Patterns of Antimicrobial Resistance in a Pediatric Cardiac Intensive Care Unit: Five Years’ Experience

Objectives: The identification of antimicrobial resistance of isolates present in pediatric cardiac intensive care unit (PCICU) is important to prevent further spread, because this department limited choice of antibiotic. The aim of the present study is to report the antibiotic resistance rate of most frequently pathogens in PCICU during a five-year period. Methods: A prospective study was performed on 4228 clinical samples (bloodstream, wound samples, respiratory tract, tracheobronchial tree, and central venous catheter) from patients in PCICU during the period 2012-2016. Identification of isolates and antibiotic susceptibility testing were performed by Vitek 2 automated system. Results: The percentages of most frequently isolated microorganisms in our PCICU were as follows: Klebsiella pneumoniae 8.9%, Pseudomonas aeruginosa 7.5%, Staphylococcus aureus 6.9%, Coagulase-Negative Staphylococci 5.3%, and Candida spp. 3.4%. During study period there is tendency increasing the percentage of detection P. aeruginosa from 2.6% to 10.8% (p=0.018), K. pneumoniae from 2.6% to 10.5% (p=0.023), and Candida spp . from 1.6% to 5.9% (p=0.033). These isolates showed tendency of significant increasing resistance to 3rd generation cephalosporins and carbapenems. Conclusion: The present study reported that most frequent isolates in our PCICU were P. aeruginosa and K. pneumoniae . Reporting of dramatically increasing resistance rates of these isolates necessitates a well-designed hospital infection control strategy, including good hygiene, microbiological monitoring; all of this will greatly reduce the risk of nosocomial infection.