Health Care Associated Multidrug-Resistant Bacteria in a Pediatric Hospital: Five Year Experience

Authors

  • Patrícia Mação Unidade de Infecciologia. Hospital Pediátrico. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
  • João Casalta Lopes Serviço de Biofísica. Instituto Biomédico de Investigação de Luz e Imagem. Faculdade de Medicina da Universidade de Coimbra. Coimbra. Portugal.
  • Henrique Oliveira Laboratório de Microbiologia. Serviço de Patologia Clínica. Hospital Geral. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
  • Guiomar Oliveira Centro do Desenvolvimento. Hospital Pediátrico. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
  • Fernanda Rodrigues Unidade de Infecciologia. Hospital Pediátrico. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.

DOI:

https://doi.org/10.20344/amp.99

Abstract

Introduction: In recent years there has been an increase of infections caused by multidrug-resistant bacteria. Paediatric data are scarce, particularly at national level.
Aims: To analyse trends of health-care associated multidrug-resistant bacteria infections in a paediatric hospital.
Material and Methods: A retrospective incidence study was conducted in medical, surgical and intensive care wards in a level III paediatric hospital, from January 2005 to December 2009. The studied multidrug-resistant bacteria were methicillin-resistant Staphylococcus aureus (MRSA), ESBL-producing bacilli, vancomycin-resistant Enterococcus spp, multidrug-resistant Pseudomonas aeruginosa (PA-MDR) and Acinetobacter baumannii resistant to carbapenems. Demographic, clinical and laboratory data, treatment and presence of risk factors for these infections were analysed.
Results: During the study period 106 multidrug-resistant bacteria were identified, related to 72 children, predominantly male (65.3%). The most frequently identified multidrug-resistant bacteria were MRSA (35.8%), PA-MDR (29.2%) and ESBL-producing bacilli (17.9%). Of the 106 multidrug-resistant bacteria, 45 (42.5%) were causing infection. During the study period the annual proportion of infections caused by multidrug-resistant bacteria went up from 32.0% in 2006 to 55.6% in 2009 (p = 0.376). The overall incidence rate of infection was 0.400 per 1 000 hospitalization-days, corresponding to 0.274 infections per 100 admissions, remaining stable over the five years. The most frequent infections were bloodstream (31.1%), intra-abdominal (20.0%), catheter-related (17.8%) and skin and soft tissue (11.1%). All children had risk factors and the most frequently identified were previous antibiotic therapy and underlying chronic disease (> 90%). Six children (13.3%) died during hospitalisation.
Conclusions: During the study period, there was an increase in the proportion of multidrug-resistant bacteria but with no statistical significance. The overall incidence rate of multidrug-resistant bacteria infection remained stable. MRSA were the most frequently identified bacteria, followed by PA-MDR and ESBL-producing bacilli. Bloodstream infections were the most frequent infections, followed by intra-abdominal and catheter-related. All children had risk factors, mainly previous antibiotic therapy and chronic disease.

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Author Biographies

Patrícia Mação, Unidade de Infecciologia. Hospital Pediátrico. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.

João Casalta Lopes, Serviço de Biofísica. Instituto Biomédico de Investigação de Luz e Imagem. Faculdade de Medicina da Universidade de Coimbra. Coimbra. Portugal.

Henrique Oliveira, Laboratório de Microbiologia. Serviço de Patologia Clínica. Hospital Geral. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.

Guiomar Oliveira, Centro do Desenvolvimento. Hospital Pediátrico. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.

Fernanda Rodrigues, Unidade de Infecciologia. Hospital Pediátrico. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.

Published

2013-08-30

How to Cite

1.
Mação P, Lopes JC, Oliveira H, Oliveira G, Rodrigues F. Health Care Associated Multidrug-Resistant Bacteria in a Pediatric Hospital: Five Year Experience. Acta Med Port [Internet]. 2013 Aug. 30 [cited 2024 Mar. 19];26(4):385-91. Available from: https://actamedicaportuguesa.com/revista/index.php/amp/article/view/99