Australian Group on Antimicrobial Resistance (AGAR) surveillance outcome programs - bloodstream infections and antimicrobial resistance patterns in Australian children and adolescents, January 2022 - December 2023
Anita Williams, Geoffrey Coombs, Jan Bell, Denise Daley, Shakeel Mowlaboccus, Penelope Bryant, Anita Campbell, Louise Cooley, Annaleise Howard-Jones, Jon Iredell, …
Australian Group on Antimicrobial Resistance (AGAR) antimicrobial resistance surveillance paediatrics bacteraemia Enterobacterales Staphylococcus aureus Enterococcus
Between January 2022 and December 2023, there were 1,827 bloodstream infection (BSI) isolates in 1,745 children and adolescents reported to the Australian Group on Antimicrobial Resistance (AGAR) surveillance outcome programs, with 40% of episodes in children aged < 12 months. Two-thirds of BSIs were community-onset.
Of 1,034 gram-negative isolates, 932 (90%) were Enterobacterales. Gram-negative BSI episodes were more commonly community-onset and in children < 12 months of age. Of Enterobacterales isolates, 17.9% were ciprofloxacin resistant; 14.0% were ceftriaxone and/or ceftazidime resistant; 9.5% were gentamicin and/or tobramycin resistant; and 8.9% were piperacillin-tazobactam resistant. Increasing ciprofloxacin resistance was noted, primarily due to the increase in Salmonella Typhi BSI. Overall, 13% of Enterobacterales were extended spectrum β-lactamase producers, and 18.5% were multi-drug resistant (MDR).
Of 601 Staphylococcus aureus isolates, 13.6% were methicillin-resistant (MRSA), and 5.5% were MDR. Overall, 14.4% of S. aureus isolates were erythromycin resistant; 10.3% were clindamycin resistant; and 5.0% were ciprofloxacin resistant. Erythromycin, clindamycin, and ciprofloxacin resistance in MRSA were significantly higher than in methicillin-sensitive isolates. No co-trimoxazole resistant S. aureus was isolated.
There were 192 enterococcal isolates reported; 70.8% were E. faecalis and 17.2% were E. faecium. All ampicillin-resistant, vancomycin-resistant, and MDR enterococci were E. faecium.
The 2022–2023 AGAR Kids Biennial Report shows relative stability in the antimicrobial resistance landscape within the Australian paediatric population, with few significant differences detected when compared to the 2020–2021 report. Small increases in the proportion of resistant Enterobacterales and Enterococcus spp. isolates highlight the importance of ongoing surveillance to inform stewardship and infection prevention interventions.
Details
Title
Australian Group on Antimicrobial Resistance (AGAR) surveillance outcome programs - bloodstream infections and antimicrobial resistance patterns in Australian children and adolescents, January 2022 - December 2023
Authors/Creators
Anita Williams
Geoffrey Coombs
Jan Bell - Australian Antarctic Division
Denise Daley
Shakeel Mowlaboccus
Penelope Bryant
Anita Campbell
Louise Cooley
Annaleise Howard-Jones
Jon Iredell
Adam Irwin
Brendan McMullan
Morgyn Warner
Phoebe Williams
Christopher Blyth
Publication Details
Communicable diseases intelligence (2018), Vol.49
Publisher
Australian Government. Department of Health, Disability and Ageing acknowledges