Epidemiologic Study of Nosocomial Bacterial Infection of Pediatric Patients at BMA Medical College and Vajira Hospital(cid:31)
Taweewong Tantracheewathorn MD*, Niramon Vititpatarapak BSc**, Uraporn Phumisantiphong BSc**
Affiliation : (cid:31) Presented at the 10th Congress of Pediatric Infectious Disease Society of Thailand, Pattaya, Thailand, May 4-5, 2006 * Department of Pediatrics, Bangkok Metropolitan Administration Medical College and Vajira Hospital ** Microbiology Unit, Department of Clinical Pathology, Bangkok Metropolitan Administration Medical College and Vajira Hospital
Background : Nosocomial infection is a global public health problem, particularly by multi-drug resistant
bacteria, increasing morbidity, mortality, and health care costs. The distribution of pathogens and antimicro-
bial sensitivity patterns change with time and vary among hospitals.
Objective : To determine and compare the bacterial pathogens causing nosocomial infections in pediatric
patients and their susceptibility patterns between January 2000-December 2002 and January 2003-Decem-
ber 2005.
Materials and Methods : The bacterial pathogens and antimicrobial susceptibilities of children diagnosed as
nosocomial infections at BMA Medical College and Vajira Hospital between January 2000 - December 2002
and January 2003- December 2005 were comparatively analyzed.
Results : 1,863 and 1,884 isolates were identified in 2000-2002 and 2003-2005, respectively. The common
sites of infections were bloodstream (28.6%), lower respiratory tract (15.3%), skin and soft tissue (14.9%),
and urinary tract (12.5%). The major isolated gram positive pathogens were S. aureus, coagulase negative
Staphylococcus and Enterococus. The major gram negative pathogens were E. coli, P. aeruginosa, K. pneumo-
niae, Enterobacter spp. and Acinetobacter spp. Compared between 2000-2002 and 2003-2005, methicillin
resistant S. aureus (MRSA) was decreased from 4.3% to 1.5% P. aeruginosa from 13.3% to 7.5%, Enterobacter
spp. from 4.2% to 2.4%, Serratia spp. from 1.3% to 0.3%, but methicillin resistant coagulase negative Staphy-
lococcus was increased from 5.6% to 10.5% and K. pneumoniae from 5.5% to 7.7%, (p < 0.05). All gram
positive cocci remained sensitive to vancomycin and linezolid. In 2003-2005, gram negative rods were less
sensitive to 3rd and 4th generation cephalosporins and aminoglycosides than in 2000-2002. Sensitivity of gram
negative rods to 3rd and 4th generation cephalosporins were not significantly different except Enterobacter
spp. and Serratia spp., which were more sensitive to 4th generation cephalosporin (p < 0.05). Most gram
negative pathogens (80-100%) were sensitive to ciprofloxacin except Acinetobacter spp. (61%). Carbapenems
sensitivity were 100% except 92-100% for Enterobacter and 67-86% for P.aeruginosa, Acinetobacter spp. and
Serratia spp.
Conclusion : The bacterial pathogens causing nosocomial infections and their susceptibility patterns change
with time, so periodic surveillance are essential as a guide for more proper empirical therapy especially in
serious or life threatening infections that need urgent appropriate antibiotics.
Keywords : Nosocomial bacterial infection, Epidemiologic study, Children, Susceptibility patterns
