Microorganisms isolated from patients in the pediatric intensive care unit and their antibiotic sensitivities, specialization thesis in medicine, department of pediatrics

Fighting infection in Pediatric Intensive Care Units (PICU) has become a more important issue over time. Risk factors for intensive care unit (ICU) infections are gradually changing. This situation affects the rate of mortality. Despite the resistance created by causative microorganisms, the limited number of antibiotics used in treatment and the rapid development of antibiotic resistance puts physicians in a difficult situation in the fight against ICU infections caused by polymicrobial resistant pathogens. Empirical antibiotic treatment is preferred in patients with severe life-threatening infections. For this reason, it is an inevitable necessity to know the causative pathogens found in the flora of each ICU and their sensitivity and resistance patterns. Our study was conducted by collecting the data of patients who were hospitalized in the Pediatric Intensive Care Unit of Gaziantep University Faculty of Medicine, for more than 48 hours between March 2020 and March 2022, and whose tracheal aspirate and/or blood culture were taken at least once during hospitalization. Blood culture samples taken from the patients were collected into pediatric blood culture bottles (BD BACTEC, USA) and sent to the microbiology laboratory without delay. It was incubated for 7 days in an automated blood culture system (BACTEC FX, USA) in the microbiology laboratory. Blood culture bottles with positive growth signals during the incubation period were inoculated into 5% sheep blood agar (BD, USA) and Eosin-Methylene Blue Agar (BD, USA) medium plates and cultivation was performed. Tracheal aspirate samples were inoculated onto 5% sheep blood agar (BD, USA) and Eosin-Methylene Blue Agar (BD, USA) medium plates in accordance with sterility rules and inoculated. Subsequently, the inoculated plates were placed in the oven and incubated at 37°C for 24 hours, and antibiotic sensitivity profiles were determined with an automated system (Vitek 2, France). Microorganisms grown in blood culture and tracheal aspirate culture were classified according to their antibiogram sensitivities and the results were given as percentages. 165 patients whose blood cultures were taken were included in the study. 97 (58.7%) of the patients were boys and 68 (41.2%) were girls. The mean age of the patients was 5.6±0.38 SD years. A total of 677 blood cultures were taken from the patients. Growth occurred in 279 of these cultures (41.2%). The 5 most frequently occurring microorganisms were evaluated. The most common microorganism was Staphlococcus haemolyticus (n:54, 7.9%). Tracheal aspirate cultures taken from 93 patients hospitalized in the PICU were included in the study. Of the 93 patients, 58 (62.3%) were male and 35 (37.6%) were female. The mean age of the patients was 5.6±0.5 SD years. 407 tracheal aspirate cultures were taken from 93 patients in the PICU. Growth was detected in 297 (72.9%) of these cultures. The 5 most common microorganisms that reproduced were evaluated. The most common microorganism in tracheal aspirate culture growth was Pseudomonas aeruginosa (n: 106, 26%). In our study, the 5 most frequently occurring infectious agents were identified in blood and tracheal aspirate culture in the pediatric intensive care unit of our hospital, and their antibiotic sensitivities were determined. 75% of S. haemolyticus, the most commonly produced microorganism in blood culture, was found to be thygecycline sensitive. 66% of P. aeruginosa, the most commonly reproduced microorganism in tracheal aspirate culture, were found to be cholestin-sensitive.When we compared our results with studies conducted in the world and in our country, it was seen that the common infectious agents were compatible with other studies. Empiric antibiotics were determined for patients who needed rapid antibiotic therapy for the PICU of our hospital. Keywords: Pediatric Intensive Care Unit, Hospital Infections, Blood Culture, Tracheal Aspirate Culture