Background: Severe acute malnutrition (SAM) significantly increases the risk of infections and mortality in children, with sepsis being a major contributor. Early identification of bacteremia and understanding the microbial profile are essential for appropriate management. Objectives: To study the age and sex distribution, prevalence of bacteremia, and the spectrum of organisms isolated from blood cultures in severely malnourished children with suspected sepsis. Methods: This hospital-based observational study included 72 children aged 6 months to 5 years diagnosed with SAM and admitted with clinical suspicion of sepsis. Blood cultures were obtained under aseptic precautions and processed using standard microbiological techniques. Data regarding demographic profile and culture results were analyzed. Results: Children below 2 years constituted 93% of cases, with 50% aged <1 year and 43.1% between 1–2 years. Females accounted for 56.9% and males 43.1%. Blood culture positivity was observed in 41.7% of cases, while 58.3% were sterile. Gram-negative organisms predominated (73.34%), with Escherichia coli (33.34%) being the most common isolate, followed by Staphylococcus aureus (20%), Salmonella spp. (13.24%), and Klebsiella spp. (10%). Other isolates included Proteus, Pseudomonas aeruginosa, Streptococcus pneumoniae, and Haemophilus influenzae. Conclusion: SAM children, particularly those under two years of age, are highly susceptible to bacteremia, predominantly caused by Gram-negative organisms. Early diagnosis, routine blood culture, and prompt empirical antibiotic therapy are crucial to improving outcomes in this high-risk group.

Severe acute malnutrition, bacteremia, sepsis, blood culture, Gram-negative organisms, children