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583 Three Year Survey of Blood Stream Infections (Bsi) in a Paediatric Intensive Care Unit (Picu)
  1. A Gupta1,
  2. A Top1,
  3. M Farrington2
  1. 1Paediatric Intensive Care Unit
  2. 2Microbiology, Addenbrookes Hospital, Cambridge, UK

Abstract

Background and Aims Nosocomial infection is a common cause of morbidity and mortality in PICU. Timely microbiological surveillance and assessment of antimicrobial resistance is important in treatment. We studied the microbiological spectrum and susceptibility pattern of pathogens in PICU over 3 years.

Methods Results of blood cultures and antimicrobial susceptibility were reviewed retrospectively over a three year period (April 2008 to 2011). The incidence of nosocomial infections and associated pathogens was analyzed. Positive blood cultures after 48hours of admission were considered as nosocomial BSI.

Results There were 1653 PICU admissions of which 836 patients stayed for more than 48 hours. Overall incidence of BSI was 3.6% (60 episodes in 1653 patients). Incidence of nosocomial BSI was 2.9% (24 episodes in 836 patients).

During first 48 hours there were 36 positive blood cultures, 24 Gram-positive (67%) and 12 Gram-negative (33%). After 48 hours, there were 24 positive cultures, 20 Gram-positive (83%) and 4 Gram-negative (17%). Coagulase negative staphylococcus was the commonest isolate (13/24 nosocomial infections). Other nosocomial pathogens were Staphylococcus aureus (n=4), Enterococus (n=3), E. coli, Klebsiella, Pseudomonas and Acinetobacter (1 each).

Varying degree of resistance observed to first line antibiotics (penicillin, gentamicin, 3rd generation cephalosporins). No resistance to second and third line antibiotics (vancomycin, meropenem and tazocin).

Conclusions Gram positive organisms are the predominant cause of nosocomial infections in this study. No multiresistant organisms isolated. However, judicious use of antibiotics is important to prevent emergence of multiresistant strains.

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