Incidence of emerging multidrug-resistant organisms and its impact on the outcome in the pediatric intensive care

Abstract Background Healthcare-associated infections (HCAI) are a worldwide threat in intensive care units particularly in the pediatric intensive care units with a major cause of morbidity and mortality among this age group. The aim of the study is to determine the prevalence and risk factors predi...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Ahmed R. Rezk, Somaia Abdelhammed Bawady, Nashwa Naguib Omar
Formato:	article
Lenguaje:	EN
Publicado:	SpringerOpen 2021
Materias:	Multidrug-resistant organisms (MDROs) Pediatric ICU Antimicrobial resistance Pediatrics RJ1-570
Acceso en línea:	https://doaj.org/article/63270d6044e04bf4b546c020e3cfff03
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:63270d6044e04bf4b546c020e3cfff03
record_format	dspace
spelling	oai:doaj.org-article:63270d6044e04bf4b546c020e3cfff032021-11-08T11:15:15ZIncidence of emerging multidrug-resistant organisms and its impact on the outcome in the pediatric intensive care10.1186/s43054-021-00071-12090-9942https://doaj.org/article/63270d6044e04bf4b546c020e3cfff032021-11-01T00:00:00Zhttps://doi.org/10.1186/s43054-021-00071-1https://doaj.org/toc/2090-9942Abstract Background Healthcare-associated infections (HCAI) are a worldwide threat in intensive care units particularly in the pediatric intensive care units with a major cause of morbidity and mortality among this age group. The aim of the study is to determine the prevalence and risk factors predisposing to multidrug-resistant organisms (MDROs) infections among pediatric intensive care unit (PICU) patients at Ain Shams Pediatric University Hospitals as well as determining mortality and morbidity rates along with the length of stay at PICU. Results Culture results revealed that of the 282 patients evaluated, only 26 (9.2%) were MDROs (half of the affected patients had Acinetobacter species (50%) and the rest of them were free, 256 (90.8%). Our study revealed that the majority of MDROs were isolated from sputum in more than half of the patients 19/32 (59.3%) followed by whole blood in 10/32 (31.2%) and urine in 3/32 (9.4%). Pulmonary system was the most common affected site and was mainly colonized by MDR Acinetobacter (71.4%) followed by MDR Klebsiella (41.6%). Regarding MDR risk factors in our PICU, multivariate logistic regression analyses showed significant relationship between MDROs and age under 1 year (odds ratio [OR] 2.4554; 95% confidence interval [95% CI] (1.072–5.625); p = 0.043) and underlying pulmonary disease (OR 2.417; 95% CI (1.014–5.761); p = 0.592). A statistically significant higher mortality was detected in patients colonized with MDROs 9/26 (34.6%) versus MDROs non-colonized patients 32/256 (12.5%) [P=0.002]. Moreover, MDROs infection has negative significant risk with discharged patients ([OR] 0.269; [95% CI] (0.111–0.656); p = 0.002). Additionally, patients infected with MDROs did have significantly greater PICU stay than those non-infected [median (IQR), 16.5 (10.7–22), 5 (4–8), P=0.00] and have longer ventilation [median (IQR), 15.5 (10–18), 3 (2–10), P=0.00]. Conclusion Prevalence of MDROs (9.2%) was low among PICU cases at Ain Shams University Hospitals. Most common MDROs were Acinetobacter and Klebsiella followed by pseudomonas species. The frequency of gram-negative organisms is much more common than gram-positive organisms. An increasing rate of antimicrobial resistance with increasing mortality and morbidity among PICU patients is observed worldwide; even for new categories, so, strict infection control programs should be implemented.Ahmed R. RezkSomaia Abdelhammed BawadyNashwa Naguib OmarSpringerOpenarticleMultidrug-resistant organisms (MDROs)Pediatric ICUAntimicrobial resistancePediatricsRJ1-570ENEgyptian Pediatric Association Gazette, Vol 69, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Multidrug-resistant organisms (MDROs) Pediatric ICU Antimicrobial resistance Pediatrics RJ1-570
spellingShingle	Multidrug-resistant organisms (MDROs) Pediatric ICU Antimicrobial resistance Pediatrics RJ1-570 Ahmed R. Rezk Somaia Abdelhammed Bawady Nashwa Naguib Omar Incidence of emerging multidrug-resistant organisms and its impact on the outcome in the pediatric intensive care
description	Abstract Background Healthcare-associated infections (HCAI) are a worldwide threat in intensive care units particularly in the pediatric intensive care units with a major cause of morbidity and mortality among this age group. The aim of the study is to determine the prevalence and risk factors predisposing to multidrug-resistant organisms (MDROs) infections among pediatric intensive care unit (PICU) patients at Ain Shams Pediatric University Hospitals as well as determining mortality and morbidity rates along with the length of stay at PICU. Results Culture results revealed that of the 282 patients evaluated, only 26 (9.2%) were MDROs (half of the affected patients had Acinetobacter species (50%) and the rest of them were free, 256 (90.8%). Our study revealed that the majority of MDROs were isolated from sputum in more than half of the patients 19/32 (59.3%) followed by whole blood in 10/32 (31.2%) and urine in 3/32 (9.4%). Pulmonary system was the most common affected site and was mainly colonized by MDR Acinetobacter (71.4%) followed by MDR Klebsiella (41.6%). Regarding MDR risk factors in our PICU, multivariate logistic regression analyses showed significant relationship between MDROs and age under 1 year (odds ratio [OR] 2.4554; 95% confidence interval [95% CI] (1.072–5.625); p = 0.043) and underlying pulmonary disease (OR 2.417; 95% CI (1.014–5.761); p = 0.592). A statistically significant higher mortality was detected in patients colonized with MDROs 9/26 (34.6%) versus MDROs non-colonized patients 32/256 (12.5%) [P=0.002]. Moreover, MDROs infection has negative significant risk with discharged patients ([OR] 0.269; [95% CI] (0.111–0.656); p = 0.002). Additionally, patients infected with MDROs did have significantly greater PICU stay than those non-infected [median (IQR), 16.5 (10.7–22), 5 (4–8), P=0.00] and have longer ventilation [median (IQR), 15.5 (10–18), 3 (2–10), P=0.00]. Conclusion Prevalence of MDROs (9.2%) was low among PICU cases at Ain Shams University Hospitals. Most common MDROs were Acinetobacter and Klebsiella followed by pseudomonas species. The frequency of gram-negative organisms is much more common than gram-positive organisms. An increasing rate of antimicrobial resistance with increasing mortality and morbidity among PICU patients is observed worldwide; even for new categories, so, strict infection control programs should be implemented.
format	article
author	Ahmed R. Rezk Somaia Abdelhammed Bawady Nashwa Naguib Omar
author_facet	Ahmed R. Rezk Somaia Abdelhammed Bawady Nashwa Naguib Omar
author_sort	Ahmed R. Rezk
title	Incidence of emerging multidrug-resistant organisms and its impact on the outcome in the pediatric intensive care
title_short	Incidence of emerging multidrug-resistant organisms and its impact on the outcome in the pediatric intensive care
title_full	Incidence of emerging multidrug-resistant organisms and its impact on the outcome in the pediatric intensive care
title_fullStr	Incidence of emerging multidrug-resistant organisms and its impact on the outcome in the pediatric intensive care
title_full_unstemmed	Incidence of emerging multidrug-resistant organisms and its impact on the outcome in the pediatric intensive care
title_sort	incidence of emerging multidrug-resistant organisms and its impact on the outcome in the pediatric intensive care
publisher	SpringerOpen
publishDate	2021
url	https://doaj.org/article/63270d6044e04bf4b546c020e3cfff03
work_keys_str_mv	AT ahmedrrezk incidenceofemergingmultidrugresistantorganismsanditsimpactontheoutcomeinthepediatricintensivecare AT somaiaabdelhammedbawady incidenceofemergingmultidrugresistantorganismsanditsimpactontheoutcomeinthepediatricintensivecare AT nashwanaguibomar incidenceofemergingmultidrugresistantorganismsanditsimpactontheoutcomeinthepediatricintensivecare
_version_	1718442336889864192

Incidence of emerging multidrug-resistant organisms and its impact on the outcome in the pediatric intensive care

Ejemplares similares