Factors influencing antimicrobial resistance and outcome of Gram-negative bloodstream infections in children

Abstract

Rates of multidrug resistance and mortality in children with Gram-negative bloodstream infections remain high in our settings. Empiric broad-spectrum antibiotics and combination therapy could be recommended, especially in children with malignant diseases, patients admitted to the PICU, and for cases with septic shock, who have higher mortality risk.

Multidrug-resistant Gram-negative bacilli sepsis from a neonatal intensive care unit: a case-case-control study

“…However, this incidence was lower than a study from Egypt (83.4%) but the data in that study were not clear because there was no clear definition of MDR sepsis [28]. The data from studies in Taiwan (18.6%) [4] and Hungary (including both neonatal and pediatric ICUs, 33.6%) [29] were much lower compared to our study. We found in our study that the CFR in MDRGNB sepsis was 37.6%, which again was lower than the data from Egypt (79%) [28] but higher than the reported data from Taiwan (28.6%) [4] and Hungary (24.4%) [29].…”

“…The data from studies in Taiwan (18.6%) [4] and Hungary (including both neonatal and pediatric ICUs, 33.6%) [29] were much lower compared to our study. We found in our study that the CFR in MDRGNB sepsis was 37.6%, which again was lower than the data from Egypt (79%) [28] but higher than the reported data from Taiwan (28.6%) [4] and Hungary (24.4%) [29]. Reports from Egypt, Taiwan, Hungary, and this study found a correlation between the incidence rate of MDRGNB and the CFR.…”

Prevalence of Pseudomonas aeruginosa and antimicrobial-resistant Pseudomonas aeruginosa in patients with pneumonia in mainland China: a systematic review and meta-analysis

“…36 The presence of polymicrobial infections seemed to be associated with the acquisition of MDR among Chinese patients, which in turn was an independent predictor of poor outcomes, including higher in-hospital mortality; this observation was in agreement with findings from other populations. [37][38][39] Moreover, patients infected by two or more pathogens had an increased severity of pneumonia. 40 These results suggest the potential prognostic implications of polymicrobial infections, particularly in patients with severe pneumonia.…”

Risk factors for multidrug‐resistant Gram‐negative bacteria infection in intensive care units: A meta‐analysis

“…According to the results of Gram staining, bacteria can be classified into 2 categories: Gram‐positive G+ and Gram‐negative G−(Delfiner, Martinez, & Pavia, ). Hospital‐acquired infections caused by antibiotic‐resistant Gram‐negative bacteria (GNB) are increasingly seen (Ivády et al, ). In developed countries, 3% to 12% of hospitalized patients acquire health care‐associated infection (HAI), of which approximately a quarter occur in intensive care unit (ICU) settings, accompanied with high antibacterial drug resistance and mortality (Luna, Rodrigueznoriega, & Bavestrello, ).…”