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Rapid Identification of Gram Negative Bacteria from Blood Culture Broth Using MALDI-TOF Mass Spectrometry
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Infections with Carbapenem-Resistant Gram-Negative Bacteria are a Serious Problem Among Critically Ill Children: A

Fatih Aygun1, Fatma Deniz Aygun2, Fatih Varol3

  • 1Department of Pediatric Intensive Care Unit, Istanbul University Cerrahpasa Medical Faculty, Fatih, Istanbul 34098, Turkey. faygun999@gmail.com.

Pathogens (Basel, Switzerland)
|May 24, 2019
PubMed

Insights

Critically ill children in pediatric intensive care units (PICUs) frequently develop bacterial infections, particularly from gram-negative bacteria. These infections are linked to increased mortality and resistance, highlighting the need for improved infection control strategies.

Area of Science:

  • Pediatric Intensive Care
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Children in pediatric intensive care units (PICUs) face high infection risks due to invasive device use.
  • Understanding infection prevalence, risk factors, and outcomes is crucial for this vulnerable population.

Purpose of the Study:

  • To determine the prevalence of bacterial infections in a PICU.
  • To identify factors associated with infections and their impact on patient prognosis.
  • To analyze the characteristics of identified bacterial pathogens, including antibiotic resistance.

Main Methods:

  • Retrospective analysis of culture results from 477 pediatric patients admitted to the PICU (January 2014 - March 2019).
  • Evaluation of demographic, clinical, and treatment data to identify associated factors.
  • Assessment of bacterial species and antimicrobial resistance patterns, focusing on gram-negative bacteria and carbapenem resistance.

Main Results:

  • 18.9% of patients had bacterial infections, predominantly gram-negative.
  • Younger age was associated with culture-positive status, mortality, and clinical factors.
  • Infections correlated with increased use of mechanical ventilation, RBC transfusions, and inotropic drugs.
  • Carbapenem resistance was observed in approximately one-third of gram-negative isolates, common in tracheal aspirates and with Klebsiella spp.
  • Total parenteral nutrition was a significant risk factor (OR: 5.870).
  • Positive blood cultures were linked to poorer survival outcomes.

Conclusions:

  • Bacterial infections, particularly those involving carbapenem-resistant gram-negative bacteria, pose a significant threat to critically ill children in PICUs.
  • Identifying risk factors like invasive ventilation, transfusions, and TPN is essential for targeted interventions.
  • The high prevalence of resistance necessitates vigilant infection control and antimicrobial stewardship programs.

Keywords:
carbapenem resistancecolistinnosocomial infectionpaediatric patientstigecycline

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