Identification of Bacterial Agents and Antibiotic Resistance Patterns in Pediatric Blood Infections at Hakim Children's Hospital, Tehran; [شناسایی عوامل باکتریایی و الگوی مقاومت آنتیبیوتیکی در عفونت خون کودکان در بیمارستان حکیم تهرا ن] Publisher



Nojookambari NY ; Ghalavand Z ; Dashti N ; Nikmanesh B
Source: Journal of Isfahan Medical School Published:2026

Abstract

Background: Bloodstream infections (BSIs) are life-threatening hospital-acquired infections with high mortality in children, especially neonates. Antimicrobial resistance (AMR) has emerged as a global challenge, complicating the management of these infections. This study aimed to investigate the prevalence and antibiotic resistance patterns of bacteria isolated from blood cultures in pediatric patients. Methods: A cross-sectional study was conducted at Hakim Hospital, Tehran, on 11,208 blood cultures from children aged 1 day to 15 years. Bacterial isolates were identified using standard blood culture methods and biochemical tests. Antibiotic susceptibility was determined using the Kirby-Bauer disk diffusion method according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Findings: Among 478 positive cultures (4.3%), 54% were Gram-negative bacilli (Pseudomonas, Klebsiella, and Stenotrophomonas maltophilia), 34.5% were Gram-positive cocci (predominantly Staphylococcus and Enterococcus species), and 12.3% were Candida species. Gram-negative isolates showed high resistance to third-generation cephalosporins (97–100%) and ampicillin-sulbactam (98.3%). Co-trimoxazole and levofloxacin were the most effective antibiotics. Gram-positive isolates demonstrated high resistance to penicillin (100%) and erythromycin (85%), but linezolid remained highly effective (97.3% susceptibility). Conclusion: The high prevalence of antimicrobial resistance in pediatric bloodstream infections underscores the necessity of evidence-based antibiotic prescribing based on susceptibility testing results and the implementation of enhanced infection control programs. © 2026, Isfahan University of Medical Sciences(IUMS). All rights reserved.