Multi-drug resistant gram negative infections and use of intravenous polymyxin B in critically ill children of developing country: retrospective cohort study

Siddiqui, Nadeem Ahmed; Qamar, Farah Naz; Jurair, Humaira; Haque, Anwarul

doi:10.1186/s12879-014-0626-9

Cited by 25 publications

(17 citation statements)

References 37 publications

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“…Many studies reported that multidrug resistance bacterial infections represented a growing public health problem in children, especially infant under 1-year-old [ 43 ]. Limited children with MDR infections were found in the retrospective study.…”

Section: Discussionmentioning

confidence: 99%

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Antimicrobial resistance in bacterial pathogens among hospitalized children with community acquired lower respiratory tract infections in Dongguan, China (2011–2016)

Xie

et al. 2017

BMC Infect Dis

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BackgroundBacterial pathogens are a major cause of childhood community acquired lower respiratory tract infections (CA-LRTIs), and few data described the impact of antimicrobial resistance on children with CA-LRTIs. This study aims to investigate the antimicrobial resistance in common bacterial agents among hospitalized children with CA-LRTIs between 2011 and 2016 in Dongguan, China.MethodsSputum samples were collected from hospitalized children (0–5 years old) with CA-LRTIs in Dongguan Children’s Hospital. Bacterial pathogens were detected using traditional culture methods, and disc diffusion tests were used to determine antibiotic resistance.ResultsAmong the 2360 samples analyzed, 342 (14.5%) were positive for bacterial infection. The most prevalent pathogen was MSSA (2.3%), followed by MRSA (1.5%), E. coli (1.7%), E. coli ESBLs (1.2%), K. pneumonia ESBLs (1.5%), K. pneumonia (1.4%) and S. pneumonia (1.3%). Of the hospitalized patients with bacteria causing of CA-LRTIs, 90.1% were less than 1-year-old. MSSA and MRSA were more commonly isolated in infants less than 3 months. E. coli, K. pneumonia and K. pneumonia ESBLs were more common bacteria causing CA-LRTIs in infants less than 1 month. Resistance levels to penicillins, fluoroquinolones, macrolides, cephalosporins, carbapenems and vancomycin varied in different bacteria.Conclusions S. aureus, E coli and K. pneumonia were the common bacterial isolates recovered from chidren with CA-LTRIs during 2011–2015. Age group of under 1 year old was at a high risk of bacterial infections. Many isolates showed antibiotic resistance level was associated with antibiotic usage in clinic. Increasing surveillance of antibiotic resistance is urgently needed and develops better strategies to cure the antibiotic abuse in China.

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Section: Discussionmentioning

confidence: 99%

“…It might be explained by a view that most of patients were from the regular ward. Generally, the patients from Intensive Care Units (ICUs) or Pediatric Intensive Care Units (PICU) were high risk population with MDR infections [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial resistance in bacterial pathogens among hospitalized children with community acquired lower respiratory tract infections in Dongguan, China (2011–2016)

Xie

et al. 2017

BMC Infect Dis

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“…Because of difficulties in the treatment and prolonged hospitalization, they also constitute an increased clinical and economic burden (8)(9)(10)(11). Carbapenem-resistant Gramnegative bacilli (CRGN) infections, including CREs, P. aeruginosa, and A. baumannii, are being widely reported in pediatric and neonatal critical care units (12)(13)(14)(15)(16)(17). Immediately initiating the appropriate antibiotics can be lifesaving in these infections.…”

Section: Introductionmentioning

confidence: 99%

The effect of aminoglycosides on colistin-containing regimens in the treatment of carbapenem resistant gram-negative infections in pediatric intensive care units: a two-center experience

Bal¹

2019

Erciyes Med J

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Objective: This study aimed to assess the outcomes including morbidity and mortality of carbapenem-resistant gram-negative (CRGN) infections in pediatric critical care setting. The second aim was to investigate the impact of aminoglycosides on colistin-containing regimen in CRGN-infected pediatric critical care patients. Materials and Methods: We retrospectively evaluated medical records of 82 patients who had received colistin in combination with an aminoglycoside (CA group) or another antibiotic (CO group) at two reference pediatric intensive care units (PICUs) between February 2011 and February 2016. Results: We enrolled 82 CRGN-infected patients who were admitted to PICUs of two hospitals. The median age of the patients was 24 (25 th-75 th percentile; 8-78.75) months, and the median duration of hospital stay was 30 days (25 th-75 th percentile; 16.7-57.7). No statistical difference was observed in the variables, including microbiological response, attributable mortality, crude mortality, and the duration of achieving first negative culture (p>0.05). Clinical response was significantly more observed in the CA group (85.5% vs. 63.2; p=0.048), and attributable mortality was higher in the CO group (12.7% vs. 31.6%; p=0.055). Nephrotoxicity did not show statistical difference between groups (p=0.357), and neurotoxicity was not observed. Conclusion: Colistin-containing regimen in combination with an aminoglycoside may be an effective and safe antimicrobial agent without a significant increase in side effects.

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“…Infections due to CRE in adult populations have been associated with poor clinical outcomes, including mortality rates as high as 40-65% while mortality can reach up to 90% in children (4,5). Data regarding bloodstream infections (BSIs) due to a CRGN pathogen in pediatric ICUs still remain limited (6,7). Therefore, we evaluated the clinical and laboratory features of BSIs caused by a CRGN pathogen and compared them with other types of infections including urinary tract infections (UTI), ventilator-associated pneumonia (VAP) and meningitis.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors of Bloodstream Infections Caused by Carbapenem-resistant Gram-negative Pathogens in Pediatric Critical Care Settings

Bal¹,

Duyu²,

Kamit³

et al. 2019

jpr

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Infections and sepsis are the leading causes of death in non-cardiac intensive care units (ICUs) and account for 40 percent of all ICU expenditures. Data regarding bloodstream infections (BSIs) due to a carbapenem-resistant gram negative (CRGN) microorganisms in pediatric ICUs still remain limited. Materials and Methods: This study was conducted retrospectively in patients who were admitted to two pediatric critical care units between January 2011 and December 2017. Patients were assigned to two groups. Patients with BSI caused by a CRGN microorganism and infections were assigned to the BSI group and those other than BSI were assigned to the non-BSI group. Results: This study included 89 critically ill children with a mean age of 52.1 (±65.1) months. The requirements for invasive procedures including tracheostomy, Foley catheter and central venous catheter were not statistically different among the groups, p values were 0.159, 0.291 and 0.803, respectively. The majority of the patients admitted to pediatric intensive care unit were due to sepsis/septic shock in the BSI group (n=18, 58%) and in the non-BSI group, this figure was 37.9% (n=24). Prior third/fourth generation cephalosporin exposure was significantly more common in the BSI group (51.6% vs 15.5%, p<0.001), carbapenem exposure was not significantly different among the groups (35.5% vs 56.9%, p=0.054). Neutropenia (<500/mm 3) and thrombocytopenia (150x103/mm 3) were significantly more common in the BSI group (p=0.011 and p=0.010) and the C-reactive protein level was significantly higher (p=0.018). Crude and attributable mortality did not show any significance between the groups, p values were 0.578 and 0.955, respectively. Conclusion: CRGN infections are still a major cause of morbidity, mortality and healthcare associated infections. In this study, we evaluated patients with BSI due to a CRGN microorganism and compared them with other infection types. The risk factors and outcomes were similar except for prior cephalosporin exposure. As a conclusion, we have to enhance infection control programs and prevent patients from redundant antibiotic exposure.

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Multi-drug resistant gram negative infections and use of intravenous polymyxin B in critically ill children of developing country: retrospective cohort study

Cited by 25 publications

References 37 publications

Antimicrobial resistance in bacterial pathogens among hospitalized children with community acquired lower respiratory tract infections in Dongguan, China (2011–2016)

Antimicrobial resistance in bacterial pathogens among hospitalized children with community acquired lower respiratory tract infections in Dongguan, China (2011–2016)

The effect of aminoglycosides on colistin-containing regimens in the treatment of carbapenem resistant gram-negative infections in pediatric intensive care units: a two-center experience

Risk Factors of Bloodstream Infections Caused by Carbapenem-resistant Gram-negative Pathogens in Pediatric Critical Care Settings

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