Determining the Infectious Pathogens and Their Resistance to Antibiotics in a Pediatric Intensive Care Unit
03 May 2017
05 September 2017
07 October 2017 (eFirst)
Introduction Nosocomial infections are one of the main causes of morbidity and mortality. It is important to know the common infectious pathogens and their resistance profiles in intensive care units (ICUs) to determine appropriate treatment protocols. The aim of this study was to determine the epidemiological profile of microorganisms isolated in a pediatric ICU (PICU) and to determine antibiotic resistance in isolated strains.
Materials and Methods This retrospective study was performed at the Meram Medical Faculty Hospital, Necmettin Erbakan University, Konya, Turkey. A total of 1,502 bacteria that were isolated from various specimens from children who were hospitalized in PICUs between January 2014 and December 2015 were included in this study to determine the isolated bacteria diversity and susceptibility to various antibiotics.
Results Staphylococcus spp. was the most frequently isolated microorganism followed by Escherichia coli and Klebsiella spp., respectively. The sites where pathogens were isolated were as follows: 616 blood, (41%), 445 urine (29.6%), 60 sputum (4%), 44 cerebrospinal fluid (2.9%), 25 wound swab (1.6%), 20 tracheal aspirate (1.3%), and 26 others (1.7%). The carbapenem resistance rate was 40.8% among Pseudomonas aeruginosa isolates. Among 60 Acinetobacter baumannii isolates tested, 62% were resistant to carbapenems. Sensitivity rates of A. baumannii isolates to tigecycline and colistin were as high as 98 and 96%, respectively. Meropenem and colistin resistance rates to Klebsiella spp. were 16.2 and 15%, respectively.
Conclusion In conclusion, it is essential to identify the infectious pathogens and their resistance to antibiotics especially in ICUs where infections with multidrug-resistant bacteria are frequent. Studies on this issue should be performed at appropriate time intervals.
- 1 Kepenekli E, Soysal A, Yalindag-Ozturk N. , et al; Turkish PICU-HCAI Study Group. Healthcare-Associated Infections in Pediatric Intensive Care Units in Turkey: a National Point-Prevalence Survey. Jpn J Infect Dis 2015; 68 (05) 381-386
- 2 Kuzdan C, Soysal A, Çulha G, Altinkanat G, Söyletir G, Bakir M. Three-year study of health care-associated infections in a Turkish pediatric ward. J Infect Dev Ctries 2014; 8 (11) 1415-1420
- 3 Atici S, Soysal A, Kepenekli Kadayifci E. , et al. Healthcare-associated infections in a newly opened pediatric intensive care unit in Turkey: results of four-year surveillance. J Infect Dev Ctries 2016; 10 (03) 254-259
- 4 Kölgelier S, Küçük A, Demir NA, Özçimen S, Demir LS. Nosocomial infections in intensive care units: etiology and predisposing factors. Kafkas J Med Sci 2012; 2 (01) 1-5
- 5 Rosenthal VD, Maki DG, Salomao R. , et al; International Nosocomial Infection Control Consortium. Device-associated nosocomial infections in 55 intensive care units of 8 developing countries. Ann Intern Med 2006; 145 (08) 582-591
- 6 Lee CR, Cho IH, Jeong BC, Lee SH. Strategies to minimize antibiotic resistance. Int J Environ Res Public Health 2013; 10 (09) 4274-4305
- 7 Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. CLSI M100–S21, Wayne, PA, CLSI. Available at: https://goo.gl/6mLW2g . Accessed 2014.
- 8 Kaya S, Arıdoğan BC, Çetin H, Demirci M. Isolated microorganisms in blood culture received children patients and antibiotic resistances. Firat Tip Derg 2007; 12 (01) 34-36
- 9 Ismail A, El-Hage-Sleiman AK, Majdalani M, Hanna-Wakim R, Kanj S, Sharara-Chami R. Device-associated infections in the pediatric intensive care unit at the American University of Beirut Medical Center. J Infect Dev Ctries 2016; 10 (06) 554-562
- 10 Ben Jaballah N, Bouziri A, Mnif K, Hamdi A, Khaldi A, Kchaou W. Epidemiology of hospital-acquired bloodstream infections in a Tunisian pediatric intensive care unit: a 2-year prospective study. Am J Infect Control 2007; 35 (09) 613-618
- 11 El-Nawawy AA, Abd El-Fattah MM, Metwally HA, Barakat SS, Hassan IA. One year study of bacterial and fungal nosocomial infections among patients in pediatric intensive care unit (PICU) in Alexandria. J Trop Pediatr 2006; 52 (03) 185-191
- 12 Tao L, Hu B, Rosenthal VD, Gao X, He L. Device-associated infection rates in 398 intensive care units in Shanghai, China: International Nosocomial Infection Control Consortium (INICC) findings. Int J Infect Dis 2011; 15 (11) e774-e780
- 13 Raymond J, Aujard Y. ; European Study Group. Nosocomial infections in pediatric patients: a European, multicenter prospective study. Infect Control Hosp Epidemiol 2000; 21 (04) 260-263
- 14 Rutledge-Taylor K, Matlow A, Gravel D. , et al; Canadian Nosocomial Infection Surveillance Program. A point prevalence survey of health care-associated infections in Canadian pediatric inpatients. Am J Infect Control 2012; 40 (06) 491-496
- 15 Taşbent FE, Doğan M, Feyzioğlu B, Baykan M. Antibiotic resistance of Pseudomonas strains isolated from various clinical specimens. TürkMikrobiyolCemDerg 2013; 43 (04) 138-143
- 16 Rhomberg PR, Jones RN. Summary trends for the meropenem yearly susceptibility test information collection program: a 10-year experience in the United States (1999-2008). Diagn Microbiol Infect Dis 2009; 65 (04) 414-426
- 17 Thaden JT, Lewis SS, Hazen KC. , et al. Rising rates of carbapenem-resistant Enterobacteriaceae in community hospitals: a mixed-methods review of epidemiology and microbiology practices in a network of community hospitals in the southeastern United States. Infect Control Hosp Epidemiol 2014; 35 (08) 978-983
- 18 Le NK, Hf W, Vu PD. , et al. High prevalence of hospital-acquired infections caused by gram-negative carbapenem resistant strains in Vietnamese pediatric ICUs: A multi-centre point prevalence survey. Medicine (Baltimore) 2016; 95 (27) e4099
- 19 Ertürk A, Çiçek AÇ, Köksal E, Köksal ZŞ, Özyurt S. Microorganisms isolated from various clinical samples and their antibiotic susceptibilities in intensive care unit patients. ANKEM Derg 2012; 26 (01) 1-9
- 20 Doğan M, Aydemir Ö, Feyzioğlu B, Baykan M. Bacteria isolated from the urine samples of children and their antibiotic susceptibilities. ANKEM Derg 2013; 27 (04) 206-212