|LETTER TO EDITOR
|Year : 2016 | Volume
| Issue : 4 | Page : 142-143
Antimicrobial surveillance associated with bloodstream infection in children: A tertiary care hospital-based observation
NH Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, West Bengal, India
|Date of Web Publication||22-Nov-2016|
NH Rabindranath Tagore International Institute of Cardiac Sciences, 124, Mukundapur, EM Bypass, Kolkata - 700 099, West Bengal
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Bhattacharjee P. Antimicrobial surveillance associated with bloodstream infection in children: A tertiary care hospital-based observation. Curr Med Issues 2016;14:142-3
|How to cite this URL:|
Bhattacharjee P. Antimicrobial surveillance associated with bloodstream infection in children: A tertiary care hospital-based observation. Curr Med Issues [serial online] 2016 [cited 2019 Nov 12];14:142-3. Available from: http://www.cmijournal.org/text.asp?2016/14/4/142/194489
Bloodstream infections (BSIs) are very common in children and one of the common causes of morbidity and mortality. The rate of BSIs in children is about 20%-50% in developing countries. , Children have a weak immune barrier. Moreover, other risk factors and congenital anomalies make children more susceptible to infections. Even self-limiting infections progress to life-threatening sepsis, requiring rapid and aggressive antimicrobial treatment. The incidence of bacteremia in children varies widely, and pathogens are becoming more resistant to antibiotics, used by health-care professional. Frequent use of antibiotics possesses a major challenge to treat septicemia in the children. 
To understand the susceptibility patterns of BSI pathogens endemic in a Tertiary Care Hospital, Kolkata, India, the antimicrobial susceptibility patterns among 292 patients, age group varying from 2 months to 15 years, were reviewed for a 4-year period (2011-2014). It has been observed that Gram-positive and Gram-negative bacterial percentage were 4.45% and 95.55%, respectively. Klebsiella spp. (50%) and Acinetobacter spp. (17.47%) were the most frequent and common causative agent for BSIs [Table 1]. About half of the Klebsiella spp., isolates tested were resistant to ceftriaxone, cefepime, cotrimoxazole, and piperacillin-tazobactam. The rate of Escherichia coli resistance to ceftriaxone and cefepime was similar to that of Klebsiella spp. Both the organisms showed more susceptibility to polymyxin B and colistin [Table 1]. Staphylococcus aureus was highly susceptible to linezolid and vancomycin and more resistance to cotrimoxazole and oxacillin.
For management of septicemia, bacteriological culture is the keystone and such culture result takes time; therefore, understanding the regional bacterial susceptibility and pattern of resistance to antimicrobial agents are very important to prepare treatment guidelines in a developing country where the uses of antibiotics are frequent and multidrug resistant strains are much higher, especially in the children compared to other countries in the world. In previous two other studies which were conducted during 1995-2000 and 2001-2005, the prevalence of Gram-positive bacteria was reported as 72.0% and 47.6%, respectively. , However, the recent trend has changed and data showed that the Gram-negative microorganisms have taken a lead role and become much more prevalent. This study data also show that the recent pattern of antimicrobial resistance in Tertiary Care Hospital in Kolkata is similar with the other parts of the India. 
This study shows that the Gram-negative isolates from blood in children are more susceptible to the aminoglycosides, carbapenems, and polypeptides, mixed response from the quinolones but more resistance to penicillin group of antibiotics. This study also shows that the Klebsiella spp. is the most common pathogen for BSIs in children and more resistance to the third and fourth generation of cephalosporins which are a warning message to the health-care professional and medical science and researcher should find the alternate option to treat the BSIs in children to decrease the rate of mortality and morbidity. As it is a retrospective study, root cause analysis of the BSI, correlation with morbidity and mortality, and other markers of sepsis were not possible. Inclusion of these data would have definitely enhanced the utility of this study since the study involves children.
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Conflicts of interest
There are no conflicts of interest.
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