Current epidemiology of resistance among Gram-negative bacilli in paediatric patients in Turkey

• Published in: Journal of global antimicrobial resistance. 2017-12, Vol.11, p.140-144
• Main Authors: Aykac, Kubra, Ozsurekci, Yasemin, Tanır Basaranoglu, Sevgen, Akin, Mustafa Senol, Cengiz, Ali Bulent, Bicakcigil, Asiye, Sancak, Banu, Kara, Ates, Ceyhan, Mehmet
• Format: Article
• Language: English
• Subjects: Adolescent; Bacteremia - epidemiology; Child; Child, Preschool; Children; Drug Resistance, Bacterial; Female; Gram-negative bacteria; Gram-Negative Bacteria - classification; Gram-Negative Bacteria - drug effects; Gram-Negative Bacteria - isolation & purification; Gram-Negative Bacterial Infections - epidemiology; Gram-Negative Bacterial Infections - microbiology; Humans; Incidence; Infant; Infant, Newborn; Male; Meningitis, Bacterial - epidemiology; Paediatric; Resistance; Retrospective Studies; Tertiary Care Centers; Turkey - epidemiology
• ISSN: 2213-7165; 2213-7173
• DOI: 10.1016/j.jgar.2017.07.018

•Resistance of Gram-negative bacteria to amikacin, ciprofloxacin, carbapenems and colistin increased from 2014.•Klebsiella spp. was the most common cause of Gram-negative nosocomial infection in children, with high resistance rates.•Acinetobacter spp. was associated with higher infection-related and overall mortality rates. The increasing incidence of infections caused by drug-resistant Gram-negative organisms has led to a re-emergence worldwide. This study attempted to investigate the changes in resistance of Gram-negative bacteria to different classes of antibiotics and the treatment options for invasive infections. A retrospective study was performed between January 2012 and January 2017 in a Turkish tertiary care university hospital. A total of 302 patients with Gram-negative bacteraemia (n=274; 90.7%) or meningitis (n=28; 9.3%) were identified and their demographic, clinical and microbiological features were evaluated. A total of 302 patients with Gram-negative bacterial infection (bacteraemia or meningitis) were investigated. Klebsiella spp. was the most frequent causative agent (n=119; 39.4%), followed by Escherichia coli (n=67; 22.2%), Acinetobacter spp. (n=42; 13.9%), Pseudomonas spp. (n=41; 13.6%) and Enterobacter spp. (n=33; 10.9%). In total, 115 isolates (38.1%) were multidrug-resistant (MDR), 63 (20.9%) were extensively drug-resistant (XDR) and 6 (2.0%) were pandrug-resistant (PDR). Over the years, peak antibiotic resistance occurred in 2013, with an increase in the following years. These data indicate that the resistance pattern of Gram-negative bacteria may change over the years in hospital settings. Therefore, active surveillance of the resistance patterns of micro-organisms is necessary for better management of infections caused by highly resistant bacteria.