Caspian Journal of Pediatrics

Background and Objective: Nosocomial infections are a serious threat in healthcare settings, particularly in paediatric intensive care units (PICU), and understanding the microbiological landscape is crucial for effective infection control and improved patient outcomes. This study seeks to identify and characterize the microorganisms present in the PICU and their resistance to antibiotics.
Methods: This study was a prospective observational research in Jaipur, Rajasthan, India, from July 1, 2022 to December 31, 2023.the PICU. Various samples (blood, urine, endotracheal aspirates, swabs etc) were collected and analysed. Antimicrobial susceptibility testing was performed using the vitek-2 compact system. Results were interpreted according to CLSI guidelines (2022). Positive isolates were categorized and their antimicrobial susceptibility and resistance patterns were documented and presented as the number of isolates and percentage of resistance to specific agents.
Findings: Of the 1116 culture samples tested, 111 were positive (9.94% positivity rate). Blood culture were most common (41.4%), followed by endotracheal (31.5%) and urine (12.6%) cultures. Most positive patients were children under 6 years old (76%). Coagulase negative staphylococcus aureus (CONS) and Acinetobacter species were the most frequent bacteria (18% and 18.9% respectively). Resistance rates were high for benzathine penicillin and quinolones whereas linezolid and daptomycin were most effective against gram-positive organisms. Carbapenems, Colistin, and tigecycline were most effective against gram-negative isolates. Extended spectrum beta-lactam (ESBL) resistance was high in Acinetobacter spp., klebsiella, E.coli, and pseudomonas spp.
Conclusion: The study highlights the importance of understanding the microbiological landscape in paediatric intensive care unit to implement effective infection control measures and select appropriate antimicrobial therapies.