Healthcare-associated bacterial infections in the paediatric ICU.
Journal
JAC-antimicrobial resistance
ISSN: 2632-1823
Titre abrégé: JAC Antimicrob Resist
Pays: England
ID NLM: 101765283
Informations de publication
Date de publication:
Sep 2020
Sep 2020
Historique:
received:
13
05
2020
accepted:
01
07
2020
entrez:
5
7
2021
pubmed:
6
7
2021
medline:
6
7
2021
Statut:
epublish
Résumé
An estimated 3.2 million patients annually develop healthcare-associated infections (HCAIs) in Europe alone amid the major challenge of increasing antimicrobial resistance. Critically ill children warrant specific evaluation because of differences in epidemiology, causative organisms and infection sites. To examine the prevalence and antimicrobial susceptibility patterns of three types of HCAI in critically ill children and determine the effect on their disease course. Retrospective cohort review of critically ill children admitted to a general paediatric ICU (PICU) at a regional academic tertiary referral centre over a 3 year period. There were 1930 admissions with a median age of 38 months. Children with HCAIs had a higher incidence of comorbidities (74% versus 24%) and a longer median length of stay (8 days versus 3 days). We identified 26 positive isolates (blood, lower respiratory and urine) taken 48 h or more after admission. The combined incidence was 1.34%. Hospital-acquired pneumonia accounted for 58% of HCAIs, urinary tract infections for 31% and bloodstream infections for 11%. The majority (61.5%) of HCAIs were caused by Gram-negative organisms. Seven isolates were resistant to antimicrobials used to treat HCAI. All of these were Gram-negative organisms ( These data revealed a low incidence of HCAIs, 27% of which were resistant Gram-negative organisms. Critically ill children with HCAIs were more likely to have comorbidities and an increased length of stay. These factors may increasingly impact on PICU bed availability, an already limited resource.
Sections du résumé
BACKGROUND
BACKGROUND
An estimated 3.2 million patients annually develop healthcare-associated infections (HCAIs) in Europe alone amid the major challenge of increasing antimicrobial resistance. Critically ill children warrant specific evaluation because of differences in epidemiology, causative organisms and infection sites.
OBJECTIVES
OBJECTIVE
To examine the prevalence and antimicrobial susceptibility patterns of three types of HCAI in critically ill children and determine the effect on their disease course.
MATERIALS AND METHODS
METHODS
Retrospective cohort review of critically ill children admitted to a general paediatric ICU (PICU) at a regional academic tertiary referral centre over a 3 year period.
RESULTS
RESULTS
There were 1930 admissions with a median age of 38 months. Children with HCAIs had a higher incidence of comorbidities (74% versus 24%) and a longer median length of stay (8 days versus 3 days). We identified 26 positive isolates (blood, lower respiratory and urine) taken 48 h or more after admission. The combined incidence was 1.34%. Hospital-acquired pneumonia accounted for 58% of HCAIs, urinary tract infections for 31% and bloodstream infections for 11%. The majority (61.5%) of HCAIs were caused by Gram-negative organisms. Seven isolates were resistant to antimicrobials used to treat HCAI. All of these were Gram-negative organisms (
CONCLUSIONS
CONCLUSIONS
These data revealed a low incidence of HCAIs, 27% of which were resistant Gram-negative organisms. Critically ill children with HCAIs were more likely to have comorbidities and an increased length of stay. These factors may increasingly impact on PICU bed availability, an already limited resource.
Identifiants
pubmed: 34223023
doi: 10.1093/jacamr/dlaa066
pii: dlaa066
pmc: PMC8210264
doi:
Types de publication
Journal Article
Langues
eng
Pagination
dlaa066Informations de copyright
© The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy.
Références
Am J Infect Control. 2006 Jun;34(5 Suppl 1):S3-10; discussion S64-73
pubmed: 16813980
Pediatrics. 1999 Apr;103(4):e39
pubmed: 10103331
Arch Dis Child. 2018 Jun;103(6):540-547
pubmed: 28705790
Clin Microbiol Infect. 2012 Mar;18(3):268-81
pubmed: 21793988
Ann Intensive Care. 2015 Dec;5(1):61
pubmed: 26261001
Lancet Infect Dis. 2017 Apr;17(4):381-389
pubmed: 28089444
Infect Control Hosp Epidemiol. 2000 Apr;21(4):260-3
pubmed: 10782588
BMJ. 2010 May 18;340:c2096
pubmed: 20483949
J Antimicrob Chemother. 2010 Sep;65(9):1842-52
pubmed: 20573657
Euro Surveill. 2012 Nov 15;17(46):
pubmed: 23171822