medigraphic.com

2017, Number 2

<< Back Next >>

Enf Infec Microbiol 2017; 37 (2)

Microbiological isolation and antimicrobial resistance in blood cultures of pediatric patients according to their age group

Sánchez SLM, Velarde BR, García CJA, Aguilar FCA, Sepúlveda NAI

Language: Spanish
References: 24
Page: 50-55
PDF size: 152.90 Kb.


ABSTRACT

Background. A change in the etiology of bacteremia has been seen and it is possible that the habitual pathogens are being replaced by pathogens with high levels of antimicrobial resistance.
Material and Methods. Cross-sectional, retrospective, observational study of blood-cultures of pediatric patients hospitalized at Hospital No. 25 in Monterrey, Nuevo León, IMSS from January 2014 to October 2015. They were divided into different age groups. Chi-square test or Fisher exact test was used and a p ‹0.05 value was considered with statistical significance.
Results. A total of 172 blood cultures of pediatric patients were reviewed, of which 116 were positive (67.5%). The most frequently isolated microorganisms were: Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus; Acinetobacter baumannii predominated in adolescents. Candida spp. was more frequent in newborns (p = 0.009), Acinetobacter baumannii in schoolchildren (p = 0.099). Increased antimicrobial resistance to ampicillin, gentamicin, penicillin g, trimetopim and clindamycin was detected, and a major increase resistance to levofloxacin. Antimicrobial resistance to meropenem, vancomycin, amikacin and most cephalosporins remains low. There was no significant difference between age groups.
Conclusions. Staphylococcus aureus, Pseudomonas aeruginosa and Klebsiella pneumoniae are the most frequently isolated microorganisms in blood cultures of pediatric patients. Infants are more susceptible to Candida infections, whereas Acinetobacter baumannii is common in adolescents. Sensitivity to meropenem, vancomycin, amikacin and most cephalosporins is still good.


REFERENCES

  1. Greenhow, T.L., Hung, Y.Y., Herz, A.M., Losada, E. y Pantell, R.H., “The changing epidemiology of serious bacterial infections in young infants”, Pediatr Infect Dis J, 2014, 33: 595-599.

  2. Greenhow, T.L., Hung, Y.Y. y Herz, A.M., “Changing epidemiology of bacteremia in infants aged 1 week to 3 months”, Pediatrics, 2012, 129: 590-596.

  3. Ciapponi, A., Elorriaga, N., Rojas, J.I., Romano, M., García- Marti, S., Bardach, A. y Ruvinsky, S., “Epidemiology of pediatric pneumococcal meningitis and bacteremia in Latin America and the Caribbean”, Pediatr Infect Dis J, 2014, 33: 971-978.

  4. Loonen, A.J., Wolffs, P.F., Bruggeman, C.A. y Van den Brule, A.J., “Developments for improved diagnosis of bacterial bloodstream infections”, Eur J Clin Microbiol Infect Dis, 2014, 33: 1687-1702.

  5. Buchan, B.W., Ginocchio, C.C., Manii, R., Cavagnolo, R., Pancholi, P., Swyers, L., Thomson, R.B. Jr., Anderson, C., Kaul, K. y Ledeboer, N.A., “Multiplex identification of gram-positive bacteria and resistance determinants directly from positive blood culture broths: evaluation of an automated microarray-based nucleic acid test”, plos Med, 2013, 10: 1001478.

  6. Yaacobi, N., Bar-Meir, M., Shchors, I. y Bromiker, R., “A prospective controlled trial of the optimal volume for neonatal blood cultures”, Pediatr Infect Dis J, 2015, 34: 351-354.

  7. Iwata, K. y Takahashi, M., “Is anaerobic blood culture necessary? If so, who needs it?”, Am J Med Sci, 2008, 336: 58-63.

  8. Doganis, D., Asmar, B., Yankelevich, M., Thomas, R. y Ravindranath, Y., “How many sources should be cultured for the diagnosis of a blood stream infection in children with cancer?”, Pediatr Hematol Oncol, 2013, 30: 416-424.

  9. Slayton, R.B., Toth, D., Lee, B.Y., Tanner, W., Bartsch, S.M., Khader, K., Wong, K., Brown, K., McKinnell, J.A., Ray, W., Mille, L.G., Rubin, M., Kim, D.S., Adler, F., Cao, C., Avery, L., Stone, N.T., Kallen, A., Samore, M., Huang, S.S., Fridkin, S. y Jernigan, J.A., “Vital signs: estimated effects of a coordinated approach for action to reduce antibiotic-resistant infection in health care facilities: United Sates”, Morbidity and Mortality Weekly Report, 015, disponible en http://www.cdc.gov/mmwr.

  10. Magiorakos, A.P., Srinivasan, A., Carey, R.B., Carmeli, Y., Falagas, M.E. y Giske, C.G., “Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance”, Clin Microbiol Infect, 2012, 18: 268-281.

  11. Rodríguez-Noriega, E., León-Garnica, G., Petersen-Morfín, S., Pérez-Gómez, H.R., González-Díaz, E. y Morfín- Otero, R., “La evolución de la resistencia bacteriana en México, 1973-2013”, Biomedica, 2014, 34: 181-190.

  12. Dreser, A., Wirtz, V.J., Corbett, K.K. y Echániz, G., “Uso de antibióticos en México: revisión de problemas y políticas”, Salud Pública Mex, 2008, 50: 480-487.

  13. Colvin, J.M., Jaffe, D.M. y Muenzer, J.T., “Evaluation of the precision of emergency department diagnoses in young children with fever”, Clin Pediatr (Phila), 2012, 51: 51-57.

  14. Er, J., Wallis, P., Maloney, S. y Norton, R., “Paediatric bacteraemias in tropical Australia”, J Paediatr Child Health, 2015, 51: 437-442.

  15. Stoesser, N., Moore, C.E., Pocock, J.M., Peng An, K., Emary, K., Carter, M., Sona, S., Poda, S., Day, N., Kumar, V. y Parry, C.M., “Pediatric bloodstream infections in Cambodia 2007 to 2011”, Pediatr Infec Dis J, 2013, 32: 272-276.

  16. Luthander, J., Bennet, R., Giske, C.G., Nilsson, A. y Eriksson, M., “Age and risk factors influence the microbial aetiology of bloodstream infections in children”, Acta Paediatr, 2013, 102: 182-186.

  17. Mercado-Uribe, M.C., Luévanos-Velázquez, A., Echániz- Avilés, I.G., Martínez-Arce, P.A. y Guerrero-Becerra, M., “Impacto de la vacunación contra el neumococo en la etiología de empiema en niños”, Revista Médica, 2014, 5 (4): 215-219.

  18. Echániz-Avilés, G., San Román-Álvarez, L., Sánchez-Alemán, M., Carnalla-Barajas, M.N. y Soto-Noguerón, A., “Prevalencia de Streptococcus pneumoniae serotipo 19A antes y después de la introducción de la vacuna conjugada heptavalente en México”, Salud Pública Mex, 2014, 56: 266-271.

  19. Luthander, J., Bennet, R., Giske, C.G., Nilsson, A. y Eriksson, M., “The aetiology of paediatric bloodstream infections changes after pneumococcal vaccination and group b Streptococcus prophylaxis”, Acta Paediatr, 2015, 104: 933-939.

  20. Wang, P. y Hu, P., “Strategies on reducing blood culture contamination”, Reviews in Medical Microbiology, 2012, 23: 63-66.

  21. Self, W.H., Mickanin, J., Grijalva, C.G., Grant, F.H., Henderson, M.C., Corley, G. et al., “Reducing blood culture contamination in community hospital emergency departments: multicenter evaluation of a quality improvement intervention”, Acad Emerg Med, 2014, 21 (3): 274-282.

  22. Gómez, B., Mintegi, S., Benito, J., Egireun, A., García, D. y Astobiza, E., “Blood culture and bacteremia predictors in infants less than three months of age with fever without source”, Pediatr Infect Dis J, 2010, 29 (1): 43-47.

  23. Makoka, M.H., Miller, W.C., Hoffman, I.F., Cholera, R., Gilligan, P.H., Kamwendo, D. et al., “Bacterial infections in Lilongwe, Malawi: aetiology and antibiotic resistance”, bmc Infectious Diseases, 2012, 12: 67-71.

  24. Erdem, I., Ozgultekin, A., Inan, A.S., Dincer, E., Turan, G., Ceran, N. et al., “Incidence, etiology, and antibiotic resistance patterns of Gram-negative microorganisms isolated from patients in a medical-surgical intensive care unit of a teaching hospital in Istanbul, Turkey (2004- 2006)”, Jpn J infect Dis, 2008, 61: 339-342.




2020     |     www.medigraphic.com