Profile of Blood Stream Infections in Paediatric Patients in Rural Tertiary Care Hospital

Abstract

Background: Blood stream infections (BSI) are the major cause of morbidity and mortality worldwide. It is often associated with hospitalization, and management involving invasive therapeutic and diagnostic procedures. Timely detection and identification of blood-borne pathogens, would reduce mortality, and turnaround time and improve patient management. Aims: 1. To identify the common pathogens causing bacteremia in different age group in pediatric patients. 2. To identify the risk factors and other screening parameters associated with bacteremia. 3. To study the turnaround time using automated BacT/Alert 3D system Settings and Design: Observational study done in a rural tertiary care Hospital, Tamaka, Kolar. Meterials and Methods: A total of 176 paired blood culture samples were collected from paediatric patients admitted signs and symptoms of sepsis and PUO in pediatric wards during February 2012 – August 2013 The samples were collected under strict aseptic precautions before starting of antibiotics. Blood cultures were processed by BacT/Alert 3D system (bioMerieux). Growth was identified by the standard microbiological techniques and antibiotic and antifungal susceptibility testing were done according to CLSI guidelines. Statistical analysis used: Results: Among the blood cultures processed, 41.5% were identified as pathogens, 0.5% as contaminants and 58% had no growth. Most of the positive blood cultures were detected within 24 hours. Bacteremia was more common among neonates (69.9%).The most common organisms isolated were, Staphylococcus aureus (17.8%), followed by Candida krusei (12.3%), Candida tropicalis (10.9%), C.albicans (10.9%), and Klebsiella species (9.6%). The predominant sepsis screening parameters in the positive cultures were CRP and tachypnea. The most common risk factors observed were birth asphyxia, preterm babies and low birth weight. Conclusion: BSI are more common among neonates and The BacT/ Alert 3D system is useful in detecting the infective organisms early and the paired samples are necessary us in confirming the pathogens from contaminants. Key-words: Blood stream infection, Bacteriological profile, neonatal septicemia, Bac T/Alert, pediatric BSI