Determination of bacterial profile and spectrum of antimicrobial drug resistance in pediatric wound infections

Abstract

Pediatric wound infections lead to the prolonged morbidity of the child and financial burden for the parents. The present study aimed to determine the causative pathogens and the spectrum of their drug resistance to reduce the fatality in pediatric wound infections. The study conducted prospectively on wound specimens collected from a pediatric facility of Lahore, Pakistan. The specimens were processed on routine culture media, and the conventional biochemicals, analytical profile index (API) 20 E, and 20 NE identified the organisms. The spectrum of drug resistance observed against several classes of antibiotics. Of 960 cases, 695 (72.4%) were culture positive and 265 (27.6%) culture-negative cases. The pediatric cases of < 1 year of age had significant (p = 0.01) association with negative cultures. Illiteracy and primary education of the parents were significantly (p < 0.01 and 0.01, respectively) associated with pediatric wound infections. The distribution of the bacterial pathogens demonstrated 216 (27.6%) Gram-positive and 568 (72.4%) Gram-negative bacteria. Gram-positive isolates were resistant to most of the penicillins, co-trimoxazole, and cephalosporins, while none of these was resistant to linezolid and vancomycin. The majority of Gram-negative bacteria were resistant to cephalosporins and aminoglycosides, while lesser resistance observed against carbapenems, piperacillin-tazobactam, and cefoperazone-sulbactam. The wound infections could be polymicrobial with the expanded spectrum of drug resistance to most of the penicillin, cephalosporins, aminoglycosides, and fluoroquinolones. These infections lead to serious pediatric morbidity if not treated meticulously.