MICROORGANISMS AND ANTIBIOTIC RESISTANCE IN PEDIATRIC ICU PATIENTS: A RETROSPECTIVE STUDY, MOGADISHU, SOMALIA

Abstract

Antimicrobial resistance is a major public health issue, especially in developing countries.  This study retrospectively assessed microorganisms and antibiotic resistance in patients from a pediatric intensive care unit (PICU) of a tertiary hospital in Mogadishu, Somalia, between January 2022 and December 2023.  Cultures and antibiotic susceptibility tests were conducted on clinical samples collected.  Standard bacteriological methods identified 24.5% of the samples (n = 1,424) as positives, 85% from patients ≤1 year of age, with 66% being male.  Cultures were predominantly from blood (73%), followed by urine (10%) and then wound (7%), with Gram-negative bacteria accounting for 58%, Gram-positive bacteria 27% and Candida spp 15% of the samples.  The most frequent Gram-negative and -positive bacteria were Escherichia coli (26%) and coagulase-negative staphylococci (19%).  Antibiogram profiling revealed that the Gram-negative bacteria isolates were resistant to amoxicillin/clavulanic acid (59%), ampicillin/sulbactam (60%), and trimethoprim/sulfamethoxazole (52%), while Gram-positive bacteria isolates were resistant to ciprofloxacin (69%), levofloxacin (72%) and methicillin (51%).  Although the data were limited to a single hospital, the high prevalence of antibiotic resistance emphasizes the need for maintaining an up-to-date antibiogram database for appropriate antibiotic use, especially among the very young PICU patients in Somalia and elsewhere.