This article is more than 5 years old. Information may no longer be current.
MDR P. aeruginosa cases in children increased significantly over 12 years
Click Here to Manage Email Alerts
All health care facilities, particularly in the care of children, should take antimicrobial stewardship programs and rapid molecular diagnostic platforms into consideration to reduce the burden of multidrug-resistant and carbapenem-resistant Pseudomonas aeruginosa, according to study findings.
“As in adults, serious and systemic, often opportunistic, infections are substantial in children with critical illness, in those who require ventilator support, and in patients who are immunocompromised and/or have a hematologic-oncologic disease,” Latania K. Logan, MD, of the departments of pediatrics and internal medicine, division of infectious diseases at Rush Medical College, Rush University Medical Center, and colleagues wrote.
“The majority of P. aeruginosa studies have examined the effect of these infections on patients of cystic fibrosis. Despite the annual numbers of infection and rising rates of antibiotic resistance, no pediatric studies have assessed national or regional trends in MDR or carbapenem-resistant P. aeruginosa.”
To determine the epidemiology of P. aeruginosa in children in the U.S., the investigators collected P. aeruginosa isolate samples from The Surveillance Network (TSN) Database (Eurofin-Medinet, Herndon, VA), which included clinical microbiology laboratories that provided services to 300 hospitals selected by the 9 U.S. Census Bureau regional geographic divisions. The isolates were from pediatric patients aged 1 to 17 years who had spent time in outpatient, inpatient ICU, inpatient non-ICU or a long-term care setting between January 1999 and June 2012. Patients with cystic fibrosis and neonates were excluded. The investigators applied logistic regression to calculate trends in the prevalence of MDR and carbapenem-resistance in P. aeruginosa.
Among the 77,349 P. aeruginosa isolates tested, 15,653 isolates were MDR, 8,763 were carbapenem-resistant (CR) and 6,510 were both. Further, most resistant isolates were found among outpatients (MDR = 8,267 and CR = 3,868), a respiratory tract source (MDR = 12,117 and CR = 6,234), patients aged 13 to 17 years (MDR = 7,148 and CR = 3,705) and the West North Central region of the U.S. (MDR = 3,888 and CR = 2,067). Moreover, logistic regression analysis showed a significant increase in trends in the proportion of both MDR (15.4% to 26%; P < .001) and CR (9.4% to 20%; P < .001) P. aeruginosa isolates during the study period; each year, the isolates increased by 4% (OR = 1.04; 95% CI, 1.03-1.04 and OR = 1.04; 95% CI, 1.04-1.05, respectively).
“Pseudomonas infections are quickly becoming resistant to our last line of defense, the carbapenems,” Sumanth Gandra, MD, fellow at the Center for Disease Dynamics, Economics & Policy, said in a press release. “As these infections become more difficult to treat, they will bring significantly higher costs for hospitals and communities, and more importantly, increase the risk of death.” – by Kate Sherrer
Disclosure: Gandra reports support from the Global Antibiotic Resistance Partnership, funded by the Bill and Melinda Gates Foundation. Logan reports support from the National Institute of Allergy and Infectious Diseases. Please see the full study for a list of all other researchers’ relevant financial disclosures.
Click Here to Manage Email Alerts