Journal Article

Pathogen Distribution and Antimicrobial Resistance Among Pediatric Healthcare-Associated Infections Reported to the National Healthcare Safety Network, 2011–2014

Saiman, Lisa, Milstone, Aaron M., Lake, Jason G., Magill, Shelley S., Weiner, Lindsey M., See, Isaac

2018

Overview

OBJECTIVE To describe pathogen distribution and antimicrobial resistance patterns for healthcare-associated infections (HAIs) reported to the National Healthcare Safety Network (NHSN) from pediatric locations during 2011-2014. METHODS Device-associated infection data were analyzed for central line-associated bloodstream infection (CLABSI), catheter-associated urinary tract infections (CAUTI), ventilator-associated pneumonia (VAP), and surgical site infection (SSI). Pooled mean percentage resistance was calculated for a variety of pathogen-antimicrobial resistance pattern combinations and was stratified by location for device-associated infections (neonatal intensive care units [NICUs], pediatric intensive care units [PICUs], pediatric oncology and pediatric wards) and by surgery type for SSIs. RESULTS From 2011 to 2014, 1,003 hospitals reported 20,390 pediatric HAIs and 22,323 associated pathogens to the NHSN. Among all HAIs, the following pathogens accounted for more than 60% of those reported: Staphylococcus aureus (17%), coagulase-negative staphylococci (17%), Escherichia coli (11%), Klebsiella pneumoniae and/or oxytoca (9%), and Enterococcus faecalis (8%). Among device-associated infections, resistance was generally lower in NICUs than in other locations. For several pathogens, resistance was greater in pediatric wards than in PICUs. The proportion of organisms resistant to carbapenems was low overall but reached approximately 20% for Pseudomonas aeruginosa from CLABSIs and CAUTIs in some locations. Among SSIs, antimicrobial resistance patterns were similar across surgical procedure types for most pathogens. CONCLUSION This report is the first pediatric-specific description of antimicrobial resistance data reported to the NHSN. Reporting of pediatric-specific HAIs and antimicrobial resistance data will help identify priority targets for infection control and antimicrobial stewardship activities in facilities that provide care for children. Infect Control Hosp Epidemiol 2018;39:1-11.

• Publisher: Cambridge University Press
• Subject: Anti-Bacterial Agents / Antibiotics / Antimicrobial agents / Bacterial Infections - drug therapy / Bacterial Infections - epidemiology / Bacterial Infections - etiology / Carbapenems - therapeutic use / Catheter-Related Infections - epidemiology / Catheter-Related Infections - microbiology / Catheters, Indwelling - adverse effects / Centers for Disease Control and Prevention, U.S / Child / Child, Preschool / Cross Infection - drug therapy / Cross Infection - epidemiology / Cross Infection - microbiology / Disease control / Drug resistance / Drug Resistance, Bacterial / E coli / Enterococcus faecalis - drug effects / Enterococcus faecalis - isolation & purification / Equipment Contamination - statistics & numerical data / Escherichia coli - drug effects / Escherichia coli - isolation & purification / Health care / Hospitals / Hospitals - statistics & numerical data / Humans / Infant / Infant, Newborn / Intensive care / Klebsiella pneumoniae - drug effects / Klebsiella pneumoniae - isolation & purification / Medical instruments / Medical laboratories / Nosocomial infections / Pathogens / Patient safety / Pediatrics / Pneumonia, Ventilator-Associated - epidemiology / Pneumonia, Ventilator-Associated - microbiology / Public health / Rehabilitation / Staphylococcus - drug effects / Staphylococcus - isolation & purification / Surgical site infections / Surgical Wound Infection - epidemiology / Surgical Wound Infection - microbiology / Surveillance / United States - epidemiology