Epidemiologic study of nosocomial bacterial infection of pediatric patients at BMA Medical College and Vajira Hospital
Tantracheewathorn, T.; Vititpatarapak, N.; Phumisantiphong, U.
Journal of the Medical Association of Thailand 90(2): 258-265
2007
ISSN/ISBN: 0125-2208 PMID: 17375629 Document Number: 2706
Background. Nosocomial infection is a global public health problem, particularly by multi-drug resistant bacteria, increasing morbidity, mortality, and health care costs. The distribution of pathogens and antimicrobial sensitivity patterns change with time and vary among hospitals.Objective: To determine and compare the bacterial pathogens causing nosocomial infections in pediatric patients and their susceptibility patterns between January 2000-December 2002 and January 2003-December 2005.Material and Method. The bacterial pathogens and antimicrobial susceptibilities of children diagnosed as nosocomial infections at BMA Medical College and Vajira Hospital between January 2000 - December 2002 and January 2003- December 2005 were comparatively analyzed.Results: 1,863 and 1,884 isolates were identified in 2000-2002 and 2003-2005, respectively. The common sites of infections were bloodstream (28.6%), lower respiratory tract (15.3%), skin and soft tissue (14.9%), and urinary tract (12.5%). The major isolated gram positive pathogens were S. aureus, coagulase negative Staphylococcus and Enterococus. The major gram negative pathogens were E. coli, P. aeruginosa, K pneumoniae, Enterobacter spp. and Acinetobacter spp. Compared between 2000-2002 and 2003-2005, methicillin resistant S. aureus (MRSA) was decreased from 4.3% to 1.5% P aeruginosa from 13.3% to 7.5%, Enterobacter spp. from 4.2% to 2.4%, Serratia spp. from 1.3% to 0.3%, but methicillin resistant coagulase negative Staphylococcus was increased from 5.6% to 10.5% and K. pneumoniae from 5.5% to 7.7%, (p < 0.05). All gram positive cocci remained sensitive to vancomycin and linezolid In 2003-2005, gram negative rods were less sensitive to 3(rd) and 4(th) generation cephalosporins and aminoglycosides than in 2000-2002. Sensitivity of gram negative rods to 3(rd) and 4(th) generation cephalosporins were not significantly different except Enterobacter spp. and Serratia spp., which were more sensitive to 4(th) generation cephalosporin (p < 0.05). Most gram negative pathogens (80-100%) were sensitive to ciprofloxacin except Acinetobacter spp. (61%). Carbapenems sensitivity were 100% except 92-100% for Enterobacter and 67-86% for P.aeruginosa, Acinetobacter spp. and Serratia spp.Conclusion: The bacterial pathogens causing nosocomial infections and their susceptibility patterns change with time, so periodic surveillance are essential as a guide for more proper empirical therapy especially in serious or life threatening infections that need urgent appropriate antibiotics.
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