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Antibiotic-resistant bacteria and infection in children with cerebral palsy requiring mechanical ventilation

Kentigern Thorburn1, Michelle Jardine, Nia Taylor

  • 1Department of Paediatric Intensive Care, Royal Liverpool Children's Hospital, Alder Hey, UK. kent.thorburn@alderhey.nhs.uk

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|December 6, 2008
PubMed

Insights

Children with cerebral palsy (CP) admitted to the pediatric intensive care unit (PICU) frequently carry abnormal and antibiotic-resistant bacteria. These children experience higher infection rates and mortality, underscoring the need for targeted interventions.

Area of Science:

  • Pediatric Intensive Care
  • Infectious Diseases
  • Microbiology

Background:

  • Severe and chronic illnesses can alter oropharyngeal and gut bacterial flora.
  • Limited data exists on the bacterial flora of children with chronic neurologic impairment.

Purpose of the Study:

  • To assess the carriage of abnormal bacterial flora and antibiotic-resistant bacteria in children with cerebral palsy (CP) admitted to the pediatric intensive care unit (PICU).
  • To evaluate infection rates and mortality in this patient population.

Main Methods:

  • Prospective observational single-center cohort study.
  • Included children with CP ventilated for >= 4 days in the PICU.
  • Surveillance and diagnostic samples of throat and rectum were collected.

Main Results:

  • 89% of children with CP carried abnormal bacterial flora/potential pathogens (e.g., Pseudomonas, Klebsiella).
  • 47% carried antibiotic-resistant bacteria.
  • 35 children developed 86 infections; infection rates were significantly higher than in children without CP.

Conclusions:

  • Children with moderate to severe chronic neurologic impairment admitted to the PICU have a high incidence of abnormal bacteria, antibiotic-resistant bacteria, and infections.
  • These findings highlight significant risks in this vulnerable pediatric population.
Abstract

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