Antibiotic resistance and genotyping of gram-negative bacteria causing hospital-acquired infection in patients referred to Children’s Medical Center

Figures & data

Table 1 Characteristics of studied patients

Characteristics		N (%)
Gender	Male	84 (59.2)
	Female	58 (40.8)
Age (years)	<1	71 (50)
	1–5	45 (31.7)
	>5	26 (18.3)
Ward	Surgical	19 (13)
	Emergency	17 (12)
	EPICU	14 (10)
	NICU	13 (9)
	PICU	12 (8.5)
	NICU OPH	10 (7)
	Nephrology	8 (6)
	Oncology	8 (6)
	Infectious	7 (5)
	Gastroenterology	7 (5)
	CICU	7 (5)
	Rheumatology	5 (3.5)
	Neonatal	4 (3)
	IICU	3 (2)
	Urology	3 (2)
	Neurology	2 (1)
	Cardiology	2 (1)
	Transplant	1 (0.7)

Abbreviations: EPICU, Emergency Intensive Care Unit; NICU, Neonatal Intensive Care Unit; PICU, Pediatric Intensive Care Unit; OPH, Ophthalmology; CICU, Cardiac Intensive Care Unit; IICU, Intermediate Intensive Care Unit.

Table 2 Frequency of occurrence of GNB isolated from blood, wounds, and sterile body fluid cultures

Sample	Escherichia coli	Klebsiella pneumoniae	Klebsiella oxytoca	Pseudomonas spp.	Serratia marcescens	Stenotrophomonas maltophilia	Acinetobacter baumannii	Enterobacter spp.	Pseudomonas aeruginosa	Morganella morganii	Salmonella spp.	Total
	N (%)	N (%)	N (%)	N (%)	N (%)	N (%)	N (%)	N (%)	N (%)	N (%)	N (%)	N (%)
Blood	15 (17)	19 (21)	2 (2)	15 (17)	10 (11)	11 (12)	6 (7)	4 (4)	6 (7)	1 (1)	1 (1)	90 (63)
Wound	6 (30)	2 (10.5)	1 (5)	0 (0)	2 (10.5)	0 (0)	2 (10.5)	0 (0)	7 (37)	0 (0)	0 (0)	20 (13.7)
Abdominal fluid	8 (89)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	1 (12.5)	0 (0)	0 (0)	9 (6.7)
CSF	2 (25)	2 (25)	0 (0)	2 (25)	0 (0)	0 (0)	0 (0)	1 (12.5)	1 (12.5)	0 (0)	0 (0)	8 (6)
Central venous catheter tip	0 (0)	2 (28.5)	0 (0)	0 (0)	2 (28.5)	0 (0)	2 (28.5)	1 (14)	0 (0)	0 (0)	0 (0)	7 (5)
Ascitic fluid	1 (33)	1 (33)	1 (33)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	3 (2)
Dialysis fluid	0 (0)	1 (50)	0 (0)	0 (0)	1 (50)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	2 (1)
Other sterile fluids	0 (0)	(100)2	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	2 (1.4)
Pleural fluid	0 (0)	0 (0)	0 (0)	0 (0)	1 (100)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	1 (0.7)
Total	32 (22.5)	29 (20)	4 (3)	17 (12)	16 (11)	11 (8)	10 (7)	6 (4)	15 (11)	1 (0.7)	1 (0.7)	142 (100)

Abbreviations: GNB, gram-negative bacteria; CSF, cerebrospinal fluid.

Table 3 In vitro antimicrobial resistance of evaluated gram-negative bacteria

Bacteria	Piperacillin-Tazobactam	Imipenem	Meropenem	Gentamicin	Amikacin	Cefepime	Cefotaxime	Trimethoprim-Sulfamethoxazole	Colistin	Ceftazidime	Ciprofloxacin	Ampicillinsulbactam
	N (%)	N (%)	N (%)	N (%)	N (%)	N (%)	N (%)	N (%)	N (%)	N (%)	N (%)	N (%)
Escherichia coli	13/31 (42)	2/6 (33)	2/3 (67)	6/31 (19)	5/31 (16)	21/32 (66)	26/32 (81)	24/32 (75)	–	–	–	–
Klebsiella pneumoniae	16/26 (61.5)	6/17 (35)	1/1 (100)	15/28 (53.5)	13/28 (46)	25/29 (86)	28/29 (96.5)	19/29 (65.5)	0/6 (0)	–	–	–
Serratia marcescens	13/16 (81)	1/14 (7)	–	13/13 (100)	13/16 (81)	15/16 (94)	16/16 (100)	2/16 (12.5)	0/1 (0)	–	–	–
Pseudomonas spp.	1/15 (7)	2/15 (13)	–	13/15 (87)	13/15 (87)	10/15 (67)	4/15 (27)	–	–	–	–	–
Klebsiella oxytoca	1/4 (25)	0/1 (0)	–	1/4 (25)	3/4 (75)	3/4 (75)	3/4 (75)	1/4 (25)	–	–	–	–
Acinetobacter baumannii	8/10 (80)	8/10 (80)	–	8/10 (80)	8/10 (80)	8/10 (80)	10/10 (100)	8/10 (80)	0/8 (0)	8/10 (80)	7/8 (87.5)	6/8 (75)
Enterobacter spp.	3/6 (50)	–	–	1/6 (17)	0/6 (0)	3/6 (50)	4/4 (100)	1/4 (25)	–	–	–	–
Pseudomonas aeruginosa	0/15 (0)	3/15 (20)	1/1 (100)	1/15 (7)	0/15 (0)	0/15 (0)	–	–	–	1/15 (0)	–	–

Figure 1 Genotyping of isolated Acinetobacter baumannii (A), Klebsiella pneumoniae (B), Escherichia coli (C), Pseudomonas aeruginosa (D), and Enterobacter spp. (E) Strains that met hospital-acquired infection criteria.