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Survey of aerobic bacterial infections in paediatric surgical intensive care unit patients
Insights
Infections are common in critically ill pediatric surgical patients, with respiratory infections being most frequent. Antibiotic resistance highlights the need to reconsider ampicillin use.
Area of Science:
- Pediatric Surgery
- Infectious Diseases
- Critical Care Medicine
Background:
- Infections significantly contribute to morbidity and mortality in pediatric surgical patients admitted to intensive care units.
- Understanding infection epidemiology and antimicrobial resistance is crucial for optimizing patient outcomes.
Purpose of the Study:
- To describe the epidemiology of infections in pediatric surgical intensive care patients.
- To correlate infection sources with underlying medical conditions.
- To determine the antibiotic sensitivity patterns of isolated pathogens.
Main Methods:
- A retrospective review of 133 pediatric surgical intensive care unit cases over one year.
- Analysis of infection incidence, sources, and causative organisms.
- Evaluation of antibiotic sensitivity testing results.
Main Results:
- Overall infection incidence was 35%, with emergency surgery patients having the highest rate (47%).
- Respiratory tract infections were the most common source, linked to ventilator use.
- Enterobacteriaceae were the most frequent isolates, showing high resistance to ampicillin.
Conclusions:
- Gentamicin and vancomycin are recommended empirical antibiotics for suspected gram-negative and severe infections, respectively.
- Ampicillin should not be used as a first-line monotherapy due to high resistance rates in this patient population.
- Targeted antibiotic strategies are essential for managing infections in pediatric surgical intensive care.
Abstract:
Infections cause a significant amount of morbidity and mortality in paediatric surgical patients requiring intensive care. The study aims to describe the epidemiology of infection among these patients, to correlate the source of infection with the underlying medical condition, and to determine the antibiotic sensitivity pattern of the organisms. Through a retrospective review over a period of one year, 133 cases were analysed. The overall incidence of infection was 35%. Those who had emergency surgery had the highest infection rate (47%). Respiratory tract infections were the commonest source of infection, and were associated with ventilator therapy rather than the underlying medical condition. The Enterobacteriaceae were the most common isolates seen. From antibiotic sensitivity tests, the empirical antibiotics of choice are gentamicin for suspected gram-negative infection and vancomycin for severe infections where methicillin-resistant Staphylococcus aureus is a likely cause. A high rate of resistance to ampicillin was seen and its use as a first-line monotherapy drug should be discontinued in our patient population.