Increase in Incidence Rates and Risk Factors for Multidrug Resistant Bacteria in Septic Children: A Nationwide...

Area of Science:

• Pediatric Infectious Diseases
• Antimicrobial Resistance
• Critical Care Medicine

Background:

• Multidrug-resistant (MDR) bacteria pose a significant threat in pediatric intensive care units (PICUs), especially in sepsis cases.
• Accurate dosing is crucial for treating pediatric sepsis, making understanding MDR patterns essential.

Purpose of the Study:

• To investigate the incidence rates and associated risk factors of MDR sepsis in children within Spanish PICUs.
• To analyze trends in MDR bacterial infections from 2013 to 2019.

Main Methods:

• Utilized data from the Spanish ENVIN-HELICS PICU registry spanning 2013-2019.
• Analyzed rates of MDR bacteria in pediatric sepsis cases and identified independent risk factors.

Main Results:

• MDR bacteria incidence in septic children rose significantly from 5.8% to 16.2% between 2013 and 2019, with a notable increase after 2015.
• Gram-negative bacteria, particularly ESBL-Enterobacterales (63.7%), were the predominant cause of MDR sepsis.
• Community-onset MDR sepsis accounted for 67.4% of cases, with malnutrition and prior antibiotic exposure identified as key risk factors.

Conclusions:

• An alarming rise in pediatric MDR sepsis, predominantly community-acquired gram-negative infections, necessitates urgent attention.
• Malnourished infants and children with recent antibiotic exposure require enhanced surveillance for MDR sepsis.