Antimicrobial Susceptibility Pattern and Associated Factors of Pediatric Septicemia in Southern Ethiopia

Figures & data

Table 1 Socio-Demographic & Socio-Economic Characteristics of Study Participants and Their Care Givers

Variables	Frequency	Percent (%)
Sex
Male	118	49.6
Female	120	50.4
Age (Year)
< 1	66	27.7
1–4	83	34.9
5–9	53	22.3
10–15	36	15.1
Pediatric BMI
<18.5kg/m^2	42	17.6
18.5–24.9kg/m^2	188	79
>25kg/m^2	8	3.4
Resident
Urban	128	53.8
Rural	110	46.2
Educational status of care givers
Illiterate	69	29
Primary education	51	21.4
Secondary education	77	32.4
Tertiary education	41	17.2
Occupational status care givers
Government employee	46	19.3
Farmer	43	18.1
Merchant	41	17.2
Daily labor	40	16.8
Private organizations	40	16.8
House servant	17	7.2
Others*	11	4.6
Family Size
≤4	25	10.5
5–9	182	76.5
≥ 10	31	13
Monthly Income of Parents (Birr)
< 1000	133	55.9
≥1000	105	44.1

Note: Other* includes House wife and Driver.

Table 2 Clinical Characteristics of Study Participants

Variables	Frequency	Percent
Hospital Admission
Yes	85	35.7
No	153	64.3
Admission Date
<10	64	75.3
≥10	21	24.7
Medical Procedures Usage
Intravenous device	61	25.6
Endotracheal tube	6	2.5
Surgery	4	1.7
Prolonged antibiotic usage
Yes	10	4.2
No	228	95.8
Chronic Disease
HIV/AIDS	6	2.5
Others*	9	3.8
Clinical Diagnosis
Burns case	23	9.7
Respiratory disease	47	19.7
Febrile illness	87	36.6
Wound case	17	7.1
Urinary tract disease	17	7.1
Gastrointestinal disease	21	8.8
Skin disease	16	6.7
Others**	11	4.1

Notes: Others* includes diabetes mellitus, chronic liver disease, chronic kidney disease and asthmatic patient; Others** includes skin disease, heart disease, generalized swelling.

Figure 1 Distribution of bacterial species isolated in study participants.

Table 3 Factors Associated with Pediatric Septicemia in Study Participants

Variables	Positive N (%)	Negative N (%)	COR (95% CI)	AOR (95% CI)	P-value
Age
1–11 months	17 (25.8)	49 (74.2)	4.80 (1.77, 12.99)	4.18 (1.34, 13.00)	0.014
1–4 years	4 (4.8)	79 (95.2)	0.70 (0.19,2.58)	0.68 (0.17, 2.78)	0.591
5–15 years	6 (6.7)	83 (93.3)	Ref	Ref	Ref
Admission Date
No admissions	11 (7.2)	142 (92.8)	Ref	Ref	Ref
≤10	6 (9.4)	58 (90.6)	0.99 (0.34, 2.95)	0.81 (0.24, 2.67)	0.723
>10	10 (47.6)	11 (52.4)	10.68 (3.78, 30.21)	5.54 (1.51, 20.41)	0.010
Wound case
Yes	7 (41.2)	10 (58.8)	7.04 (2.41, 20.50)	5.52 (1.50, 20.34)	0.010
No	20 (9)	201 (91.0)	Ref	Ref	Ref
Burn case
Yes	8 (34.8)	15 (65.2)	5.50 (2.07,14.64)	3.55 (1.02, 12.38)	0.047
No	19 (8.8)	196 (91.2)	Ref	Ref	Ref
Usage of intravenous device
Yes	9 (14.8)	52 (85.2)	1.53 (0.65, 3.61)	0.41 (0.09, 1.89)	0.253
No	18 (10.2)	159 (89.8)	Ref	Ref	Ref

Abbreviations: COR, crude odds ratio; AOR, adjusted odds ratio; CI, confidence interval; Ref, reference.

Table 4 Antimicrobial Susceptibility Pattern of Gram-Positive Bacteria Isolated from Study Participants

Antibiotics	S. aureus (%)			CONS (%)			Total (%)
	S	I	R	S	I	R	S	I	R
CTR	0	0	100	0	0	100	0	0	100
AMC	0	0	100	0	14.3	85.7	0	6.2	93.8
AMP	22.2	0	77.8	71.4	14.3	14.3	43.8	6.2	50
DOX	22.2	0	77.8	85.7	0	14.3	50	0	50
CPR	11.1	11.1	77.8	14.3	42.9	42.9	12.5	25	62.5
CHL	55.6	33.3	11.1	85.7	0	14.3	68.8	18.8	12.5
CLT	88.9	11.1	0	85.7	14.3	0	87.5	12.5	0
K	22.2	44.4	33.3	14.3	57.1	28.6	18.8	50	31.2
TET	22.2	0	77.8	57.1	0	42.9	37.5	0	62.5
GEN	44.4	22.2	33.3	42.9	28.6	28.6	43.8	25	31.2
CXT	77.8	0	22.2	85.7	0	14.3	81.2	0	18.8
COT	22.2	0	77.8	71.4	0	28.6	43.8	0	56.2
ERY	11.1	0	88.9	28.6	42.9	28.6	18.8	18.8	62.5
PEN	0	22.2	77.8	0	71.4	28.6	0	43.8	56.2
AUG	55.6	22.2	22.2	71.4	28.6	0	62.5	25	12.5

Abbreviations: CTR, ceftriaxone; AMC, amoxicillin; AMP, ampicillin; DOX, doxycycline; AUG, amoxicillin-clavulanic acid; CLT, cephalothin; CHL, chloramphenicol; CPR, ciprofloxacin; GEN, gentamicin; TET, tetracycline; K, kanamycin; PEN, penicillin; COT, trimethoprim-sulfamethoxazole; CXT, cefoxitin; ERY, erythromycin; S, sensitive; I, intermediate; R, resistance; MRSA, methicillin resistant Staphylococcus aureus; MSSA, methicillin sensitive Staphylococcus aureus.

Table 5 Antimicrobial Susceptibility Pattern of Gram Negative Bacteria Isolated from Study Participants

Bacteria Isolates (%)		Antibacterial Drugs
		CTR	AMC	AMP	DOX	CPR	CHL	CLT	TET	GEN	COT	STR	AUG
K. pneumoniae	S	0	0	0	50	75	0	0	75	0	100	0	0
	I	50	0	0	25	25	75	0	0	50	0	0	0
	R	50	100	100	25	0	25	100	25	50	0	100	100
E. coli	S	0	0	0	100	100	66.7	0	66.7	0	100	0	0
	I	33.3	0	0	0	0	33.3	0	33.3	0	0	0	0
	R	66.7	100	100	0	0	0	100	0	100	0	100	100
P. mirabilis	S	100	0	0	0	100	100	0	0	0	100	0	100
	I	0	0	50	0	0	0	50	0	50	0	0	0
	R	0	100	50	100	0	0	50	100	50	0	100	0
Salmonella species	S	50	0	0	100	100	100	0	100	0	100	0	100
	I	50	0	50	0	0	0	50	0	0	0	0	0
	R	0	100	50	0	0	0	50	0	100	0	100	0
P. aeruginosa	S	0	0	0	0	0	0	0	0	100	0	0	0
	I	0	0	0	100	100	0	0	0	0	0	0	0
	R	100	100	100	0	0	100	100	100	0	100	100	100
Total	S	25	0	0	58.3	83.3	50	0	58.3	8.3	91.7	0	33.3
	I	33.3	0	16.7	16.7	16.7	33.3	16.7	8.3	25	0	0	0
	R	41.7	100	83.3	25	0	16.7	83.3	33.3	66.7	8.3	100	66.7

Abbreviations: CTR, ceftriaxone; AMC, amoxicillin; AMP, ampicillin; DOX, doxycycline; AUG, amoxicillin-clavulanic acid; CLT, cephalothin; CHL, chloramphenicol; CPR, ciprofloxacin; GEN, gentamicin; TET, tetracycline; COT, trimethoprim-sulfamethoxazole; STR, streptomycin; S, sensitive; I, intermediate; R, resistance.

Figure 2 Multi-drug resistance isolates among identified bacteria from blood sample.