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A new metric of antibiotic class resistance in gram-negative bacilli isolated from hospitalized children

Sameer J Patel1, Dana O'Toole, Elaine Larson

  • 1Department of Pediatrics, Columbia University, New York, NY 10032, USA. sp2172@columbia.edu

Infection Control and Hospital Epidemiology
|May 8, 2012
PubMed

Insights

Electronic health records effectively tracked antibiotic-resistant gram-negative bacilli (GNB) in hospitalized children. This study identified patterns of multidrug-resistant (MDR) GNB and additive drug resistance, informing infection control strategies.

Area of Science:

  • Pediatric infectious diseases
  • Antimicrobial resistance surveillance
  • Healthcare epidemiology

Background:

  • Antibiotic resistance in gram-negative bacilli (GNB) poses a significant threat to public health.
  • Effective surveillance is crucial for understanding and combating the spread of resistant organisms in hospital settings.
  • Electronic health records (EHRs) offer a valuable tool for real-time monitoring of antimicrobial resistance patterns.

Purpose of the Study:

  • To describe patterns of infection or colonization with antibiotic-resistant gram-negative bacilli (GNB) in hospitalized children.
  • To utilize electronic health records for comprehensive tracking of GNB resistance over time and across hospitalizations.
  • To differentiate between multidrug-resistant (MDR) GNB and additive drug resistance in pediatric patients.

Main Methods:

  • Retrospective analysis of pediatric patients (≤18 years) hospitalized between January 1, 2006, and December 31, 2008, at a tertiary care facility.
  • Identification of children with positive cultures for multidrug-resistant (MDR) GNB (resistant to ≥3 antibiotic classes) or additive drug resistance (collective resistance to ≥3 classes across multiple GNB isolates).
  • Comparison of clinical characteristics, including prior admissions, comorbidities, procedures, and antibiotic exposure, between the MDR GNB and additive drug resistance groups.

Main Results:

  • Out of 56,235 pediatric patients, 46 had MDR GNB infections/colonization, with 16 resistant to 3 classes and 30 to 4 classes.
  • An additional 39 patients exhibited additive drug resistance.
  • Patients with additive drug resistance were more likely to have prior long-term facility admissions (P = .04) and more mean admissions and antibiotic-days (P < .01).

Conclusions:

  • Electronic health records are effective for tracking antibiotic class resistance in GNB isolates from hospitalized children.
  • EHR data facilitates monitoring of resistance trends across multiple cultures and hospitalizations.
  • This approach aids in understanding the epidemiology of antibiotic resistance in pediatric populations.
Abstract

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