Carriage of multidrug-resistant bacteria among pediatric patients before and during their hospitalization in a tertiary pediatric unit in Tunisia

Abstract

The pandemic spread of multidrug-resistant (MDR) bacteria (i.e., methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum b-lactamase-producing Enterobacteriaceae (ESBLPE), vancomycin-resistant enterococci, carbapenemase-producing Enterobacteriaceae (CPE), multiresistant Pseudomonas aeruginosa and multiresistant Acinetobacter baumannii) pose a threat to healthcare Worldwide. We found limited data of MDR bacteria in pediatric patients hospitalized in Tunisian tertiary healthcare.The aim of the study is to evaluate the acquisition rate of MDR acquisition during hospitalization and to explore some of the associated risk factors for both carriage and acquisition at the pediatric department, Sahloul University Hospital. During September and October 2016, newly admitted patients were screened, at admission, during care and at discharge. Risk factors for colonization were explored by multivariate analysis. Of 112 newly admitted patients, 8.92% were colonized with at least one MDR. No risk factor was identified at admission. During hospitalization, five newly acquisition MDR (4.9%) were detected and eight (7.84%) at discharge. The specie most frequently detected on admission was Escherichia coli (50%), whereas, on discharge, Escherichia coli and K. pneumoniae were the species most frequently detected (52.7%). The pediatric intensive care unit (PICU) hospitalization, the length of hospital stay (more than 3days) and age under 2 years were identified as risk factor for acquisition of MDR during hospitalization. We identified several independent risk factors for contracting MDR bacteria during hospitalization in a tertiary pediatric department. The incidence of symptomatic MDR Infection among those colonized should be under close surveillance and long-term screening for those children is required. An institutional screening program for MDR especially in PICU might be discussed in regards to cost effectiveness.

Maternal-Infant Correlation of Multidrug-Resistant Staphylococcus aureus Carriage: A Prospective Cohort Study

“…On the contrary, the prevalence of MDR S. aureus in MRSA among mothers and their newborns were 88.5 and 91.7%, respectively. These results were similar to current observed studies that MRSA is always MDR S. aureus , but MDR S. aureus is not necessarily MRSA (7, 11). Therefore, it is significant to assess the mother-infant relationship of MDR S. aureus .…”

“…Most of the available data on the detection of MDR S. aureus carriage have been in hospitalized non-pregnant adults (6, 7). Despite the fact that MDR S. aureus outbreaks in infants have been linked to the infected or colonized mother, there are limited data on MDR S. aureus carriage rates among mothers or on the risk of transmission of MDR S. aureus from pregnant MDR S. aureus carriers to their newborn infants (8, 9).…”

Surveillance of multidrug-resistant bacteria in pediatric and neonatal intensive care units in Rio de Janeiro State, Brazil

“…Since 2013, efforts have been made to increase the reporting of colonization-and infection-associated MDR bacteria in adult and pediatric hospitals. In this study, an increase in the absolute number of 4/7 15 .…”

“…Surveillance systems help in HAI tracking and prevention measure evaluation, provide data needed to identify critical issues, and contribute to HAI reduction 14 . Knowledge on colonized MDR bacteria patients contributes to the establishment of better infection control practices that prevent their spread in neonatal and pediatric intensive care units, and the defi nition of appropriate antimicrobial schemes in case of infection 15,16 .…”

Epidemiology of Multidrug-resistant Organisms in Africa

“…Tfifha et al [27] at Sahloul Hospital, a university-affiliated hospital in Tunisia, evaluated different MDR bacteria including Enterococcus faecalis and E. faecium. All 320 (100%) Enterococcus spp.…”