Antimicrobial Resistance in Invasive Bacterial Infections in Hospitalized Children, Cambodia, 2007–2016

Autor: Andrew Fox-Lewis, Junko Takata, Thyl Miliya, Yoel Lubell, Sona Soeng, Poda Sar, Kolthida Rith, Gregor McKellar, Vanaporn Wuthiekanun, Erin McGonagle, Nicole Stoesser, Catrin E. Moore, Christopher M. Parry, Claudia Turner, Nicholas P.J. Day, Ben S. Cooper, Paul Turner
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Zdroj: Emerging Infectious Diseases, Vol 24, Iss 5, Pp 841-851 (2018)
Druh dokumentu: article
ISSN: 1080-6040
1080-6059
DOI: 10.3201/eid2405.171830
Popis: To determine trends, mortality rates, and costs of antimicrobial resistance in invasive bacterial infections in hospitalized children, we analyzed data from Angkor Hospital for Children, Siem Reap, Cambodia, for 2007–2016. A total of 39,050 cultures yielded 1,341 target pathogens. Resistance rates were high; 82% each of Escherichia coli and Klebsiella pneumoniae isolates were multidrug resistant. Hospital-acquired isolates were more often resistant than community-acquired isolates; resistance trends over time were heterogeneous. K. pneumoniae isolates from neonates were more likely than those from nonneonates to be resistant to ampicillin–gentamicin and third-generation cephalosporins. In patients with community-acquired gram-negative bacteremia, third-generation cephalosporin resistance was associated with increased mortality rates, increased intensive care unit admissions, and 2.26-fold increased healthcare costs among survivors. High antimicrobial resistance in this setting is a threat to human life and the economy. In similar low-resource settings, our methods could be reproduced as a robust surveillance model for antimicrobial resistance.
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