Microbiological Profile, Antibiotic Susceptibility Pattern of Isolates and Clinical Outcome of Paediatric Parapneumonic Effusion in Nigerian Children

Abstract

Parapneumonic effusion (PPE) remains a significant cause of morbidity among children with pneumonia, especially in low- and middle-income countries where diagnostic limitations and antibiotic resistance complicate management.

Objective: To determine the incidence, diagnostic modalities, bacteriological profile, antimicrobial susceptibility patterns, and outcomes of pediatric PPE in a tertiary hospital in Nigeria.

Methods: A five-year retrospective study was conducted among children aged 0–15 years diagnosed with PPE. Relevant data on socio-clinical characteristics, diagnostic findings, complications, comorbidities, and outcomes were extracted from patient records.

Results: Forty-two PPE cases were identified, giving an incidence rate of 1.1 per 1,000 pneumonia admissions. The mean age was 7.9 ± 3.8 years, with a male predominance (66.7%). Most had received prior antibiotics (88.1%) and were underweight (69.1%). Mycobacterium tuberculosis was detected in 14.3% of cases. Bacterial culture was positive in 28.6% of cases, with Streptococcus pneumoniae, Staphylococcus aureus (including MRSA), Streptococcus agalactiae, and Escherichia coli as the leading isolates. Gram-positive isolates were sensitive to cefuroxime, ceftriaxone, and gentamicin, while MRSA and MDR E. coli were sensitive to ciprofloxacin. Major complications included hypoxaemia and sepsis.

Conclusion: PPE is a significant pediatric respiratory complication. Strengthening pneumococcal vaccination, improving diagnostics, and implementing antimicrobial stewardship are crucial for better outcomes.