Bacterial Etiology and Antibacterial Susceptibility Patterns of Pediatric Bloodstream Infections: A Two Year Study From Nemazee Hospital, Shiraz, Iran

Abstract

Background: Sepsis refers to an illness resulting from a systemic inflammatory response to infection, mainly caused by bacterial agents. Any delay in sepsis treatment can lead to high morbidity and mortality. Objectives: The aims of this study were to identify the common bacterial agents responsible for pediatric septicemia and determine their antimicrobial susceptibility patterns in Nemazee Hospital, Shiraz, Iran. Patients and Methods: This cross-sectional study was conducted within a two year period (2011 - 2013) for all patients with clinical manifestations of septicemia. Blood specimens were collected aseptically in BACTEC TM blood bottles, and conventional bacteriological methods were followed for isolation and identification of the bacteria. Antimicrobial susceptibility tests were performed by using the disk diffusion method in accordance with CLSI recommendations. Results: From a total of 491 blood cultures, 74 (15.1%) samples were detected as positive. The most common isolates were Gram positive cocci, and Staphylococcus epidermidis (48.6%) was found to be the most common Gram positive cocci. Among recovered Gram negative isolates, Acinetobacter spp. (8.1%) were the predominant isolates. Overall, the most effective antibiotics against Gram positive cocci were vancomycin (98%) and chloramphenicol (72.5%). In addition, the highest sensitivities to the agents tested against Gram negative isolates were to ciprofloxacin (47.8%) and chloramphenicol (30.4%). Conclusions: Due to the variable nature of antibiotic susceptibility patterns and etiological agents of septicemia, continual assessment of the most frequent pathogens associated with bloodstream infections and detection of their sensitivity patterns to locally available antibiotics seem to be reasonable measures.