Increase in Incidence Rates and Risk Factors for Multidrug Resistant Bacteria in Septic Children: A Nationwide Spanish Cohort Study (2013-2019)

• Main Authors: María Slocker-Barrio (Author), Jesús López- (Author), Amaya Bustinza-Arriortúa (Author), Elena Fresán-Ruiz (Author), Iolanda Jordán-García (Author), Juan Carlos de Carlos-Vicente (Author), Elvira Morteruel-Arizcuren (Author), Patricia García-Soler (Author), Montserrat Nieto-Moro (Author), Cristina Schüffelmann (Author), Sylvia Belda-Hofheinz (Author), Laura Ximena Herrera-Castillo (Author), Sonia María Uriona-Tuma (Author), Laia Pinós-Tella (Author), Yolanda Peña-López (Author), on behalf of the Pediatric- (Author)
• Format: Book
• Published: MDPI AG, 2023-11-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

The emergence of multidrug-resistant (MDR) bacteria in children is a growing concern, particularly among septic patients, given the need for first-right dosing. Our aim was to determine the incidence rates and factors associated with MDR-sepsis in the pediatric intensive care unit (PICU), using data from the Spanish ENVIN-HELICS PICU registry between 2013 and 2019. The rate of MDR bacteria among septic children ranged between 5.8 and 16.2% throughout this study period, with a significant increase since 2015 (<i>p</i> = 0.013). MDR-gram-negative bacteria (92%), particularly EBL-Enterobacterales (63.7%), were the most frequent causative microorganisms of MDR-sepsis. During this study period, sixteen MDR-sepsis (32.6%) corresponded to intrahospital infections, and 33 (67.4%) had community-onset sepsis, accounting for 10.5% of the overall community-onset sepsis. Independent risk factors associated with MDR-sepsis were antibiotics 48 h prior to PICU admission (OR 2.38) and PICU onset of sepsis (OR 2.58) in >1 year-old children, and previous malnourishment (OR 4.99) in <1 year-old children. Conclusions: There was an alarming increase in MDR among septic children in Spain, mainly by gram-negative (ESBL-Enterobacterales), mostly coming from the community setting. Malnourished infants and children on antibiotics 48 h prior to PICU are at increased risk and therefore require closer surveillance.

Item Description

10.3390/antibiotics12111626
2079-6382