High proportion of multidrug-resistant organisms in children hospitalized abroad

Area of Science:

• Infectious Diseases
• Microbiology
• Public Health

Background:

• Hospital-acquired infections pose a significant threat to patient safety.
• Multidrug-resistant organisms (MDROs) are a growing global health concern.
• International travel can facilitate the spread of infectious diseases and resistant organisms.

Purpose of the Study:

• To assess the prevalence of MDROs in children hospitalized abroad before admission to a Japanese hospital.
• To identify specific MDROs and resistance mechanisms, particularly those rare in Japan.
• To evaluate the effectiveness of active screening for preventing MDRO introduction into the hospital.

Main Methods:

• Prospective screening of pediatric patients with a history of hospitalization abroad.
• Microbiological culture and susceptibility testing for MDRO detection.
• Molecular methods for identifying carbapenemase genes in Enterobacteriaceae isolates.

Main Results:

• MDROs were detected in 19 out of 34 screened children (56%).
• Three isolates of carbapenemase-gene-harboring Enterobacteriaceae were identified, a finding rare in Japan.
• Screening identified a substantial burden of MDROs in this high-risk population.

Conclusions:

• Active screening of children with prior international hospitalization is essential for early MDRO detection.
• This strategy can help prevent the introduction of novel resistance mechanisms, such as carbapenemase-producing Enterobacteriaceae, into the hospital.
• Implementing targeted surveillance is critical for maintaining hospital infection control and combating antimicrobial resistance.