"EPIDEMIOLOGICAL SURVEILLANCE AND RESISTANCEPROFILING OF MULTIDRUG-RESISTANT BACTERIALISOLATES FROM PEDIATRIC PATIENTS: INSIGHTS FROM ATERTIARY CARE CENTER IN NORTHERN INDIA"
Main Article Content
Keywords
Bacterial pathogens, Resistance to drugs, Escherichia coli, Infections of the urinary tract
Abstract
Background: The rise of antimicrobial resistance presents a significant global challenge for healthcare professionals. Infections resulting from multidrug-resistant organisms (MDROs) pose a considerable threat within Paediatric Intensive Care Units (PICUs). Aim: The current study investigates aims to evaluate the impact of antimicrobial agent resistance in hospital isolates from pediatric patients and to examine the resistance patterns exhibited by MDROs. Materials and Methods: This research involved clinical specimens collected from pediatric patients, both in outpatient and inpatient settings. The samples were developed on blood agar, chocolate agar, and MacConkey agar, with urine cultures being specifically carried out on CLED agar. Bacterial isolates were identified through conventional biochemical testing, and antibiotic susceptibility was evaluated following the 2019 CLSI guidelines using the Kirby-Bauer disk diffusion method. Findings: The overall total is 256 clinical samples were analyzed, leading to the identification of 100 bacterial isolates, which accounts for 39.07% of the samples. The predominant source of these isolates was urine, contributing 65 samples, followed by blood with 22, exudates with 9, and respiratory samples with 4. Among the identified isolates, 22 were classified as multidrug-resistant organisms (MDROs), with 14 originating from urine, 5 from blood, 2 from exudates, and 1 from respiratory samples. The most frequently identified MDROs included E. coli (54%), Klebsiella spp. (36%), and Enterococcus spp. (0.9%). In terms of antibiotic sensitivity for Gram-negative bacteria, polymyxin-B exhibited the highest efficacy at 100%, followed closely by imipenem at 98% and meropenem at 90%. For Gram positive bacteria, the most potent antibiotics were linezolid (100%), vancomycin (97%), and teicoplanin (94%). Conclusion: This investigation reveals the prominent prevalence of multi drug resistant (MDR) pathogens within the pediatric age group. The primary multidrug-resistant organisms (MDROs) identified included E. coli, Klebsiella species, and Enterococcus species, which were mainly sourced from urine culture samples.
References
2. Papp-Wallace, K. M., et al. (2019). Pediatric infections caused by multidrug-resistant pathogens: Mechanisms and challenges. Pediatric Infectious Disease Journal, 38(5), 489-497.
3. Kumar, A., et al. (2020). Emergence of multidrug-resistant Gram-negative bacteria in pediatric populations in India. Indian Journal of Medical Microbiology, 38(2), 200-206.
4. Thakur, A., et al. (2022). Bacterial profile and antimicrobial resistance patterns in pediatric patients at a tertiary care hospital in India. Journal of Global Antimicrobial Resistance, 27, 10-18.
5. Bhat, G. R., et al. (2021). The role of antibiotic misuse and overuse in the emergence of antimicrobial resistance in India. Antibiotics, 10(4), 472-480.
6. Rai, A., et al. (2021). Resistance patterns of hospital-associated pathogens in pediatric patients in India: A study from a tertiary care hospital. International Journal of Pediatrics, 2021, Article 7613921.
7. Sharma, R., et al. (2018). Prevalence of methicillin-resistant Staphylococcus aureus in pediatric patients and its clinical implications. Indian Journal of Pediatrics, 85(9), 778-784.
8. Bhat, M. K., et al. (2021). Antibiotic resistance in pediatric patients: A major public health concern in India. Journal of Infection and Public Health, 14(2), 153-158. https://doi.org/10.1016/j.jiph.2020.04.011
9. Kumar, A., et al. (2020). Multidrug-resistant bacteria in pediatric patients: Epidemiology, challenges, and therapeutic strategies. Indian Journal of Pediatrics, 87(9), 715-721. https://doi.org/10.1007/s12098-020-03328-0
10. Papp-Wallace, K. M., et al. (2019). Mechanisms of antimicrobial resistance in pediatric infections: A review. Pediatric Infectious Disease Journal, 38(3), 271-280. https://doi.org/10.1097/INF.0000000000002276
11. Rai, P., et al. (2021). Prevalence of multidrug-resistant Gram-negative bacteria in neonatal intensive care units: A hospital-based study in India. Journal of Global Antimicrobial Resistance, 25, 193-199. https://doi.org/10.1016/j.jgar.2021.03.005
12. Sharma, N., et al. (2018). A study on the prevalence and antimicrobial resistance of Staphylococcus aureus in pediatric infections. International Journal of Pediatric Research, 5(1), 23-28. https://doi.org/10.17511/ijpr.2018.01.05
13. Tate, H., et al. (2020). Antibiotic resistance in pediatrics: A review of current challenges and strategies. Journal of Clinical Pediatric Infectious Diseases, 19(2), 103-112. https://doi.org/10.1097/INF.0000000000000221
14. Thakur, R., et al. (2022). Molecular epidemiology and antimicrobial resistance patterns of Klebsiella pneumoniae in pediatric infections. Indian Journal of Medical Microbiology, 40(1), 12-17. https://doi.org/10.4103/ijmm.IJMM_173_20
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Mohit Kumar
Demonstrator Department of Medical Microbiology, School of Health Sciences, C.S.J.M.U.
Kanpur (U.P.)
Soumya Singh
Assistant Professor, Department of Microbiology, ASMC Sultanpur (U.P.)
Bhavna Bhadauria
Tutor, Department of Microbiology, ASMC Lakhimpur Kheri (U.P.)
Muzziburahaman
Assistant professor, Department of Microbiology, Shri Ramswaroop Memorial University,
Lucknow (U.P.)
Anurag Trivedi
Scientific officer, Institute- Paras Yash Kothari Hospital Kanpur U.P. (A unit of Paras health)