Antibiotic susceptibility patterns in US children's hospitals

Area of Science:

• Pediatric Infectious Diseases
• Antimicrobial Resistance Surveillance
• Clinical Microbiology

Background:

• Antibiograms are crucial for guiding empirical antibiotic selection in pediatric care.
• Aggregate antibiograms offer value when local data are scarce, aiding regional and national comparisons.
• Current aggregate reporting practices for pediatric antibiograms are limited.

Purpose of the Study:

• To analyze antibiotic susceptibility patterns in pediatric bacterial isolates.
• To compare antibiotic resistance patterns based on isolate source and geographic region within the United States.

Main Methods:

• Surveyed 51 US children's hospitals for institutional antibiogram data in April 2023.
• Standardized and aggregated data from 46 submitted antibiograms for comprehensive analysis.
• Employed logistic regression to identify regional variations in antibiotic susceptibilities.

Main Results:

• Staphylococcus spp. and Escherichia coli/Klebsiella spp. were the most common Gram-positive and Gram-negative bacteria, respectively.
• Methicillin resistance was observed in 35.4% of Staphylococcus aureus isolates; 80% remained susceptible to clindamycin.
• Significant regional differences in antibiotic susceptibility were noted, with lower oxacillin susceptibility for S. aureus in the Southern US.

Conclusions:

• The study presents crucial regional and national pediatric antibiotic susceptibility data from US children's hospitals.
• Enhanced use and reporting of aggregate antibiograms can significantly improve antimicrobial stewardship.
• Aggregate data are vital for monitoring trends in antimicrobial resistance in pediatric populations.