Clinico-bacteriological Profile of Pneumonia, Meningitis and Sepsis in under Five Children from a Tertiary Care Hospital in Central India

Abstract

Introduction: Invasive Bacterial Diseases (IBD) are the major causes of morbidity and mortality in under five children in India. There is difference in the pattern and aetiology of IBD according to the geographical variation and the antimicrobial susceptibility of causative organisms are also variable. There is lack of data on patterns of IBD from central India. Aim: To generate the data on the burden of pneumonia, meningitis and sepsis among under five children in central India and the microorganisms associated with them. Materials and Methods: This prospective observational study was conducted from August 2019 to July 2020 at the Department of Paediatrics at Mahatma Gandhi Memorial Medical College and MY Hospital, indore, India on children of 1-59 months of age admitted with pneumonia, meningitis and sepsis. A detailed history was recorded for all the participants and thorough physical examination was done along with chest X-ray , routine laboratory examination and blood cultures were performed. Latex Agglutination Test (LAT) and Antibiotic Susceptibility Testing (AST) were performed on Cerebrospinal Fluid (CSF) samples. All the data collected were recorded in Microsoft (MS) excel sheet and frequency (n), percentages (%) and chi-square test for significance level, were calculated to analyse the collected data. Results: Of the total 450 cases enrolled, 283 (62.8%) had confirmed IBD. Out of the confirmed cases, 183 (64.6%) had pneumonia, 52 (18.3%) had meningitis and 48 (16.9%) had sepsis. Highest case fatality rate was seen with sepsis followed by meningitis and pneumonia. The most common organism isolated was Staphylococcus aureus. Overall, gram negative bacilli were found to be more resistant to the conventional antibiotics than gram positive organisms. An 40 (83%) of Staphylococcus aureus were susceptible to methicillin whereas only 12 (45%) of Klebsiella pneumoniae were susceptible to amikacin. Conclusion: The present study highlights the predominance of staphylococcus aureus and adverse outcomes of IBD in children with Severe Acute Malnutrition (SAM) and incomplete immunisation. Emergence of resistant bacterial strains to conventional antibiotics warrants the need to consider the locally prevailing antimicrobial susceptibility patterns for the effective management of these diseases.