Device-associated multidrug-resistant bacteria surveillance in critically ill children: 10 years of experience
Por:
Girona M, Fresán-Ruiz E, Garcia-Garcia A, Bobillo-Perez S, Balaguer-Gargallo M, Felipe-Villalobos A, Esteban ME and Jordán-García I
Publicada:
1 ene 2021
Ahead of Print:
1 may 2020
Resumen:
Aim Multidrug-resistant bacterial infections are a public health problem worldwide. However, most of the information available refers to adults. The main objectives were to determine the incidence, risk factors, and outcomes for device-associated infections, especially those involving multidrug-resistant bacteria.
Methods This is a prospective, observational study. Children aged >= 1 month and <18 years admitted to the paediatric intensive care unit from 2008 to 2017, with a device-associated infection microbiologically confirmed were included. Patients infected with resistant bacteria were compared with those who had a drug-susceptible infection.
Results The study included 213 patients. Out of all the device-associated infections, 22% (48 patients) were caused by multidrug-resistant bacteria. The most frequent were extended-spectrum beta-lactamase (ESBL)-producing enterobacteria. Cardiovascular diseases, age under 1year, comorbidity, prolonged use of invasive device, and length of stay until infection were risk factors for resistant bacteria, but not specifically for ESBL-producing bacteria. Length of stay and mortality was increased in patients with multidrug-resistant bacteria.
Conclusion Being under 1-year-old and having a cardiovascular disease were the two major risk factors for resistant bacterial infection. ESBL-producing bacteria were the most frequent multidrug-resistant agents. However, patients with ESBL-producing bacteria did not have any additional risk factors, so they may have been colonised in the community.
Filiaciones:
Girona M:
Paediatric Intensive Care Unit, Institut de Recerca Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
Immunological and Respiratory Disorders in the Paediatric Critical Patient Research Group, Institut de Recerca Hospital Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
Fresán-Ruiz E:
Paediatric Intensive Care Unit, Institut de Recerca Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
Immunological and Respiratory Disorders in the Paediatric Critical Patient Research Group, Institut de Recerca Hospital Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
Garcia-Garcia A:
Immunology Department, Hospital Sant Joan de Déu-Clínic, University of Barcelona, Barcelona, Spain
Bobillo-Perez S:
Paediatric Intensive Care Unit, Institut de Recerca Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
Immunological and Respiratory Disorders in the Paediatric Critical Patient Research Group, Institut de Recerca Hospital Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
Balaguer-Gargallo M:
Paediatric Intensive Care Unit, Institut de Recerca Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
Immunological and Respiratory Disorders in the Paediatric Critical Patient Research Group, Institut de Recerca Hospital Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
Felipe-Villalobos A:
Paediatric Intensive Care Unit, Institut de Recerca Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
Immunological and Respiratory Disorders in the Paediatric Critical Patient Research Group, Institut de Recerca Hospital Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
Esteban ME:
GREAB- Biological Anthropology Research Group, Zoology and Anthropology Section, Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, Institut de Recerca de la Biodiversitat (IRBio), University of Barcelona, Barcelona, Spain
Jordán-García I:
Paediatric Intensive Care Unit, Institut de Recerca Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
Immunological and Respiratory Disorders in the Paediatric Critical Patient Research Group, Institut de Recerca Hospital Sant Joan de Déu, Hospital Sant Joan de Déu, Barcelona, Spain
Paediatric Intensive Care Unit, CIBERESP, Hospital Sant Joan de Déu-Clínic, University of Barcelona, Barcelona, Spain
Open Access
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