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Published on: March 3, 2023
Development of a multi-year pediatric antibiogram in Georgia identifies antibiotic resistance changes over the past
Matthew Linam1,2, Madeleine Goldstein1,2, Tracy Huang3
1Division of Pediatric Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA.
Insights
Pediatric antibiograms in Georgia show decreasing methicillin-resistant Staphylococcus aureus (MRSA) rates and increasing Streptococcus pneumoniae susceptibility over ten years. These trends support current antibiotic treatment guidelines for common childhood infections.
Area of Science:
- Microbiology
- Infectious Diseases
- Public Health
Background:
- Antibiograms are crucial for monitoring antibiotic resistance patterns and guiding empirical antibiotic therapy.
- Statewide pediatric antibiograms can significantly enhance antimicrobial stewardship efforts in children's hospitals.
Purpose of the Study:
- To analyze trends in antibiotic susceptibility and resistance among common pediatric pathogens in Georgia over a decade (2014-2023).
- To compare interhospital variations in susceptibility for key pathogens like MRSA and E. coli.
- To assess changes in antibiotic susceptibility over time to inform clinical practice.
Main Methods:
- Collected annual pediatric antibiograms from five Georgia children's hospitals (2014-2023).
- Utilized Clinical and Laboratory Standards Institute guidelines for antibiogram development.
- Combined data for common bacteria (e.g., S. aureus, S. pneumoniae, E. coli) and compared susceptibility between 2014 and 2023.
Main Results:
- In 2023, clindamycin susceptibility was 78% for MSSA and 82% for MRSA; amoxicillin/clavulanate susceptibility for S. pneumoniae was 96%.
- Gram-negative bacteria maintained high susceptibility to 3rd generation cephalosporins (90-92%) and meropenem (95-99%).
- From 2014 to 2023, MRSA rates decreased (49% to 33.5%), S. pneumoniae susceptibility increased, while E. coli showed slight decreases in susceptibility to cefazolin, ceftriaxone, and meropenem.
Conclusions:
- Georgia pediatric antibiogram data from 2014-2023 indicate a decline in MRSA and improved S. pneumoniae susceptibility.
- Gram-negative bacilli susceptibility remained largely stable with minor decreases observed.
- These findings support current antibiotic treatment recommendations for pediatric infections in Georgia.
Background:
Antibiograms monitor antibiotic resistance trends and help guide empiric antibiotic treatment. A statewide pediatric antibiogram can help inform stewardship efforts.
Methods:
Annual pediatric antibiograms for the five children's hospitals in Georgia from 2014-2023 were collected. All sites used the Clinical and Laboratory Standards Institute guidelines for antibiogram development. Antibiogram data were combined, and the most common bacteria were included: Staphylococcus aureus, Streptococcus pneumoniae, Enterococcus faecalis, Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae complex and Pseudomonas aeruginosa. Interhospital differences were compared for methicillin-susceptible S. aureus (MSSA), methicillin-resistant S. aureus (MRSA), E. coli and K. pneumoniae. The combined data from 2014 and 2023 were compared to demonstrate antibiotic susceptibility changes over time.
Results:
Data in 2023 for MSSA and MRSA showed clindamycin susceptibility was 78% and 82%, respectively. S. pneumoniae susceptibility to amoxicillin/clavulanate was 96%. E. faecalis resistance to ampicillin and vancomycin was rare. For all included gram-negative bacteria, susceptibility remained high to 3rd generation cephalosporins (90%-92%) and meropenem (95%-99%). From 2014 to 2023, the rate of MRSA decreased from 49% to 33.5%. S. pneumoniae susceptibility to amoxicillin/clavulanate and clindamycin significantly increased. For E. coli, there was a significant decrease in susceptibility for cefazolin (90% to 84%), ceftriaxone (95% to 92%), and meropenem (100% to 99%). There were nonsignificant decreases in susceptibility for K. pneumoniae.
Conclusion:
Over the past 10 years, MRSA rates decreased, S. pneumoniae antibiotic susceptibility increased, and gram-negative bacilli susceptibility was stable to slightly decreased. Georgia antibiogram data support the recommended antibiotic treatment for common pediatric infections.
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