Abstract

Objective: Nosocomial blood stream infections (nBSIs) cause high mortality and morbidity rates in pediatric patients. Early diagnosis of nBSIs, identification of infectious agents as well as their antimicrobial resistance patterns are crucial to prognosis. The aim of this study is to demonstrate the epidemiologic features of nBSIs cases in pediatric patients.

Methods: In this study, 5486 blood cultures gathered from hospitalized patients in Erciyes University Hospital’s Pediatric Clinics between May 2014-May 2015 were tested for nBSIs according to Centers for Disease Control and Prevention (CDC) criteria. Species identification and antimicrobial susceptibility of pathogens were performed using conventional methods and an automatized system.

Results: The rate of positive cultures was found to be 13.9% out of 5486 blood cultures. The contamination rate was 8.4% and confirmed nBSIs rate was 3.9% in all positive cultures. Of all pathogens, Gram-negatives were 62%. The most fruquently isolated species were Acinetobacter baumannii (24.7%), Escherichia coli (14.4%), Klebsiella pneumoniae (11.7%), Enterococcus faecium (10.3%) and E. faecalis (8.1%). 78% of Gram-negative bacteria and 43% of Gram-positive bacteria displayed multi-drug resistance. The rate of extended-spectrum β-lactamase-producing E. coli was 73%, whereas this rate was 50% for Klebsiella spp. No colistin-resistant strain was observed. Positive culture rate was found to be higher in intensive care units than the other units.

Conclusions: A great importance should be paid to the training of health personnel in order to decrease the contamination rates to desired ranges. Isolating more Gram-negative agents might be indicating a trend shift reflected in nBSIs cases.