Registration successful
Account activated – pending validation.
Your account has been activated successfully, but we still need to validate you as a healthcare professional. We’ll send you an email with the result of the validation process in the next [five] days.
In the meantime, you can enjoy access to all the latest news, events and resources on our website
4
September, 2020
A comparison of multi-drug-resistant versus non-multi drug-resistant serious bacterial infections in early infancy 1
Introduction
Infants aged 0–90 days are more prone to serious bacterial infections (SBIs) than other paediatric groups. With the emergence of multi-drug resistant organisms (MDROs) causing SBIs in children, this study reviewed the epidemiology and bacteriology of community-acquired SBIs in infants 0–90 days old and compared the clinical features, laboratory values and final outcomes when caused by MDROs versus non-MDROs.
Methods
- Retrospective review of culture-proven SBIs (bacteraemia, urinary tract infections [UTIs], or meningitis) with age at onset of 0–90 days in patients admitted to hospital during a 7-year period (2012 to 2018).
- Healthcare-associated infections (cultures collected >3 days after admission) were excluded.
Results
- Among 94 episodes of SBI in 88 patients, UTI accounted for 54%, bacteraemia 43% and meningitis 3%.
- Median age at onset was 15 days, male gender predominated (73%) and most patients were full-term (74%).
- Gram-negative and gram-positive bacteria accounted for 67% and 33% of SBIs, respectively, with Escherichia coli the most common cause (30%) followed by Klebsiella species (25%) and group B streptococcus (16%).
- MDROs caused SBIs in 44% of patients, mostly extended-spectrum beta-lactamase (ESBL)-producing E. coli and ESBL-producing K. pneumoniae.
- Compared with non-MDROs, SBIs due to MDROs were associated with more delay in providing targeted antimicrobial therapy (74% vs 0%, p<0.001) but there was no difference in the case-fatality rate (13% vs 12%).
- There were no between-group differences in clinical features or laboratory values.
Conclusions
TMDROs are a common cause of SBIs in the first 90 days of life and are associated with a delay in providing targeted antimicrobial therapy. Knowledge of local epidemiology is imperative if appropriate antibiotics are to be administered promptly.
Adverse events should be reported. Reporting forms and information can be found at [/home/report-adverse-event.html]
Adverse events should also be reported to GlaxoSmithKline on link
