Bacteriological profile in lower respiratory tract infections in paediatric population

Background: Lower respiratory tract infections (LRTI) are commonly implicated in morbidity and mortality in the paediatric age group. Important gaps remain in our understanding of the pathogenesis and etiology of lower respiratory tract infections in children, which is further complicated by poor response to therapy, due to high anti-microbial resistance. Aim: To study the bacteriological profile and antimicrobial susceptibility pattern of lower respiratory infections in paediatric population. Materials and Methods: This prospective study was conducted in the Department of Microbiology in a tertiary care hospital in Mumbai, over a period of one and half year, in pediatric population presenting with three or more symptoms of LRTI. 100 samples were included in the study, through convenience sampling and processed for bacteriological profile and antibiotic sensitivity tests, by conventional methods. Results: 41 bacterial pathogens were isolated, with 40(97.56%) gram-negative and 1 (2.44%) gram-positive. Streptococcus pneumoniae was the only gram positive isolate (2.44%) while Acinetobacter baumannii complex 17 (41.44%) and Klebsiella pneumoniae 15 (36.50%) were predominant isolates, followed by Pseudomonas aeruginosa (17.00%) and Acinetobacter spp (2.40%).Sensitivity to only colistin was seen in all isolates of Acinetobacter baumannii complex with multidrug resistance to all other drugs. 86.67% of Klebsiella pneumoniae were resistant to carbapenems,86.67%resistant to piperacillin-tazobactam and 100%resistant to cephalosporins. All isolates of Pseudomonas aeruginosa were sensitive to aztreonam, whereas sensitivity to carbapenems and piperacillin-tazobactam was 28.57% and 14.29% respectively. Streptococcus pneumoniae was sensitive to linezolid, vancomycin and teicoplanin. Conclusion: Gram-negative bacteria are a leading cause of lower respiratory tract infections in paediatric population. They pose a burden on the healthcare system due to their high antimicrobial resistance.