Incidence of Multidrug-Resistant Organism Among Children Admitted to Pediatric Intensive Care Unit in a Developing Country

• Published in: Microbial drug resistance (Larchmont, N.Y.) Vol. 24; no. 8; pp. 1198 - 1206
• Main Authors: El-Nawawy, Ahmed, Ashraf, Galal A., Antonios, Manal A.M., Meheissen, Marwa A., El-Alfy, Marwa M.R.
• Format: Journal Article
• Language: English
• Published: United States Mary Ann Liebert, Inc., publishers 01.10.2018; Mary Ann Liebert, Inc
• Subjects: Acinetobacter; Adolescent; Anti-Bacterial Agents - therapeutic use; Antibiotics; Antimicrobial agents; Bacteria; Child; Child, Preschool; Children; Children & youth; Cross Infection - drug therapy; Cross Infection - epidemiology; Cross Infection - microbiology; Data analysis; Data collection; Developing Countries; Disease; Disease control; Drug resistance; Drug Resistance, Multiple, Bacterial - drug effects; Drug Resistance, Multiple, Bacterial - physiology; Female; Gram-negative bacteria; Gram-Negative Bacteria - drug effects; Gram-Negative Bacteria - isolation & purification; Gram-Negative Bacterial Infections - drug therapy; Gram-Negative Bacterial Infections - epidemiology; Gram-Negative Bacterial Infections - microbiology; Health facilities; Hospitals; Humans; Incidence; Infant; Infant, Newborn; Intensive care; Intensive Care Units, Pediatric; Klebsiella; LDCs; Male; Microbial Sensitivity Tests; Mortality; Mortality risk; Multidrug resistance; Multidrug resistant organisms; Nosocomial infections; Organisms; Patients; Pediatrics; Prospective Studies; Pseudomonas; Staphylococcus infections; Urine; Ventilators; antimicrobial; microbial drug resistance; nosocomial infections; bacteria; resistance
• ISSN: 1076-6294; 1931-8448; 1931-8448
• DOI: 10.1089/mdr.2017.0414

Aim: Multidrug-resistant infections are an increasingly common condition particularly in critical care units. This study aimed to determine the incidence and types of resistant bacteria acquired in a pediatric intensive care unit (PICU) of a university hospital. Subject and Methods: A prospective study was conducted during the year 2016. All children aged below 16 years were studied for infection development and pattern of susceptibility to various groups of antibiotics. Results: A total of 264 patients were admitted to the PICU: 16 patients had community-acquired infection (CAI), 23 had hospital-acquired infection, and 24 patients had PICU-acquired infection (with 36 episodes) which is equivalent to 14.75 case/1,000 patient days. The study revealed high incidence of resistant organisms in the PICU but more important is the appearance of multi- and extreme drug-resistant bacteria in CAI. The study revealed that gram-negative bacteria were more prevalent in PICU, especially Klebsiella (30.5%), Acinetobacter baumanii (22.22%), and Pseudomonas (16.67%). Infection with resistant organisms in the PICU caused initial treatment failure and increased fourfold risk of mortality. Conclusion: The incidence of resistant bacteria especially gram-negative pathogens was very high in the PICU. The top three resistant organisms of concern were Klebsiella , Acinetobacter , and Pseudomonas . This is a global concern that necessitates new strategies.