ANTIBIOTICS RESISTANCE PATTERN IN MALNOURISHED CHILDREN SUFFERING FROM ACUTE SEVERE BACTERIAL INFECTIONS AT CMC CHILDREN'S HOSPITAL, LARKANA

Background: Severe acute malnutrition (SAM) significantly compromises immunity in children, increasing their vulnerability to life-threatening bacterial infections. These infections often present with nonspecific symptoms and are further complicated by rising antimicrobial resistance. Early detection and understanding of pathogen distribution and antibiotic susceptibility patterns are critical for timely intervention, particularly in resource-limited regions such as Larkana, Pakistan. Objective: To assess the frequency of acute bacterial infections and determine the antibiotic resistance patterns in children with SAM admitted to healthcare facilities in Larkana. Methods: A cross-sectional study was conducted from October 2023 to September 2024 at the nutrition ward of Chandka Medical College and a private pediatric facility in Larkana. A total of 105 children aged 5 to 60 months, clinically diagnosed with SAM, were included. Blood samples were collected aseptically before initiating antibiotic therapy. Bacterial identification and antibiotic susceptibility testing were performed using standard microbiological protocols. Demographic, clinical, and laboratory data were recorded and analyzed using SPSS version 25. Results: Of the 105 children, 67% presented with fever, 63% with diarrhea, 54% with dehydration, 42% with vomiting, 41% with edema, and 30% with cough. Blood cultures were positive in 33 cases (31%). Escherichia coli was the most frequently isolated pathogen (39%), followed by Klebsiella pneumoniae (27%), Staphylococcus aureus (12%), Pseudomonas aeruginosa (9%), and both Streptococcus pneumoniae and Haemophilus influenzae type b (6% each). E. coli showed 85% sensitivity to imipenem, and K. pneumoniae showed 78% sensitivity to amikacin. High resistance was noted against ampicillin and multiple cephalosporins. Conclusion: Children with SAM, particularly those under one year, are highly susceptible to bacterial infections. The emergence of antibiotic-resistant pathogens underscores the need for localized antibiotic stewardship and evidence-based treatment protocols to improve pediatric outcomes in malnutrition-endemic areas.