Antimicrobial Resistance in Pathogens Causing Pediatrics Bloodstream Infections in a Saudi Hospital

Abstract

Background: Bloodstream infection (BSI) is one of the most common life-threatening conditions in hospitalized pediatrics especially if associated with resistant microbes. Aims: To determine the incidence, predisposing factors, microbiological and antimicrobial resistance patterns in suspected BSI pediatric patients in a Saudi hospital. Place and Duration of Study: Different wards of Madinah Maternity and Children's Hospital, Saudi Arabia, during one year period from July 1, 2009 to June 30, 2010. Methodology: Blood cultures were performed to all cases (n= 11968) using Bactec 9240 instrument Blood Culture Systems. Microorganisms were identified by colony morphology, Gram stain and biochemical profiles. BD Phoenix™ was used in confirmation of identification of all BSI Gram-negative isolates. Antibiotic susceptibility pattern of isolates was further done by using disk diffusion method. Results: 728 cases (6.1%) were diagnosed with BSI after having a one positive blood culture. The overall mortality rate was 11%. Gram-positive, Gram-negative and yeast accounted for 63.8%, 31.6% and 4.6% of the total isolates, respectively. Coagulase-negative staphylococci were the most prevalent Gram-positive isolates (44%); while Serratia marcescens and Klebsiella pneumoniae were the most common Gram-negatives. Gram-positive bacteria were mostly sensitive to cephalothin (82.3%) and vancomycin (72.2%), while Gram-negative bacteria were mostly sensitive to ciprofloxacin (93%), piperacillin/tazobactam (92.9%), and meropenem (89.8%). Conclusion: The incidence rate of BSI is highest in ICU neonates. Therefore, special attention should be given to the quality of care provided for them to improve safety. There was appreciable resistance to commonly used antibiotics; and continued monitoring of antibiotic resistance is of great importance to ensure the proper use of antibiotics and to detect any increasing trends in resistance.