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Purpose: To evaluate bacterial and fungal infections, and antibiotic sensitivity in children with severe acute malnutrition. Methods: Design: Cross-sectional study. Setting: Severe Malnutrition Treatment Unit of Pediatric ward of a tertiary level hospital attached to a medical college located in Rewa, Madhya Pradesh, India. Participants: 100 Children with severe acute malnutrition aged 6-59 months. Blood, urine, CSF (cerebrospinal fluid) and pleural fluid samples were cultured and antibiotic sensitivity pattern determined. Results: Blood and urine culture were positive in 28 (28%) and 16 (16%), respectively, CSF and pleural fluid culture were positive in 12.5% (1 out of 8) and 100% (1 out of 1) cases, respectively. Gram-positive bacteria constitute 25 (56.82%) of the total bacterial isolates, where Staphylococcus aureus was most common while Escherichia coli was leading gram-negative bacteria. Blood culture showed 78.57% gram-positive bacteria predominantly coagulase-negative staphylococcus (28.57%), S. aureus (25%) and Enterococcus (25%). Gram-negative blood bacterial isolates constitute equal proportions of E. coli and Klebsiella 10.71% each. Urine bacterial isolates constitute predominantly E. Coli (64.29%) followed by Klebsiella (21.43%). Bacterial isolates showed high level of susceptibility to amikacin (76.19%) followed by tetracycline (57.14%) and gentamcin (44.19%). Low level of susceptibility was observed to ampicillin (11.36%), ciprofloxacin (16.67%) and co-trimoxazole (20.59%). Conclusions: Bacteraemia affected 28% children with severe acute malnutrition predominantly gram-positive isolates. Urine culture was dominated by gram-negative bacteria mostly E. Coli. Most bacterial isolates were resistant to commonly used antibiotics. Current guidelines for antibiotic of choice need to be reviewed.

Antibiotic susceptibility of bacterial agents in children with SAM: A single-centre cross-sectional study