Abstract
Background:
Multidrug-resistant (MDR) sepsis is a big cause of morbidity and mortality among children, it also really challenges healthcare systems worldwide. The rising prevalence of antimicrobial resistance, along with those delays in diagnosis, can seriously worsen the clinical picture. If we can spot sepsis early using lab biomarkers that are easy to access, then it might help clinicians act fast and manage patients better. In practice, blood and inflammation related indices, such as C-reactive protein (CRP), total leukocyte count (TLC), and platelet count, are often taken as early clues of infection. This work was designed to look at the lab signatures and antimicrobial sensitivity profiles that are linked with MDR sepsis in pediatric patients.
Methods:
We carried out a descriptive cross-sectional study at the Department of Pathology, Pakistan Institute of Medical Sciences (PIMS) Islamabad. In total , 183 children aged 1 month to 12 years with suspected sepsis were included. After obtaining informed consent, demographic details as well as clinical information were gathered with a structured proforma. Venous blood samples were then collected for hematological assessment (TLC and platelet count), CRP testing, and blood culture. The bacteria or other organisms grown from culture were identified, and antimicrobial susceptibility was evaluated using standard microbiological methods. We processed the data with IBM SPSS Statistics version 23, and we used a p-value of <0.05 as the threshold for statistical significance.
Results:
Out of the 183 participants, about 51% were male and 49% were female. Blood cultures were negative/no growth in 66% of the cases, so the remaining ones were culture-positive. In those culture-positive samples, Salmonella species came up most often as the isolated pathogen (14%), then it was Klebsiella pneumoniae (6%) ,and Pseudomonas aeruginosa (5%). When we looked at mean TLC, platelet count, and CRP levels, they seemed pretty similar for male versus female patients, with no meaningful difference (p > 0.05). Most patients also showed high TLC and elevated CRP, suggesting ongoing systemic inflammation and infection, even if the numbers are not identical across groups. On antimicrobial susceptibility testing, there was substantial resistance to many of the antibiotics that are commonly prescribed. Imipenem showed the best activity overall against Gram-negative isolates, while Linezolid performed very well for Gram-positive organisms including methicillin-resistant Staphylococcus aureus (MRSA).
Conclusion:
Overall, the results underline the rising burden of MDR pathogens in pediatric sepsis, and they also reinforce why CRP and TLC still matter as earlier laboratory clues, especially when these are used together with blood culture findings. Strengthening antimicrobial stewardship programs plus supporting culture-guided antimicrobial therapy will be important, because that can help improve treatment results and reduce the continuing emergence of antimicrobial resistance in pediatric populations.