1
|
Sisay A, Seid A, Tadesse S, Abebe W, Shibabaw A. Assessment of bacterial profile, antimicrobial susceptibility status, and associated factors of isolates among hospitalized patients at Dessie Comprehensive Specialized Hospital, Northeast Ethiopia. BMC Microbiol 2024; 24:116. [PMID: 38575901 PMCID: PMC10993541 DOI: 10.1186/s12866-024-03224-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 02/13/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Antimicrobial resistant bacteria among hospitalized patients are becoming a major public health threat worldwide, mainly in developing countries. Infections by these multidrug resistant pathogens cause high rate of mortality, prolong hospital stays, and affect individual and country economies in greater amounts. Thus, this study aimed to assess the bacterial profile, antimicrobial susceptibility status, and associated factors of isolates from hospitalized patients at the Dessie Comprehensive Specialized Hospital. METHODOLOGY This hospital-based cross-sectional study was conducted between February and April 2021. Consecutive sampling was used to select the study participants. All bacterial isolates were identified using standard bacteriological techniques. Antibiotic susceptibility testing was performed using disk diffusion technique. The data was analyzed using SPSS version 25. Descriptive statistics and logistic regression were used. A P-value of less than 0.05 was considered statistically significant. RESULTS Of 384 clinical samples (blood, urine, stool, wound, vaginal discharge, and ear discharge) processed 180 (46.9%) were culture positive. Overall, Escherichia coli was the predominant isolate (41; 22.8%), followed by Staphylococcus aureus (36; 20%). Most of the isolates were from blood (70; 38.9%). The level of overall drug resistance of the gram-negative bacteria isolates for ampicillin, tetracycline, and cotrimoxazole was (104; 88.1%), (79; 75.9%), and (78; 75.0%), respectively. The overall multidrug rate of isolates was 143 (79.4%). Variables such as history of invasive procedures, chronic underlying diseases, history of hospitalization, and habit of eating raw animal products were statistically significant for the acquisition of bacterial infection. CONCLUSIONS AND RECOMMENDATION E. Coli and S. aureus were the most common isolates. Most of the isolates were resistant to commonly prescribed antibiotics. And also, consumption of raw animal products, chronic underlying disease, previous hospitalization, history of invasive procedures, and educational status were associated with the acquisition of bacterial infections. Therefore, routine antimicrobial susceptibility testing, proper patient management, wise use of antibiotics in clinical settings and health education are recommended.
Collapse
Affiliation(s)
- Assefa Sisay
- Department of Medical Laboratory Science, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Abdurahaman Seid
- Department of Medical Laboratory Science, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Selamyhun Tadesse
- Department of Medical Laboratory Science, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Wagaw Abebe
- Department of Medical Laboratory Science, College of Health Science, Woldia University, Woldia, Ethiopia.
| | - Agumas Shibabaw
- Department of Medical Laboratory Science, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| |
Collapse
|
2
|
Darishetty G, Kompally V, Nagajyothi VUV, Bukkapatnam SB, Gudi P, Alugoya A. Exploring Acute Febrile Illness in Children: Clinical Characteristics and Diagnostic Challenges. Cureus 2024; 16:e58315. [PMID: 38752054 PMCID: PMC11094522 DOI: 10.7759/cureus.58315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 04/15/2024] [Indexed: 05/18/2024] Open
Abstract
Background Pediatric febrile illnesses are a major cause of hospital admissions and are often associated with significant morbidity and mortality. These illnesses pose a diagnostic challenge to both clinicians and laboratories. This study aims to explore the clinical characteristics of acute febrile illness in children and examine the effectiveness of various diagnostic techniques. Methods This prospective study was carried out at the Mahatma Gandhi Memorial Hospital, Warangal, India, from January 2020 to October 2022. It included children aged one month to 12 years. Results Out of 245 identified cases, 195 met the inclusion criteria. This study found that 18 patients (9.23%) suffered from serious bacterial infections (SBIs). In 63 patients (32.20%), the source of infection remained unidentified. Among those with SBI, UTIs were the most frequent. Bacteremia was identified in 2.5% of the patients. Conclusion SBIs were identified in 18 hospitalized children (9.23%), with UTIs being the most common SBI in children aged one to 36 months. Children in this age group presenting with toxic symptoms should be thoroughly evaluated for SBIs. The study also observed a higher prevalence of Gram-negative bacteremia compared to Gram-positive cases.
Collapse
Affiliation(s)
| | - Vasudev Kompally
- Department of Pediatrics, Kakatiya Medical College, Hanamkonda, IND
| | | | | | - Pratap Gudi
- Department of Pediatrics, Kakatiya Medical College, Hanamkonda, IND
| | - Arun Alugoya
- Department of Pediatrics, Kakatiya Medical College, Hanamkonda, IND
| |
Collapse
|
3
|
Anyasodor AE, Ahmed KY, Osuagwu UL, Mgbemena NC, Kalinna BH, Thapa S, Mahmood S, Ross AG. Delays in seeking treatment for fever in children under five years of age in Nigeria: Evidence from the National Demographic Health Survey. PLoS One 2023; 18:e0295772. [PMID: 38117782 PMCID: PMC10732371 DOI: 10.1371/journal.pone.0295772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/29/2023] [Indexed: 12/22/2023] Open
Abstract
BACKGROUND In countries with high child mortality rates, such as Nigeria, early intervention for common childhood illnesses (e.g., pneumonia and malaria) is essential for improving clinical outcomes. The timely reporting and treatment of fever is therefore critical in making a differential diagnosis and choosing an appropriate course of treatment. The present study aimed to investigate the prevalence and major risk factors associated with delays in seeking treatment for fever in children under five years of age in Nigeria. METHODS This study used a total weighted sample of 7,466 children under five years of age from the 2018 National Nigerian Demographic and Health Survey. Multivariable binary logistic regression modelling was used to investigate the association between predisposing, enabling, need, health service and community level factors, and delay in treatment-seeking for fever. RESULTS We report the delays in seeking treatment for childhood fever that was reported by mothers in the last two weeks prior to the national survey. The prevalence for delayed treatment was 62.1% (95% confidence interval [CI]: 60.1%, 64.1%). Our findings showed that there were fewer delays in seeking treatment in children aged 24-59 months (adjusted odds ratio [aOR] = 0.79, 95% CI: 0.68, 0.93), among mothers who were formally employed (aOR = 0.84; 95% CI: 0.73, 0.96), regularly attended antenatal services (aOR = 0.76, 95%CI: 0.66, 0.88), and for those who resided in wealthier households (aOR = 0.71; 95% CI: 0.56, 0.89). Children whose mothers resided in the North-West geopolitical zone of Nigeria were less likely to delay seeking treatment for fever (aOR = 0.55; 95% CI: 0.42, 0.73). However, mothers who had an unwanted pregnancy had a higher odds of delaying treatment for childhood fever (aOR = 1.58; 95% CI: 1.05, 2.39). CONCLUSION There were significant delays in seeking treatment for childhood fever in poorer homes found in geopolitically unstable zones of Nigeria. Mothers who were poor, unemployed, and with younger children (<12 months) often delayed seeking treatment for their febrile child. Future health promotion strategies and microenterprise schemes should target both rural and urban mothers residing in poor households. Children under 12 months of age should be a priority.
Collapse
Affiliation(s)
| | - Kedir Y. Ahmed
- Rural Health Research Institute, Charles Sturt University, Orange, NSW, Australia
| | - Uchechukwu L. Osuagwu
- Translational Health Research Institute, Western Sydney University, Campbelltown, Penrith, NSW, Australia
- Bathurst Rural Clinical School (BRCS), School of Medicine, Western Sydney University, Bathurst, NSW, Australia
| | - Nnamdi C. Mgbemena
- School of Allied Health, Exercise and Sports Sciences, Charles Sturt University, Orange, NSW, Australia
| | - Bernd H. Kalinna
- Rural Health Research Institute, Charles Sturt University, Orange, NSW, Australia
| | - Subash Thapa
- Rural Health Research Institute, Charles Sturt University, Orange, NSW, Australia
| | - Shakeel Mahmood
- Rural Health Research Institute, Charles Sturt University, Orange, NSW, Australia
| | - Allen G. Ross
- Rural Health Research Institute, Charles Sturt University, Orange, NSW, Australia
| |
Collapse
|
4
|
Liang R, Chen Z, Yang S, Yang J, Wang Z, Lin X, Xu F. A diagnostic model based on routine blood examination for serious bacterial infections in neonates-a cross-sectional study. Epidemiol Infect 2023; 151:e137. [PMID: 37519228 PMCID: PMC10540195 DOI: 10.1017/s0950268823001231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/26/2023] [Accepted: 07/21/2023] [Indexed: 08/01/2023] Open
Abstract
Routine blood examination is an easy way to examine infectious diseases. This study is aimed to develop a model to diagnose serious bacterial infections (SBI) in ICU neonates based on routine blood parameters. This was a cross-sectional study, and data were extracted from the Medical Information Mart for Intensive Care III (MIMIC-III). SBI was defined as suffering from one of the following: pyelonephritis, bacteraemia, bacterial meningitis, sepsis, pneumonia, cellulitis, and osteomyelitis. Variables with statistical significance in the univariate logistic regression analysis and log systemic immune-inflammatory index (SII) were used to develop the model. The area under the curve (AUC) was calculated to assess the performance of the model. A total of 1,880 participants were finally included for analysis. Weight, haemoglobin, mean corpuscular volume, white blood cell, monocyte, premature delivery, and log SII were selected to develop the model. The developed model showed a good performance to diagnose SBI for ICU neonates, with an AUC of 0.812 (95% confidence interval (CI): 0.737-0.888). A nomogram was developed to make this model visualise. In conclusion, our model based on routine blood parameters performed well in the diagnosis of neonatal SBI, which may be helpful for clinicians to improve treatment recommendations.
Collapse
Affiliation(s)
- Runqiang Liang
- National Key Clinical Specialty Construction Project/Department of Neonatology, Guangdong Women and Children Hospital, Guangzhou, China
- Guangdong Neonatal ICU Medical Quality Control Center, Guangzhou, China
| | - Ziyu Chen
- Department of Respiratory Medicine, Foshan Sanshui District People’s Hospital, Foshan, China
| | - Shumei Yang
- National Key Clinical Specialty Construction Project/Department of Neonatology, Guangdong Women and Children Hospital, Guangzhou, China
- Guangdong Neonatal ICU Medical Quality Control Center, Guangzhou, China
| | - Jie Yang
- National Key Clinical Specialty Construction Project/Department of Neonatology, Guangdong Women and Children Hospital, Guangzhou, China
- Guangdong Neonatal ICU Medical Quality Control Center, Guangzhou, China
| | - Zhu Wang
- National Key Clinical Specialty Construction Project/Department of Neonatology, Guangdong Women and Children Hospital, Guangzhou, China
- Guangdong Neonatal ICU Medical Quality Control Center, Guangzhou, China
| | - Xin Lin
- Guangdong Neonatal ICU Medical Quality Control Center, Guangzhou, China
- Department of Pediatrics, Guangdong Women and Children Hospital, Guangzhou, China
| | - Fang Xu
- National Key Clinical Specialty Construction Project/Department of Neonatology, Guangdong Women and Children Hospital, Guangzhou, China
- Guangdong Neonatal ICU Medical Quality Control Center, Guangzhou, China
| |
Collapse
|
5
|
Debsarma D, Saha J, Ghosh S. Factors associated with delay in treatment-seeking behaviour for fever cases among caregivers of under-five children in India: Evidence from the National Family Health Survey-4, 2015-16. PLoS One 2022; 17:e0269844. [PMID: 35709164 PMCID: PMC9202928 DOI: 10.1371/journal.pone.0269844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 05/26/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Fever is one of the common clinical symptoms found among children suffering from various illnesses. India carries a substantial burden of febrile illness among under-five children which heighten the risk of malnutrition, mortality and morbidity. This study aims to determine the factors associated with delay in treatment-seeking for fever among under-five children in India. METHODS A cross-sectional study was carried out using the large-scale nationally representative data from the National Family Health Survey (NFHS-4), conducted in 2015-2016. The data were collected by using four survey questionnaires i.e., Household Questionnaire, Woman's Questionnaire, Man's Questionnaire, and Biomarker Questionnaire. Delay in treatment-seeking was defined as taking a child for treatment after 24 hours of fever onset. Bivariate and multivariate logistic regression models were performed to assess the factors associated with delay in treatment-seeking behaviour for fever in under-five children. RESULTS In India, 31.12% (n = 7229) of the caregivers sought treatment for children after 24 hours of the onset of fever. Findings show no significant differences in delay in treatment-seeking behaviour by age groups and sex of children. Multivariate analysis revealed that the odds of delay in treatment-seeking behaviour of fever were higher among children from the poorest wealth quintile (AOR: 2.06; 95% CI: 1.85, 2.31), belonging to the scheduled tribe (AOR: 1.35; 95% CI: 1.24, 1.48), children who resided in rural areas (AOR: 1.14; 95% CI: 1.07, 1.22), children from the northeast region (AOR: 1.29; 95% CI: 1.14, 1.46), and children of caregivers who perceived distance to health facilities as a 'big problem' (AOR: 1.16; 95% CI: 1.09, 1.23). CONCLUSION The study shows a high prevalence of delay in seeking treatment for fever among caregivers of under-five children in India. Delay in seeking treatment is associated with socio-demographic and socio-economic factors. Therefore, there is a need for intensified health promotion programs to sensitize caregivers on the importance of early health-seeking behaviour.
Collapse
Affiliation(s)
- Dhiman Debsarma
- Centre for the Study of Regional Development, School of Social Sciences, Jawaharlal Nehru University, New Delhi, India
| | - Jayanti Saha
- Centre of Social Medicine and Community Health, School of Social Sciences, Jawaharlal Nehru University, New Delhi, India
| | - Sagar Ghosh
- Government Shyamlal Pandaviya P.G. College, Morar, Gwalior, India
| |
Collapse
|
6
|
Khare S, Pathak A, Stålsby Lundborg C, Diwan V, Atkins S. Understanding Internal and External Drivers Influencing the Prescribing Behaviour of Informal Healthcare Providers with Emphasis on Antibiotics in Rural India: A Qualitative Study. Antibiotics (Basel) 2022; 11:459. [PMID: 35453210 PMCID: PMC9029264 DOI: 10.3390/antibiotics11040459] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/16/2022] [Accepted: 03/28/2022] [Indexed: 02/01/2023] Open
Abstract
Globally, Antibiotic resistance is a major public health concern, with antibiotic use contributing significantly. Targeting informal healthcare providers (IHCPs) is important to achieve universal health coverage and effective antibiotic stewardship in resource-constrained settings. We, therefore, aimed to analyse the internal and external drivers that influence IHCPs' prescribing behaviour for common illnesses in children under five, with an emphasis on antibiotic use in rural areas of India. A total of 48 IHCPs participated in focus group discussions. Thematic framework analysis with an inductive approach was used, and findings were collated in the theoretical framework based on knowledge, attitude, and practice model which depicted that the decisions made by IHCPs while prescribing antibiotics are complex and influenced by a variety of external and internal drivers. IHCPs' internal drivers included the misconception that it is impossible to treat a patient without antibiotics and that antibiotics increase the effectiveness of other drugs and cure patients faster in order to retain them. Formal healthcare providers were the IHCPs' sources of information, which influences their antibiotic prescribing. We found when it comes to seeking healthcare in rural areas, the factors that influence their choice include 'rapid cure', 'cost of treatment', 'distance' and '24 h availability', instead of qualification, which may create pressure for IHCPs to provide a quick fix. Targeted and coordinated efforts at all levels will be needed to change the antibiotic prescribing practices of IHCPs with a focus on behaviour change and to help resolve misconceptions about antibiotics.
Collapse
Affiliation(s)
- Shweta Khare
- Health Systems and Policy (HSP): Medicines, Focusing Antibiotics, Department of Global Public Health, Karolinska Institutet, Tomtebodavagen 18A, 171 77 Stockholm, Sweden; (C.S.L.); (V.D.)
- Department of Public Health and Environment, Ruxmaniben Deepchand Gardi Medical College, Ujjain 456006, Madhya Pradesh, India
| | - Ashish Pathak
- Health Systems and Policy (HSP): Medicines, Focusing Antibiotics, Department of Global Public Health, Karolinska Institutet, Tomtebodavagen 18A, 171 77 Stockholm, Sweden; (C.S.L.); (V.D.)
- Department of Pediatrics, Ruxmaniben Deepchand Gardi Medical College, Ujjain 456006, Madhya Pradesh, India
- International Maternal and Child Health Unit, Department of Women and Children’s Health, Uppsala University, 751 85 Uppsala, Sweden
| | - Cecilia Stålsby Lundborg
- Health Systems and Policy (HSP): Medicines, Focusing Antibiotics, Department of Global Public Health, Karolinska Institutet, Tomtebodavagen 18A, 171 77 Stockholm, Sweden; (C.S.L.); (V.D.)
| | - Vishal Diwan
- Health Systems and Policy (HSP): Medicines, Focusing Antibiotics, Department of Global Public Health, Karolinska Institutet, Tomtebodavagen 18A, 171 77 Stockholm, Sweden; (C.S.L.); (V.D.)
- Division of Environmental Monitoring and Exposure Assessment (Water and Soil), ICMR—National Institute for Research in Environmental Health, Bhopal 462030, Madhya Pradesh, India
| | - Salla Atkins
- Social Medicine, Infectious Diseases and Migration (SIM), Department of Global Public Health, Karolinska Institutet, Tomtebodavagen 18A, 171 77 Stockholm, Sweden;
- Global Health and Development, Faculty of Social Sciences, Tampere University, Arvo Ylpön Katu 34, 33520 Tampere, Finland
| |
Collapse
|
7
|
Khare S, Pathak A, Purohit MR, Sharma M, Marrone G, Tamhankar AJ, Stålsby Lundborg C, Diwan V. Determinants and pathways of healthcare-seeking behaviours in under-5 children for common childhood illnesses and antibiotic prescribing: a cohort study in rural India. BMJ Open 2021; 11:e052435. [PMID: 34862290 PMCID: PMC8647549 DOI: 10.1136/bmjopen-2021-052435] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To explore the healthcare-seeking pathways, antibiotic prescribing and determine the sociodemographic factors associated with healthcare-seeking behaviour (HSB) of caregivers for common illnesses in under-5 (U-5) children in rural Ujjain, India. STUDY DESIGN Prospective cohort study. STUDY SETTING AND STUDY SAMPLE The cohort included 270 U-5 children from selected six villages in rural demographic surveillance site, of the R.D. Gardi Medical College, Ujjain, Madhya Pradesh, India. A community-based cohort was visited two times weekly for over 113 weeks (August 2014 to October 2016) to record the HSB of caregivers using HSB diaries. Sociodemographic information was also solicited. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcomes: first point of care, healthcare-seeking pathway and quantify antibiotic prescribing for the common acute illnesses. SECONDARY OUTCOME HSB risk factors were determined using mixed-effects multinomial logistic regression. RESULTS A total of 60 228 HSB follow-up time points for 270 children were recorded with a total of 2161 acute illness episodes. The most common illnesses found were respiratory tract infections (RTI) (69%) and gastrointestinal tract infections (8%). No healthcare was sought in 33% of illness episodes, mostly for RTIs. The most common healthcare-seeking pathway was to informal healthcare providers (IHCPs, 49% of illness episodes). The adjusted relative risk for obtaining no treatment, home treatment and treatment by IHCPs was higher for RTIs (aRR=11.54, 1.82 and 1.29, respectively), illiterate mothers (aRR=2.86, 2.38 and 1.93, respectively), and mothers who were homemakers (aRR=2.90, 4.17 and 2.10, respectively). Socioeconomic status was associated with HSB, with the highest aRR for no treatment in the lowest two socioeconomic quintiles (aRR=6.59 and 6.39, respectively). Antibiotics were prescribed in 46% (n=670/1450) illness episodes and the majority (85%, n=572/670) were broad spectrum. CONCLUSION In our rural cohort for many acute episodes of illnesses, no treatment or home treatment was done, which resulted in overall reduced antibiotic prescribing. The most common healthcare-seeking pathway was to visit IHCPs, which indicates that they are major healthcare providers in rural areas. Most of the antibiotics were prescribed by IHCPs and were commonly prescribed for illnesses where they were not indicated.
Collapse
Affiliation(s)
- Shweta Khare
- Health Systems and Policy (HSP): Medicines, focusing antibiotics, Department of Global Public Health, Karolinska Institutet, 171 77 Stockholm, Sweden
- Department of Public Health and Environment, Ruxmaniben Deepchand Gardi Medical College, 456006 Ujjain, Madhya Pradesh, India
| | - Ashish Pathak
- Health Systems and Policy (HSP): Medicines, focusing antibiotics, Department of Global Public Health, Karolinska Institutet, 171 77 Stockholm, Sweden
- Department of Pediatrics, Ruxmaniben Deepchand Gardi Medical College, 456006 Ujjain, Madhya Pradesh, India
- Department of Women and Children's Health, International Maternal and Child Health Unit, Uppsala University, Uppsala,SE-751 85, Sweden
| | - Manju Raj Purohit
- Health Systems and Policy (HSP): Medicines, focusing antibiotics, Department of Global Public Health, Karolinska Institutet, 171 77 Stockholm, Sweden
- Department of Pathology, Ruxmaniben Deepchand Gardi Medical College, 456006 Ujjain, Madhya Pradesh, India
| | - Megha Sharma
- Health Systems and Policy (HSP): Medicines, focusing antibiotics, Department of Global Public Health, Karolinska Institutet, 171 77 Stockholm, Sweden
- Department of Pharmacology, Ruxmaniben Deepchand Gardi Medical College, 456006 Ujjain, Madhya Pradesh, India
| | - Gaetano Marrone
- Health Systems and Policy (HSP): Medicines, focusing antibiotics, Department of Global Public Health, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Ashok J Tamhankar
- Health Systems and Policy (HSP): Medicines, focusing antibiotics, Department of Global Public Health, Karolinska Institutet, 171 77 Stockholm, Sweden
- Indian Initiative for Management of Antibiotic Resistance, Department of Environmental Medicine, Ruxmaniben Deepchand Gardi Medical College, 456006 Ujjain, Madhya Pradesh, India
| | - Cecilia Stålsby Lundborg
- Health Systems and Policy (HSP): Medicines, focusing antibiotics, Department of Global Public Health, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Vishal Diwan
- Health Systems and Policy (HSP): Medicines, focusing antibiotics, Department of Global Public Health, Karolinska Institutet, 171 77 Stockholm, Sweden
- Division of Environmental Monitoring and Exposure Assessment (Water and Soil), ICMR-National Institute for Research in Environmental Health, 462030 Bhopal, Madhya Pradesh, India
| |
Collapse
|
8
|
Thattil SJ, Ajith T. Bacteriological and antibiotic profile of infection among infants in the post-neonatal period at a tertiary care hospital in South India. JOURNAL OF HEALTH RESEARCH 2021. [DOI: 10.1108/jhr-03-2020-0081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PurposeSevere bacterial infection is a major cause of neonatal morbidity and mortality worldwide. Geographical-based demographic laboratory and clinical data are required to get a conclusion about the bacterial infection and their antibiotic susceptibility for the empiric antibiotic treatment in infants who presented with suspected infection. This study was aimed to find the most prevalent bacterial infection and antibiotic sensitivity among infants in the post-neonatal period presented at a tertiary care centre in South India.Design/methodology/approachA cross-sectional study was designed among infants (29 days to 1 year old) presented with suspected infection in the paediatric department. Infants with positive culture report were analysed for the bacteriological and antibiotic profile from the medical records. Antibiotic sensitivity was determined for the isolated bacteria according to standard procedure and data statically analysed.FindingsTotal of 218 samples (138 male and 80 female) were analysed. Most of the samples (171/218, 78.4%) were throat swab (p = 0.0247). Only one sample was cerebrospinal fluid from case of meningitis. Sample from upper RTI was major (162/218, 74.3%) with male dominance followed by stool samples from cases of diarrhoea (22/218, 10.0%). Staphylococcus aureus was the major organism identified in 46/171 (26.9 %) throat swabs. The most sensitive antibiotic against bacteria isolated from throat swab and CSF was gentamicin and cloxacillin. Netilmicin and piperacillin plus tazobactam were the sensitive antibiotics against bacteria isolated from stool, ear secretion and urine samples.Originality/valueUpper RTI was the prevalent bacterial infection followed by diarrhoea in infants in the post-neonatal period. Klebsiella pneumoniae was the common organism identified in the overall report followed by E. coli and S. aureus. Community-based awareness should be provided to follow good hygiene regularly in child care. Furthermore, avoid delay in seeking treatment and provide the medicine prescribed at the right time and in the right dose to limit the morbidity and bacterial resistance.
Collapse
|