Spectrum of World Health Organization global priority pathogens in hospitalized children - A single center experience

Abstract

Objectives: To study the spectrum of World Health Organization (WHO) global priority pathogens in hospitalized children at our center. Material and Methods: This cross-sectional study was conducted between April 2021 to September 2022 in the Department of Pediatrics at Sri Aurobindo Institute of Medical Sciences and Post Graduate Institute (SAMC), Indore. All children admitted to the Pediatric and Adolescent Medicine Department; Ward, Pediatric Intensive Care Unit, Neonatal Intensive Care Unit, and Pediatric Surgical intensive Care Unit and with culture (Blood, urine, cerebrospinal fluid, and other body fluids/tissue) having grown at least one of the WHO priority pathogens, were studied. Results: In this study period, 100 children had positive cultures. We found that urine specimens had the most bacterial isolations 35 (35%), followed by blood 24 (24%). Escherichia coli was the most often isolated organism [25 (25%)], followed by Staphylococcus aureus [18 (18%)]. About 80% of E. coli and 70.59% of Klebsiella spp. were resistant to third-generation cephalosporins due to extended-spectrum beta-lactamase (ESBL), while 50% of S. aureus were Methicillin-resistant. In all, over half of the Enterobacteriaceae were resistant to carbapenem (49.21%) or third generation cephalosporins (55.56%) due to ESBL. Pseudomonas aeruginosa carbapenem resistance was found in 11.11% cases. Conclusion: In this study, WHO priority list pathogens, Enterobacteriaceae, methicillin-resistant S. aureus, Klebsiella species, and E. coli all show significant antimicrobial resistance (AMR). On the other hand, AMR trends for Acinetobacter baumanni, P. aeruginosa, and S. aureus (vancomycin resistant) are lower than the estimations provided by the WHO globally.