A Prospective Study on Bacterial Etiology and Antibiotic Resistance Pattern in Acute Lower Respiratory Tract Infections Among Hospitalized Children in a Tertiary Care Centre

Background: Acute lower respiratory tract infections (ALRTIs) remain a leading cause of morbidity and mortality among children, particularly in developing countries. The emergence of antibiotic resistance poses a major challenge in their effective management.

Objective: To determine the bacterial etiologies of ALRTI and their antibiotic resistance patterns among hospitalized paediatric patients.

Methods: This prospective observational study was conducted over a period of 12 months in the Departments of Paediatrics and Microbiology, VIMS Medical College, Gajraula . Sputum, endotracheal aspirates, and blood samples from 150 children (aged 1 month–12 years) with clinically diagnosed ALRTI were processed for bacterial culture and sensitivity testing using standard microbiological techniques. Antimicrobial susceptibility was assessed by the Kirby–Bauer disc diffusion method as per CLSI guidelines (2023).

Results: Of 150 patients, bacterial growth was obtained in 104 (69.3%) cases. The predominant isolates were Streptococcus pneumoniae (34.6%), Haemophilus influenzae (23.1%), Staphylococcus aureus (18.3%), Klebsiella pneumoniae (13.5%), and Pseudomonas aeruginosa (10.5%). High resistance was noted to ampicillin (74%) and co-trimoxazole (62%), whereas good sensitivity was retained to amoxicillin-clavulanate (68%), ceftriaxone (72%), and levofloxacin (81%).

Conclusion: S. pneumoniae and H. influenzae remain major pathogens in paediatric ALRTI. Rising resistance to first-line antibiotics underscores the need for rational antibiotic use and periodic surveillance.