Bacteriological profile of pyoderma in children

Introduction: Pyoderma are cutaneous bacterial infections, commonly seen in India and it constitutes a major portion of patients attending the dermatological clinics. It has been found to be associated with the low socioeconomic status and more prevalent in paediatric age group. Aim: To find out causative organisms and their latest antibiotic susceptibility patterns in pyodermas. Materials and Methods: All patients visiting, Dermatology Dept in Kamineni Institute of Medical Sciences, Narketpally were screened over 18 months and those with erosive skin lesions and/or purulent discharge were included in the study and swabs were received in Microbiology Department for culture and sensitivity. Results: There were 92 isolates from 100 cases, Out of 92 cases the various organisms isolated,include S.aureus, Coagulase negative staphylococcus, group A Streptococci, E.coli, Klebsiella spp, Enterobacter cloaca and Pseudomonas aeruginosa. S.aureus was the commonest organism isolated accounting for 72.5% of the total no of cases. S.aureus was most sensitive to Clindamycin (94.6%), followed by Cefazolin (90.5%), Amikacin (85.1%) and Tetracycline (74.3%). It was least sensitive to Penicillin (2.7%), Ciprofloxacin (50%) and Erythromycin (59.5%). Pseudomonas aeruginosa (8.8%) was second most common isolate and was most sensitive to Imipenem, Piperacillin/ Tazobactum, Ceftazidime/ Clavulanic acid and Amikacin (100%) each. It was least sensitive to Ciprofloxacin, Piperacillin, Ceftazidime (77.7%) each and Gentamicin (66.6%). Out of total 74 isolates of S.aureus 2 were resistant to Methicillin. Thus the percentage of MRSA isolated was 2.7%. Conclusion: The gram positive organisms were more sensitive to cefuroxime, clindamycin, cafezolin. Gram negative organisms were most sensitive to piperacillin/tazobactum, ceftazidime/clavulanic acid and amikacin. Only two staph.aureus strains were methicillin resistant and they were sensitive to vacomycin, cpirofloxacin, tetracycline. The presence of inducible clindamycin resistance among Staph.aureus strains indicates the importance of identification of such strains by D-test to avoid treatment failures with clindamycin.