Journal article
Antimicrobial resistance in Enterobacterales, Acinetobacter spp. and Pseudomonas aeruginosa isolates from bloodstream infections in Australian children, 2013-2021
Journal of the Pediatric Infectious Diseases Society, Vol.13(12), pp.617-625
2024
PMID: 39460715
Abstract
Background
Gram-negative bloodstream infections are associated with significant morbidity and mortality in children. Increasing antimicrobial resistance (AMR) is reported globally, yet efforts to track pediatric AMR at a national level over time are lacking.
Methods
The Australian Group on Antimicrobial Resistance (AGAR) surveillance program captures clinical and microbiological data of isolates detected in blood cultures across Australia. EUCAST 2022 was used for MIC interpretation and the AMR package in R for data analysis.
Results
Over a nine-year period, there were 3,145 bloodstream infections with 3,266 gram-negative isolates reported in hospitalized children aged <18 years; 21.0% were from neonates. The median length of stay was 9 days, and 30-day all-cause mortality was 5.2%. A greater odds of death was observed in those with a multi-drug resistant organism (aOR: 2.1, 95%CI: 1.3, 3.3, p: 0.001).
Escherichia coli (44.5%) and Klebsiella pneumoniae complex (12.6%) were the two most frequently reported organisms. Overall resistance in Enterobacterales to gentamicin/tobramycin was 11.6%, to ceftazidime/ceftriaxone was 12.9%, and 13.2% to ciprofloxacin. Resistance increased over time.
Of 201 Pseudomonas aeruginosa isolates reported, 19.7% were resistant to piperacillin-tazobactam, 13.1% resistant to cefepime/ceftazidime and 9.8% to ciprofloxacin. Of 108 Acinetobacter spp. isolates, one was resistant to meropenem, and two were resistant to ciprofloxacin. Resistance did not increase over time.
Conclusion
AMR in gram-negative organisms causing bloodstream infections in Australian children is increasing which should be considered when updating guidelines and empiric treatment regimens. Ongoing pediatric-specific national surveillance with pediatric reporting must remain a priority to strengthen antimicrobial stewardship and infection control programs.
Details
- Title
- Antimicrobial resistance in Enterobacterales, Acinetobacter spp. and Pseudomonas aeruginosa isolates from bloodstream infections in Australian children, 2013-2021
- Authors/Creators
- Anita Williams - Wesfarmers Centre of Vaccines and Infectious Diseases, The Kids Research Institute Australia, Nedlands, WAGeoffrey W Coombs - Australian Group on Antimicrobial ResistanceJan M Bell - Australian Group on Antimicrobial ResistanceDenise A Daley - Australian Group on Antimicrobial ResistanceShakeel Mowlaboccus - Australian Group on Antimicrobial ResistancePenelope Bryant - Royal Children's HospitalAnita Campbell - The University of Western AustraliaLouise Cooley - Royal Hobart HospitalJon Iredell - The University of SydneyAdam D Irwin - The University of QueenslandAlison Kesson - Children's Hospital at WestmeadBrendan McMullan - UNSW SydneyMorgyn S Warner - South Australia PathologyPhoebe Williams - UNSW SydneyChristopher C Blyth - The University of Western Australia
- Publication Details
- Journal of the Pediatric Infectious Diseases Society, Vol.13(12), pp.617-625
- Publisher
- Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society.
- Identifiers
- 991005708507007891
- Copyright
- © The Author(s) 2024.
- Murdoch Affiliation
- Centre for Biosecurity and One Health; School of Medical, Molecular and Forensic Sciences
- Language
- English
- Resource Type
- Journal article
Metrics
65 File views/ downloads
49 Record Views