P KZN ESBL X Being under 1‐year‐old and having a cardiovascular disease were the two major risk factors for resistant bacterial infection.

Device‐associated multidrug‐resistant bacteria surveillance in critically ill children: 10 years of experience

Mònica Girona‐Alarcón 

 

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