27 (77.1) | 11 (31.4) | 0 (0) | 6 (17.1) | NT | 1 (2.9) | 6 (17.1) | NT | 8 (22.9) | NT |
S. paratyphi (n=4) | 0 (0) | 1 (25) | 0 (0) | NT | 0 (0) | 2 (50) | 0 (0) | 0 (0) | NT | NT | NT | 3 (25) | NT | 3 (75) | NT |
P.aeruginosa (n=6) | NT | 2 (33.3) | NT | 0 | NT | 1 (16.7) | NT | 2 (33.3) | 2 (33.3) | 2 (33.3) | 5 (83.3) | 2 (33.3) | NT | 0 (0) | 2 (33.3) |
K.pneumonia (n=12) | 12 (100) | 12 (100) | NT | 9 (75) | NT | 8 (66.7) | 7 (58.3) | 12 (100) | 12 (100) | 11 (92.7) | 7 (58.3) | 12 (100) | 1 (8.3) | 3 (25) | 7 (58.3) |
Enterobacter spp (n=2) | 2 (100) | 2 (100) | NT | 0 | NT | 1 (50) | 2 (100) | 2 (100) | 1 (50) | 1 (50) | 0 (0) | 2 (100) | 0 (0) | 1(50) | 2 (100) |
Citrobacter spp (n=1) | NT | 1 (100) | NT | 0 | NT | 0 (0) | 1 (100) | 1 (100) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
E. coli (n=19) | NT | 15 (78.9) | NT | 0 | 11 (13.9) | 5 (73.3) | 13 (68.4) | 13 (68.4) | NT | 13 (68.4) | 1 (5.3) | NT | NT | 3 (15.8) | 3 (15.8) |
Total (n=79) | 25 (31.6) | 44 (55.6) | 10 (12.6) | 9 (11.3) | 22 (27.8) | 44 (55.6) | 34 (43.0) | 30 (37.9) | 21 (26.5) | 27 (34.1) | 14 (17.7) | 25 (31.6) | 1 (1.3) | 18 (22.7) | 14 (17.7) |
Table 3
Antibiotic resistance patterns of Gram-positive bacterial isolates from children with blood stream infections in Pakistan [n(%)]"
Bacteria* | Amikacin | Ampicillin/clavulanic acid | Ampicillin | Cefepime | Cefotaxime | Ceftriaxone | Cefoxitin | Chloramphenicol | Ciproflo- xacin | Clarith- romycin | Clindamycin | Co-Tria- moxazole | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Staphylococcus aureus | ||||||||||||||||||
MRSA (n=11) | 6 (54.5) | 9 (81.8) | 10 (90.9) | 11 (100) | NT | NT | 11 (100) | 2 (18.2) | 9 (81.8) | 5 (45.6) | 4 (36.4) | 5 (45.6) | ||||||
MSSA (n=7) | 0 (0) | 6 (85.7) | 6 (85.7) | NT | NT | NT | 0 (0) | 1 (14.3) | 5 (71.4) | NT | 0 (0) | 4 (57.1) | ||||||
Streptococcus spp (n=6) | NT | NT | 5 (83.3) | 6 (100) | 3 (50) | 3 (50) | NT | 0(0) | 0 (0) | 4 (66.7) | 3 (50) | NT | ||||||
Enterococcus spp (n=7) | NT | NT | 7 (100) | NT | NT | NT | NT | 5 (71.4) | 6 (85.7) | 5 (71.4) | NT | NT | ||||||
Total (n=31) | 6 (19.3) | 15 (48.4) | 28 (90.3) | 6 (100) | 3 (9.6) | 3 (9.6) | 11 (35.5) | 8 (25.8) | 20 (64.5) | 14 (45.2) | 7 (22.6) | 9 (29.0) | ||||||
Bacteria* | Doxycycline | Erythromycin | Gentamicin | Levofloxacin | Linezolid | Meropenem | Minocycline | Penicillin | Rifampicin | Teicoplanin | Vancomycin | |||||||
Staphylococcus aureus | ||||||||||||||||||
MRSA (n=11) | 5 (45.6) | 9 (81.8) | 7 (63.6) | 8 (72.2) | 0 (0) | NT | 6 (54.5) | 10 (90.9) | 2 (18.2) | NT | 0 (0) | |||||||
MSSA (n=7) | 0 (0) | 3 (42.9) | 0 (0) | NT | 0 (0) | NT | 0 (0) | 7 (100) | 0 (0) | NT | 0 (0) | |||||||
Streptococcus spp (n=6) | 4 (66.7) | 4 (66.7) | 2 (33.3) | 4 (66.7) | 0 (0) | 6 (100) | 0 (0) | 3 (50) | 3 (50) | 0 (0) | 0 (0) | |||||||
Enterococcus spp (n=7) | NT | 6 (85.7) | 4 (57.1) | NT | 0 (0) | NT | 1 (14.3) | 3 (42.9) | 7 (100) | 1 (14.3) | 0 (0) | |||||||
Total (n=31) | 9 (29.0) | 22 (70.9) | 13 (41.9) | 12 (38.7) | 0 (0) | 6 (100) | 7 (22.6) | 23 (74.2) | 12 (37.7) | 1 (3.2) | 0 (0) |
Table 4
Multidrug resistant pattern of bacterial isolates from children with blood stream infections (BSI) in Pakistan [n=111, n(%)]"
Bacterial | Isolates | Number of antibiotics being resistant to | ||||
---|---|---|---|---|---|---|
1 | 2 | 3 | 4 | >4 | ||
S. typhi | 35 (31.5) | 18 (51.4) | 13 (37.1) | 3 (8.6) | 1 (2.9) | 0 (0) |
E. coli | 19 (17.1) | 4 (21.1) | 7 (36.8) | 4 (21.1) | 4 (21.1) | 0 (0) |
S. aureus | 19 (17.1) | 2 (10.5) | 1 (5.3) | 3 (15.8) | 4 (21.1) | 9 (47.4) |
K. pneumonia | 12 (10.8) | 0 (0) | 2 (16.6) | 2 (16.7) | 0 (0) | 8 (66.7) |
P. aeruginosa | 6 (5.4) | 2 (33.3) | 2 (33.3) | 1 (16.6) | 1 (16.6) | 0 (0) |
Enterococcus spp. | 7 (6.3) | 1 (16.6) | 2 (33.3) | 0 (0) | 0 (0) | 4 (66.7) |
Streptococcus spp. | 6 (5.4) | 0 (0) | 0 (0) | 2 (33.3) | 3 (50.0) | 1 (16.6) |
S. paratyphi | 4 (3.6) | 2 (50.0) | 2 (50.0) | 0 (0) | 0 (0) | 0 (0) |
Enterobacter spp. | 2 (1.8) | 0 (0) | 0 (0) | 1 (50.0) | 0 (0) | 1 (50.0) |
Citrobacter spp. | 1 (0.9) | 0 (0) | 1 (100) | 0 (0) | 0 (0) | 0 (0) |
Total | 111 (100) | 29 (26.1) | 30 (27.0) | 16 (14.4) | 13 (11.7) | 23 (20.7) |
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