Infection with gram-negative bacteria among children in a tertiary pediatric hospital in Egypt

Labib, John Rene; Ibrahim, Sally; Salem, Marwa Rashad; Youssef, Meray Rene Labib; Meligy, Basant

doi:10.1016/j.ajic.2017.12.008

Cited by 6 publications

(16 citation statements)

References 19 publications

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“…These predominant bacteria are known to cause nosocomial infection in children less than two years. 9 The more we go from preschool to neonates in TASH setting the infection rate increases, probably this could be due to the immaturity of their immune system, contamination due to high workload, length of admission, loosen IP protocol, and the optimal temperature for bacterial growth along with crowdedness of neonatal ICU, were the possible reasons. Therefore, due to their susceptibility, health care institutions serving pediatric patients should give special attention to nosocomial infections, and a strong infection prevention protocol should be implemented.…”

Section: Discussionmentioning

confidence: 99%

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Antimicrobial Resistance and Associated Risk Factors of Gram-Negative Bacterial Bloodstream Infections in Tikur Anbessa Specialized Hospital, Addis Ababa

Beshah¹,

Desta²,

Belay³

et al. 2022

IDR

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Background Bloodstream infections (BSIs) are significant causes of morbidity and mortality in Ethiopia and worldwide. Alarming is the rapid global spread of antimicrobial resistance (AMR) in bacteria. Objective To determine the microbial profile, antimicrobial susceptibility pattern, and associated risk factors for bloodstream infections in Tikur Anbessa Specialized Hospital (TASH) Addis Ababa Ethiopia. Methods A cross-sectional study was conducted between September 2018 and March 2019. Blood collected twice from each septicemia suspected patient were processed following standard bacteriological procedures. AST was performed by using the disk diffusion test according to CLSI 2017 and 2018 guidelines. Data captured in Epidata were cleaned and analyzed by SPSS version 21 software. Results The prevalence of BSI was 28.06% and a higher proportion of pathogene detected were gram-negative bacteria (GNB) (54.5%) and gram-positive bacteria (GPB) (45.43%). The most abundant bacterial species were Klebsiella pneumoniae 17.6%, CoNS 15.2%, and Acinetobacter spp 11.0%. Culture positivity was associated with age below 6 years, neonates AOR p=<0.001, infants AOR p=<0.001, Pre-school P=0.002, ICU admission COR p=<0.001, length of admission >5 days COR P=0.016, temperature greater than 38°C, AOR p=0.013, instrument usage during medical care AOR, p=<0.001, chronic illness AOR p=0.027, and neonatal incubation AOR p=0.013. GNB average drug resistance rate was 57.9% of the commonly used antibiotics and the most efficient and inefficient drugs were amikacin (10.8%) and ampicillin (94.6%). The gram-negative isolates showed a 95.3% rate of multi-drug resistance; and MDR, XDR, and PDR were observed at 55.8%, 32.2%, and 7.3%, of isolates respectively. This finding shows children especially neonates were highly affected by drug resistant BSI. Conclusion Pediatric patients and ICU patients are more affected by BSI, and drug-resistant bacteria are a major problem. Therefore, appropriate intervention approaches need to be implemented.

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Section: Discussionmentioning

confidence: 99%

“…5 Globally, Hospital Acquired Infections (HAIs) are the most frequent adverse event to occur during hospitalization. 9 BSI represents about 15-20% of all nosocomial infections and affects approximately 1% of all hospitalized patients. 10 In Sub-Saharan countries, including Ethiopia, BSI in children, a mortality rate approaching 53%.…”

Section: Introductionmentioning

confidence: 99%

Antimicrobial Resistance and Associated Risk Factors of Gram-Negative Bacterial Bloodstream Infections in Tikur Anbessa Specialized Hospital, Addis Ababa

Beshah¹,

Desta²,

Belay³

et al. 2022

IDR

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“…Optimum antibacterial activity occurs when the fT ϾMIC value is Ն40% of the dosage interval, but a higher level (70% to 80%) is required in critically ill patients (7,10). In addition, critically ill children are affected disproportionately by multidrugresistant bacteria, which show a higher meropenem MIC and decreased fT ϾMIC and require intensified dosing strategies (11,12). The standard dosing regimen for meropenem administered as 10 to 40 mg/kg of body weight/dose every 8 h (q8h) infused for 0.5 h has been shown to achieve the pharmacodynamic (PD) target of 40% fT ϾMIC in clinically stable children (13).…”

mentioning

confidence: 99%

Reappraisal of the Optimal Dose of Meropenem in Critically Ill Infants and Children: a Developmental Pharmacokinetic-Pharmacodynamic Analysis

Wang

Chen

et al. 2020

Antimicrob Agents Chemother

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Data of developmental pharmacokinetics (PK) of meropenem in critically ill infants and children with severe infections are limited. We assessed the population PK and defined the appropriate regimen to optimize treatment in this population based on developmental PK-pharmacodynamic (PD) analysis. Blood samples were collected from pediatric intensive care unit patients with severe infection treated with standard dosage regimens for meropenem. Population PK data were analyzed using NONMEM software. Fifty-seven patients (mean age, 2.96 years [range, 0.101 to 14.4]; mean body weight, 15.8 kg [range, 5.0 to 65.0]) were included. A total of 135 meropenem concentrations were obtainable for population PK modeling. The median number of samples per patients was 2 (range, 1 to 4). A two-compartment model with first-order elimination was optimal for PK modeling. Weight and creatinine clearance (estimated by the Schwartz formula) were significantly correlated with the PK parameters of meropenem. The probabilities of target attainment for pathogens with low MICs of 1 and 2 μg/ml were 87.5% and 68.6% following administration of 40 mg/kg/dose (every 8 h [q8h]) as a 4-h infusion and 98.0% and 73.3% with high MICs of 4 and 8 μg/ml following administration of 110 mg/kg/day as a continuous infusion in critically ill infants and children under 70% fT>MIC (the free time during which the plasma concentration of meropenem exceeds the MIC), respectively. The standard dosage regimens for meropenem did not meet an appropriate PD target, and an optimal dosing regimen was established in critically ill infants and children. (This study has been registered at ClinicalTrials.gov under identifier NCT03643497.)

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“…A total of 19 of the publications included in the review described studies set in Egypt (including 1 study set across Egypt and Saudi Arabia): 18 articles were identified by the database literature searches [8,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] and an additional article was provided from author files [27] (Supplementary Table S1).…”

Section: Egyptmentioning

confidence: 99%

“…1 Flow chart summarizing the publications identified by database searching and author hand searches and the subsequent selection of studies for inclusion in the review. GCC Gulf Cooperation Council classified according to patient setting: NICUs (n = 9) [8,[10][11][12][13][14][15][16][17], PICUs (n = 3) [18,19,27], patients of mixed age (n = 3) [20][21][22], and special populations (n = 4) [23][24][25][26]. Across all settings in studies that reported the prevalence of GNB pathogens, Klebsiella spp./K.…”

Section: Studies Werementioning

confidence: 99%

A Narrative Review of Healthcare-Associated Gram-Negative Infections Among Pediatric Patients in Middle Eastern Countries

et al. 2023

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Introduction: Gram-negative bacteria (GNB) have become prominent across healthcare and community settings due to factors including lack of effective infection control and prevention (ICP) and antimicrobial stewardship programs (ASPs), GNB developing antimicrobial resistance (AMR), and difficulty treating infections. This review summarizes available literature on healthcare-associated infections (HAIs) in Middle Eastern pediatric patients. Methods: Literature searches were performed with PubMed and Embase databases. Articles not reporting data on GNB, HAIs, pediatric patients, and countries of interest were excluded.Results: The searches resulted in 220 publications, of which 49 met the inclusion criteria and 1 additional study was identified manually. Among 19 studies across Egypt reporting GNB prevalence among pediatric patients, Klebsiella species/K. pneumoniae and Escherichia coli were typically the most common GNB infections;

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Infection with gram-negative bacteria among children in a tertiary pediatric hospital in Egypt

Cited by 6 publications

References 19 publications

Antimicrobial Resistance and Associated Risk Factors of Gram-Negative Bacterial Bloodstream Infections in Tikur Anbessa Specialized Hospital, Addis Ababa

Antimicrobial Resistance and Associated Risk Factors of Gram-Negative Bacterial Bloodstream Infections in Tikur Anbessa Specialized Hospital, Addis Ababa

Reappraisal of the Optimal Dose of Meropenem in Critically Ill Infants and Children: a Developmental Pharmacokinetic-Pharmacodynamic Analysis

A Narrative Review of Healthcare-Associated Gram-Negative Infections Among Pediatric Patients in Middle Eastern Countries

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