Bacterial Etiology and Antimicrobial Susceptibility Patterns of Bloodstream Infections among Pediatric Patients in a Tertiary Care Hospital: A Cross-Sectional Study
Bloodstream infections (BSIs) are an important cause of morbidity and mortality among children, particularly in low- and middle-income countries. Early identification of causative organisms and their antimicrobial susceptibility patterns is essential for appropriate antimicrobial therapy and antimicrobial stewardship. This retrospective cross-sectional study was conducted in the Department of Microbiology and Virology, KPJ Specialized Hospital, Kashimpur, Gazipur, Bangladesh, from January 2025 to September 2025. A total of 609 blood culture specimens obtained from children aged ≤ 18 years with clinically suspected bloodstream infection were retrospectively analyzed. Blood cultures were processed using the automated BD BACTEC FXTM 40 system. Bacterial isolates were identified using conventional microbiological methods, and antimicrobial susceptibility testing (AST) was performed by the Kirby-Bauer disk diffusion method according to the applicable Clinical and Laboratory Standards Institute (CLSI) criteria. Bacterial growth was detected in 69 of 609 blood cultures (11.3%). The majority of children were aged 1 - 5 years (62.4%), and 59.4% were male. Fever was the most common presenting complaint (47.6%), followed by respiratory distress (33.3%). Among culture-positive isolates, Gram-positive and Gram-negative organisms accounted for 50.7% and 49.3%, respectively. Staphylococcus aureus was the most frequently reported bacterial isolate, followed by Klebsiella spp. and Acinetobacter spp. Resistance to several commonly used antimicrobial agents was observed among both Gram-positive and Gram-negative isolates. Susceptibility percentages were interpreted according to the number of isolates tested for each antimicrobial agent, and findings based on very small numbers of isolates were interpreted cautiously. The observed antimicrobial resistance among pediatric bloodstream isolates highlights the importance of routine blood culture testing, continuous local antimicrobial resistance surveillance, and antimicrobial stewardship. Local susceptibility data should be regularly reviewed to support appropriate empirical and definitive antimicrobial treatment.
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