Antimicrobial resistance patterns in paediatric infections at Damascus Hospital, Syria: a retrospective cohort study

Abstract

Background: Antimicrobial resistance is the third top-ranking global causative of death. Ninety per cent of babies with sepsis who were admitted to the ICU in the Middle East had antibiotic-resistant bacteria. We aim to describe the epidemiology, culture findings, bacterial antibiotic resistance, as well as the outcomes of children who present with nosocomial or community-acquired infections. Methods: A retrospective observational cohort study was conducted to analyze children with positive culture results presenting with nosocomial or community-acquired infections in Damascus Hospital, Damascus, Syria, which is considered one of the biggest hospitals in Syria. Results: In all, 116 patients with 177 positive culture results were included in the study. However, 54 (47%) were males, and 62 (53%) were females. Ages ranged between 3 h and 13 years. Cases of positive culture results peaked at the age or period of 0–11 months, that is 59(50%). The most prevalent bacteria were Staphylococcus aureus (33%), Enterobacter (21%), Pseudomonas aeruginosa (15%) and Escherichia coli (12%). The most used antibiotics were ceftriaxone (70%), vancomycin (60%) and amikacin (25%). The highest bacterial antibiotic resistance occurred with third-generation cephalosporins, and the most antibiotic-resistant bacterium was P. aeruginosa. Nosocomial infections occurred in 51% of the patients. Death was the outcome of 16% of the patients. Conclusion: The situation regarding bacterial resistance to antibiotics is critical, with the most notable examples of these resisted antibiotics being ceftriaxone, cefepime, cefotaxime, trimethoprim, gentamycin, levofloxacin and piperacillin with tazobactam, and there is no doubt that this is a major contributing factor to the high prevalence of nosocomial infections and death rates found in this study.