DOI: https://dx.doi.org/10.18203/2349-3291.ijcp20222121
Published: 2022-08-24

Clinical and bacteriological profile of children with community acquired pneumonia admitted in pediatric ward in tertiary care hospital of central Gujarat, India

Ritesh A. Chaudhari, Rinki H. Shah

Abstract


Background: Community-acquired pneumonia is the leading cause of mortality of under-five children in developing countries, including India. Based on the burden of CAP, India is among the top five countries and has over 23% of the global cases. Accurate, reliable, and rapid determination of etiology in childhood CAP is important because it would influence individual treatment decisions, antibiotic policy in the community, and also rational immunization policy at a national level. Objectives of current study were to study the clinical and bacteriological profile of children admitted with CAP and to determine sensitivity and resistance patterns to various antibiotics to these organisms.

Methods: This was a prospective and observational study conducted over one year in the Paediatric ward SSG hospital Vadodara, Gujarat, India. Blood culture and Oropharyngeal swab/endotracheal swab for culture and sensitivity were collected in all study patients. Organisms isolated in blood culture and oropharyngeal/ET swab were analysed in percentage and frequency.

Results: Chest retraction (88%) was the commonest sign observed in this study followed by tachypnoea (74%). In blood culture, Acinetobacter was the most common organism isolated and in oropharyngeal and ET swab culture was Klebsiella spp. Major co-morbidity contributing to mortality was severe anemia followed by severe acute malnutrition.

Conclusions: Bacterial cultures of blood and oropharyngeal/ ET secretion swab culture have grown predominantly Acinetobacter and Klebsiella pneumoniae in this study. Administration of sensitive antibiotics as per the geographical bacteriological profile of community-acquired pneumonia will help to improve outcomes and prevent antibiotic resistance.


Keywords


Community acquired pneumonia, Blood culture, Acinetobacter, Klebsiella

Full Text:

PDF

References


Bartlett JG, Dowell SF, Mandell LA, File TM Jr, Musher DM, Fine MJ. Practice guidelines for the management of community-acquired pneumonia in adults. Infectious Diseases Society of America. Clin Infect Dis. 2000;31(2):347-82.

Integrated management of childhood illness. Available at: https://www.who.int/. Accessed on 20 October 2021.

Fang GD, Fine M, Orloff J, Arisumi D, Yu VL, Kapoor W, et al. New and emerging etiologies for community-acquired pneumonia with implications for therapy. A prospective multicenter study of 359 cases. Bull World Health Organ. 1990;69(5):307-16.

Rudan I, Boschi-Pinto C, Biloglav Z, Mulholland K, Campbell H. Epidemiology and etiology of childhood pneumonia. Bull World Health Organ. 2008;86(5):408-16.

Bassani DG, Kumar R. Causes of neonatal and child mortality in India: a nationally representative mortality survey. Lancet. 2010;376(9755):1853-60.

Chaudhary GS, Kumar S, Kankane A, Gupta S. Microbiological profile in community acquired pneumonia in children. Int J Pediatr Res. 2018;5(5):263-7.

Shekhawat YS, Sharma P, Singh A, Payal V. Bacteriological and clinical profile of community acquired pneumonia in hospitalised children with associated co-morbidity in a tertiary care centre of Western Rajasthan, India. Int J Contemp Pediatr 2016;3:1380-4.

Singh MK, Singh SP, Kumar R, Kumar P, Suhail J, Dayal R, et al. Clinico- bacteriological profile of community acquired pneumonia (CAP) in children aged 3-59 months: A cross sectional study. Asian J Med Sci. 2021;12(5):53-7.

Champatiray J, Satapathy J, Kashyap B, Mondal D. Clinico-aetiological study of severe and very severe pneumonia in two months to five years children in a tertiary health care centre in Odisha, India. J Clin Diagn Res. 2017;11(9):SC06-10.

Reddaiah VP, Kapoor SK. Acute respiratory infections in under five: experience at comprehensive rural health services project hospital Ballabgarh. Indian J Community Med. 1995;20:1-4.

Madhusudhan K, Sreenivasaiah B, Kalivela S, Nadavapalli SS, Babu RT, Jampana VR. Clinical and bacterial profile of pneumonia in 2 months to 5 years age children: a prospective study done in a tertiary care hospital. Int J Contemp Pediatr. 2017;4:90-5.

Saha S, Darmstadt G, Naheed A, Arifeen S, Islam M, Fatima K, et al. Improving the Sensitivity of Blood Culture for Streptococcus pneumoniae. J Trop Pediatr. 2011;57(3):192-6.

UNICEF analysis based on WHO and maternal and child epidemiology estimation group interim estimates produced in September 2019, applying cause of deaths for the year 2017 to United Nations inter-agency group for child mortality estimation estimates for the year 2018. Available at: https://www.unicef.org/. Accessed on 20 October 2021.