Pediatric Sepsis: Epidemiology, Antibiotic Resistance and Outcome

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Laboratorinė medicina. 2017,
t. 19,
Nr. 3,
p. 178 -
185

Sepsis is the most common cause of children death in the world. It is important to know the etiology of sepsis in a particular hospital to improve the outcome.

Aim. Analyze the outcome of sepsis and their relations with patient’s characteristics, causativemicroorganisms, antibiotic resistance, resistance changes and sepsis outcome.

Methods. Retrospective analysis of 232 children, treated at Children’s Hospital, Affiliate of VULSK between 2012 and 2015, who had positive blood culture, antibiotic resistance and outcome. Three investigative groups were concluded: I - newi borns, II - oncohematological patients and III - other patients who had sepsis.

Results. Between 2012 and 2015, sep­sis was confirmed by positive blood culture for 232 children - in total 287 microorganisms were grown. Cocci bacteria accounted for 67.5% from the total microorganisms grown, out of which 52.6% were staphylococci. 60% of staphylococci were methicilin-resistant, 6% - vancomycin-resistant. During the investigated period, the number of penicillin-resistant streptococci and meningococci has increased. 17% of the grown cocci were clindamycin-resistant. Out of the total grown microorganisms, 25.5% were Gram negafive rods. Around 80% of Gram negative rods consisted of Klebsiella and E. Coli strains. 33% of Gram negative rods were ESBL, cephalosporin-resistant and gentamicin-resistant. There were no carbapenem-resistant Gram negative rods grown. 22 (9.5%) children died, 45.5% bel onged to group II. Out of all dead 16 (72.7%) had staphylococci grown.

Conclusions. 60% of staphycolococci were MRS and 6% were vancomycin-resistant, there were no changes noticed in their sensitivity during the 4-year period. The increase was noticed in penicylin-resistant streptococci and meningococci. 17% cocci were clindamycin-resistant. Out of all Gram negative rods, 33% were ESBL microorganisms, cephalosporin and gentamicin-resistant. 9.5% children died.

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