Spectrum of bacterial infections among severely acute malnourished children in a tertiary care center
Samreen Ashraf, Muhammad Zeeshan Khan, Fariha Ahmed Khan, Nighat Sultana, Muhammad Sarwar, Afsheen Batool Raza
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ABSTRACT
Aims: To determine common bacterial infections
in severely malnourished children and its effect on duration of hospital stay.
Methods: It was a cross
sectional observational study held at pediatric medical unit of The Children’s Hospital
and the Institute of Child Health, Lahore from March 2018 to February 2019. 150
children between 6 months to 5 years of age having severe acute malnutrition
(SAM) with positive cultures for bacterial infection included in study.
Majority of the children were between 13 to 24 months. Patients were enrolled
according to inclusion criteria. Children with chronic liver disease, chronic
kidney disease, malignancy and cardiac problem were excluded. Cultures were
taken on admission and 48 hours after admission. All positive bacterial
cultures were recorded.
Results: Bacteremia was seen in 35
(24%) of the 150 study subjects. There were a total of 8 bacterial isolates. S.
aureus (2%) was common among gram positive isolates whereas E. Coli was the
most common among Gram negative isolates followed by Klebsiella (7%) and
pseudomonas (6%) respectively. 70 patients (46%) were admitted for nutritional
rehabilitation with mild symptoms but still had bacteremia (27%).
Conclusion: High index
of suspicion of infection should be considered in SAM patients. Early
initiation of appropriate antibiotics according to common pathogen may help in
reducing the mortality and morbidity.
Key words: Bacteremia, Severe acute
malnutrition, Antibiotics
ABSTRACT
Aims: To determine common bacterial infections
in severely malnourished children and its effect on duration of hospital stay.
Methods: It was a cross
sectional observational study held at pediatric medical unit of The Children’s Hospital
and the Institute of Child Health, Lahore from March 2018 to February 2019. 150
children between 6 months to 5 years of age having severe acute malnutrition
(SAM) with positive cultures for bacterial infection included in study.
Majority of the children were between 13 to 24 months. Patients were enrolled
according to inclusion criteria. Children with chronic liver disease, chronic
kidney disease, malignancy and cardiac problem were excluded. Cultures were
taken on admission and 48 hours after admission. All positive bacterial
cultures were recorded.
Results: Bacteremia was seen in 35
(24%) of the 150 study subjects. There were a total of 8 bacterial isolates. S.
aureus (2%) was common among gram positive isolates whereas E. Coli was the
most common among Gram negative isolates followed by Klebsiella (7%) and
pseudomonas (6%) respectively. 70 patients (46%) were admitted for nutritional
rehabilitation with mild symptoms but still had bacteremia (27%).
Conclusion: High index
of suspicion of infection should be considered in SAM patients. Early
initiation of appropriate antibiotics according to common pathogen may help in
reducing the mortality and morbidity.
Key words: Bacteremia, Severe acute
malnutrition, Antibiotics