Bacterial isolates from the Pediatric patients and its correlation with microbiological flora in tertiary care hospital

Background: Infection is a health hazard of great expense and significance affecting the final outcome of treatment. Hospital indoor air contains a diverse range of microbial population. Objective: To study microbiological organism and their antibiotic sensitivity isolated from patients' blood culture and to correlate this micro-organism with pattern of microbiological flora in tertiary care hospital. Materials and methods: All the patients who fulfilled study criteria were subjected for blood culture analysis and prospectively observed for clinical conditions and there outcome. Antimicrobial susceptibility testing was performed for all blood culture isolates. Case fatality study was a comparison between deaths in blood culture positive patients with reference to resistance to first line antibiotics. A comparison was made between the type of organism found in cultures of samples taken from patients and the type of organism obtained from sites near the patients during the same time interval. Results: out of 3144 sample sent for blood culture, 888 (28.2%) samples came out to be positive. most isolates of klebseilla, Acinobacter, and E. coli were resistant to ampicillin (97 to 98%), gentamycin (70 to 80%) and cephalosporins (65% to 100%). Most of the gram negative isolates were sensitive to levofloxacin and Piperacillin-tazobactam. Staphylococcus aureus were resistant to ampicillin (90.4%). Staphylococcus aureus were sensitive with vancomycin by 98.6%. Case fatality due to gram –ve organisms were 19.45%. Gram –ve bacteria were dominating pathogens in both prefumigation samples from various sites of ICU and wards and blood culture sample from patients admitted in ICU and wards i.e. 32 (72.7%) and 815 (91.8%) respectively. It sets up a correlation between source of infection and sepsis in patients admitted to ICU and wards. Conclusion: Most organism (gram positive and gram negative) were resistant to first line antibiotics such as ampicillin, gentamycin, cephalosporins. Antibiotic combination with piperacillintazobactam or levofloxacin had better sensitivity among all gram negative organisms. Gram positive organisms were susceptible to vancomycin. Most deaths occur in patients infected with first line antibiotic resistant strains. Strong association found between source of bacterial infection and culture sample positivity.