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Multidrug-Resistant Bacterial Infections in Pediatric Patients Hospitalized at King Abdulaziz University Hospital,
Fajr A Saeedi1, Moustafa A Hegazi1,2, Hani Alsaedi1
1Department of Pediatrics, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah 80205, Saudi Arabia.
Insights
Multidrug-resistant bacterial infections are a significant threat in pediatric patients, with 42% affected. Low weight was a risk factor, and mortality was higher in infected children.
Area of Science:
- Medical Microbiology
- Pediatric Infectious Diseases
- Public Health
Background:
- Multidrug-resistant bacterial infections (MDRIs) pose a major global health challenge, increasing morbidity, mortality, and healthcare costs.
- Antimicrobial resistance in pediatric populations requires specific attention due to unique clinical and microbiological features.
Purpose of the Study:
- To determine the incidence and characteristics of MDRIs in hospitalized pediatric patients.
- To identify clinical and microbiological features associated with multidrug-resistant organisms (MDROs) in children.
Main Methods:
- A retrospective cross-sectional study was conducted at King Abdulaziz University Hospital from October 2021 to November 2022.
- Data were collected from medical files of pediatric patients (<18 years) with confirmed positive bacterial cultures from blood or body fluids.
- Analysis included identifying MDROs, types of infections, common pathogens, risk factors, and patient outcomes.
Main Results:
- Multidrug-resistant organisms (MDROs) were found in 12.8% of total cultures and 42% of patients, particularly in critically ill children in NICU and PICU.
- Pneumonia/ventilator-associated pneumonia was the most common infection (37.8%), with *Klebsiella pneumoniae* being the most frequent MDRO (39.5%).
- Low weight was the sole significant risk factor for MDROs (p=0.02), and mortality was substantially higher in patients with MDROs (32.4% vs. 3.9%, p=0.001).
Conclusions:
- The study highlights a concerning incidence of MDRIs in hospitalized pediatric patients, emphasizing the need for effective control strategies.
- MDROs are associated with increased mortality, longer hospital stays, and higher antibiotic consumption in pediatric patients.
- Findings provide crucial data for developing targeted interventions to mitigate the impact of MDROs in pediatric healthcare settings.
Abstract:
Multidrug-resistant bacterial infections (MDRIs) constitute a major global threat due to increased patient morbidity/mortality and hospital stay/healthcare costs. A few studies from KSA, including our locality, addressed antimicrobial resistance in pediatric patients. This study was performed to recognize the incidence and clinical/microbiologic features of MDRIs in hospitalized pediatric patients. A retrospective cross-sectional study included pediatric patients < 18 years, admitted to King Abdulaziz University Hospital, between October 2021 and November 2022, with confirmed positive cultures of bacteria isolated from blood/body fluids. Patients' medical files provided the required data. MDR organisms (MDROs) were identified in 12.8% of the total cultures. The incidence of MDRIs was relatively high, as it was detected in 42% of patients and in 54.3% of positive bacterial cultures especially among critically ill patients admitted to the NICU and PICU. Pneumonia/ventilator-associated pneumonia was the main type of infection in 37.8% of patients with MDROs. Klebsiella pneumoniae was the most common significantly isolated MDRO in 39.5% of MDR cultures. Interestingly, a low weight for (no need for their as terminology weight for age is standard and well-known) was the only significant risk factor associated with MDROs (p = 0.02). Mortality was significantly higher (p = 0.001) in patients with MDROs (32.4%) than in patients without MDROs (3.9%). Patients who died including 85.7% of patients with MDROs had significantly longer durations of admission, more cultures, and utilized a larger number of antibiotics than the surviving patients (p = 0.02, p = 0.01, p = 0.04, respectively). This study provided a comprehensive update on the seriously alarming problem of MDROs, and its impacts on pediatric patients. The detected findings are crucial and are a helpful guide to decid for implementing effective strategies to mitigate MDROs.
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