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Epidemiological trends of multidrug-resistant organisms in a tertiary-care pediatric hospital, 2017-2023

Carmen D'Amore1, Paola Bernaschi2, Gaetano Ciliento3

  • 1Epidemiology, Clinical Pathways and Clinical Risk Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy. carmen.damore@opbg.net.

Italian Journal of Pediatrics
|June 26, 2026
PubMed

Insights

Antimicrobial resistance (AMR) in hospitalized children decreased for MRSA and CRPA but remained stable for CRKP and VRE. Understanding local AMR trends is crucial for effective treatment strategies.

Area of Science:

  • Pediatric Infectious Diseases
  • Clinical Microbiology
  • Epidemiology

Background:

  • Antimicrobial resistance (AMR) poses a significant global health threat, especially to children under five.
  • Hospitalized pediatric populations are vulnerable to multidrug-resistant organisms (MDROs).

Purpose of the Study:

  • To investigate temporal trends in MDROs among hospitalized children in Italy from 2017 to 2023.
  • To describe the epidemiological characteristics of key MDROs in this pediatric cohort.

Main Methods:

  • Analysis of bacterial isolates from blood or cerebrospinal fluid (CSF) cultures of pediatric patients (2017-2023).
  • Included main ESKAPE pathogens and other relevant MDROs like Escherichia coli.
  • Statistical analysis using logistic regression and the Cochrane-Armitage test to assess trends and associations.

Main Results:

  • 2.9% of cultures yielded relevant microorganisms, with 13.8% identified as MDROs.
  • Highest resistance proportions observed in Carbapenem-Resistant Pseudomonas Aeruginosa (CRPA/PA, 52.8%) and Methicillin-Resistant Staphylococcus Aureus (MRSA/SA, 36.7%).
  • Significant reductions in MRSA/SA and CRPA/PA were noted over the study period; CRKP/KP and VRE/E showed no significant trends. Neonatal and PICU wards had higher MRSA odds, while Onco-hematology wards showed higher VRE odds.

Conclusions:

  • Local AMR patterns are critical for guiding empirical antibiotic therapy in diverse hospital settings.
  • Continued surveillance of MDROs in pediatric populations is necessary to adapt treatment guidelines.
Abstract

Keywords:
Antimicrobial resistanceEpidemiologyHospitalPediatrics

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