Introduction:
bacteremia continues to be one of the major causes of
morbidity and
mortality despite the existence of numerous
antimicrobial agents. this study aimed to provide a Malaysian perspective on paediatric
community-acquired bacteraemia based on the
documentation of
epidemiology and antimicrobial profile of the isolated pathogens.
Method:
A
retrospective study was conducted by analysing clinical details,
blood cultures and antimicrobial susceptibility testing results in
children between the ages of 0 to 13 years old,
who were admitted to selayang
Hospital over an 11-year period from 2001 until 2011. there were 222 bacteraemia cases and the median age was 11.7 months. the highest number (39%) of bacteraemia cases occurred between ages one month to one year. the three most commonly isolated aetiological agents were
Staphylococcus aureus (17.1%), nontyphoidal
Salmonella (16.2%), and
Streptococcus pneumoniae (12.6%). Almost 8% of the
Staphylococcus aureus isolates were
methicillin resistant, while nontyphoidal
Salmonella (Nts) isolates demonstrated 18.4%, 10.5% and 2.6% resistance towards
ampicillin,
trimethoprim-sulfamethoxazole and
ciprofloxacin respectively. All Nts isolates were sensitive to
ceftriaxone.
Streptococcus pneumoniae isolates showed 17.9% resistance to
penicillin.
skin and
soft tissue infections as well as lower
respiratory tract infections (63.2%) were the main foci of
infections in
Staphylococcus aureus bacteraemia. Acute
gastroenteritis (80.0%) and
pneumonia (60.8%) were the main presentations of Nts and
Streptococcus pneumoniae bacteraemia respectively. Overall mortality rate was 8.1%.
Conclusion:
Knowledge on the local
epidemiology and
antibiotic resistance pattern serves as a significant platform in improving the empiric
antibiotic therapy for
patients with
community acquired bacteraemia.