Hospital-Acquired Antibiotic-Resistant Infections on the Rise in Children

Hospital-acquired antibiotic-resistant Acinetobacter baumannii is on the rise among children across the United States, putting those with chronic conditions at higher risk of infection, according to a recent study.

Researchers examined data from The Surveillance Network Database to evaluate national and regional trends of antibiotic resistance in clinical specimens. Published in the Journal of the Pediatric Infectious Diseases Society, the findings showed an increase in the amount of A. baumanni samples in infected children who were resistant to the antibiotics cephalosporin and carbapenem between 1999 and 2012.

The researchers used the data to phenotypically identify antibiotic resistance in A. baumanni isolates in children 1 to 17 years old during the 13-year period. Isolates from infants were not included.

Although the overall trend indicated a rise in resistance, the researchers did observe a slight decrease in resistance after 2008.

“While we are encouraged by the slight downward trend in resistance after 2008, there is still an overall increase in these infections,” Latania Logan, MD, chief of pediatric infectious diseases and associate professor of pediatrics at Rush University Medical Center, said in a press release about the study. “Further studies are needed to assess the most effective prevention strategies in children.”

The researchers suggested that the downward trend could be due to antibiotic stewardship guidelines released in 2007 or infection control guidance aimed at combatting multi-drug resistance in health care settings.

Other key findings from the study include:

• The number of cephalosporin-resistant A. baumanni increased from 13.2% of infections in 1999 to 23.4% in 2012.
• The number of carbapenem-resistant bacteria among all A. baumanni increased each year by 3% and 8%, respectively.
• Despite a downward trend after 2008, resistance remained higher than the 1999 baseline.

Resistance of Acinetobacter puts patients with compromised immune systems at considerable risk and can increase the chances of infection of the lung, urinary tract, or other sites in children with chronic conditions after surgery, intubation, trauma, or catheterization.

The researchers concluded that, although it is promising to see the recent decreasing trend, antibiotic resistance remains higher overall. Ongoing surveillance of A. baumanni infection and assessments of prevention strategies in vulnerable populations are necessary to combat multi-drug resistance in this setting, they concluded.

Reference

Logan K Latania, Gandra S, Trett A, et al. Acinetobacter baumannii resistance trends in children in the United States, 1999—2012. Journal of the Pediatric Infectious Diseases Society. 2018. https://doi.org/10.1093/jpids/piy018

Multidrug-Resistant Infections Rising in Children [news release]. Rush’s website. http://www.rush.edu/news/press-releases/multidrug-resistant-infections-rising-children. Accessed May 14, 2018.