Bacteriological Profile and Antibiotic Sensitivity Patterns of Blood Culture Isolates Among Pediatric Patients with Suspected Septicemia: A Hospital-Based Cross-Sectional Study

Abstract

Neonatal and paediatric septicaemia remains a leading cause of morbidity and mortality in low- and middle-income countries. Empirical antibiotic therapy depends on knowledge of the prevailing bacteriological spectrum and local resistance patterns, which shift over time and geography. This study characterised the bacterial isolates and their antibiotic sensitivity profiles among paediatric patients with clinically suspected septicaemia. A hospital-based cross-sectional study was conducted from 15 November 2021 to 15 February 2022. A total of 101 blood culture samples were collected from patients aged newborn to 15 years with suspected septicaemia. Samples were processed by standard microbiological methods and antibiotic sensitivity was determined by the Kirby–Bauer disc-diffusion technique. Proportions were compared using the chi-square test and Fisher's exact test, and 95% confidence intervals (CI) were calculated using the Wilson method; p < 0.05 was considered statistically significant. Of 101 samples, 49 (48.5%; 95% CI 39.0–58.1%) were culture-positive. Gram-negative organisms accounted for 30/49 (61.2%) and Gram-positive for 19/49 (38.8%) of isolates. Staphylococcus aureus was the commonest isolate (19; 18.8%), followed by Pseudomonas aeruginosa (10; 9.9%), Klebsiella pneumoniae (9; 8.9%), Acinetobacter baumannii (7; 6.9%) and Escherichia coli (4; 4.0%). Culture positivity did not differ significantly by age (p = 1.00) or gender (p = 0.75), whereas most positive cases were from urban residents (41/49; 83.7%; p < 0.001). S. aureus was uniformly sensitive to vancomycin (100%; 95% CI 83.2–100%). Ceftazidime and linezolid showed broadly favourable activity across isolates, whereas amoxicillin–clavulanic acid and ceftriaxone performed poorly against Gram-negative organisms. Gram-negative organisms predominated among paediatric bloodstream isolates, with substantial resistance to commonly used agents. Vancomycin for Gram-positive and ceftazidime for Gram-negative organisms retained the best in-vitro activity, supporting their role in empirical therapy pending local antibiograms.