Nosocomial Blood Stream Infections in Pediatric Intensive Care Unit of Fauji Foundation Hospital, Rawalpindi Pakistan
Background: Nosocomial blood stream infections with bacterial organisms are one of the most common problems faced by health care professionals in admitted patients, since these infections complicate the treatment and affect the outcome. The objective of this study was to determine the frequency of most common bacterial organisms in nosocomial blood stream infections in children admitted in Pediatric Intensive Care Unit of a tertiary care hospital at Rawalpindi, Pakistan.
Material and Methods: This cross-sectional study was carried out from 6th July 2017 to 6th January 2018 in the Pediatric Intensive Care Unit (ICU), Fauji Foundation Hospital, Rawalpindi, a tertiary care hospital. A total of 385 patients, aged 14 days to 12 years, admitted in the ICU were monitored from the time of admission till their blood culture reports were positive for bacterial growth along with signs of clinical sepsis Blood samples for culture were collected aseptically and the bottles were incubated for 7 days. Patients were monitored from time the blood culture yielded growth of bacterial pathogens till final blood culture report with antibiotics sensitivity against the pathogen became available. Data was analyzed using SPSS Version 20. Effect modifiers like age, duration of admission and gender were controlled by stratification and chi-square test was applied for comparison with P-value less than .05 considered as statistically significant.
Results: Pseudomonas aeruginosa and Salmonella typhi were the most common bacterial organisms (n=83; 21.6% each) causing nosocomial blood stream infection, followed by Escherichia coli (n=77; 20%) and Klebsiella (n=67; 17.4%), respectively. Effect modifier, like gender (stratified and compared by Chi-square test) had a statistically significant relationship with frequency of most common bacterial organisms in nosocomial blood stream infections (P=.001). However, effect modifiers like age and duration (hours) of admission to PICU had a non-significant relationship with frequency of bacterial organisms in nosocomial blood stream infections (P>.05).
Conclusions: There is a high frequency of common bacterial organisms in nosocomial blood stream infections in children with predominance of gram-negative bacteria including Pseudomonas aeruginosa and Salmonella typhi. Thus, early initiation of appropriate antibiotic therapy can help in decreasing mortality, significantly in hospitalized patients.
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