Antimicrobial-resistant healthcare-associated infection increased dramatically among U.S. children

November 17, 2016

In just over a decade, multidrug-resistant cases of Pseudomonas aeruginosa have increased from 15 percent to 26 percent of all P. aeruginosa cases

In a study published today in The Journal of the Pediatric Infectious Diseases Society, CDDEP researchers and collaborators have found that infections due to multidrug-resistant and carbapenem-resistant strains of Pseudomonas aeruginosa increased dramatically between 1999 and 2012.

To date, there have been no pediatric studies assessing national and regional trends in multidrug-resistant (MDR) or carbapenem-resistant (CR) P. aeruginosa.

P. aeruginosa is a common cause of healthcare-associated infections, which cause significant morbidity and mortality. With its high genetic “plasticity,” P. aeruginosa develops resistance easily to several antibiotics. The Centers for Disease Control and Prevention (CDC) estimates that 51,000 healthcare-associated P. aeruginosa infections occur in adults and children each year, of which 13 percent are multidrug-resistant and responsible for 400 deaths annually.

The study relied on samples from microbiology laboratories, collected over 12 years from children from 1 to 17 years of age, from outpatient, inpatient, intensive care unit, and long-term care settings. The data were from The Surveillance Network (TSN), which collected clinical results from microbiology laboratories serving approximately 300 hospitals throughout the country, through 2012, when it ceased operation.

Researchers plotted the prevalence of multidrug-resistant and carbapenem-resistant P. aeruginosa samples over time, finding that the crude proportion of MDR P. aeruginosa increased from 15.4 percent in 1999 to 26 percent in 2012 and the proportion of CR P. aeruginosa increased from 9.4 percent in 1999 to 20 percent in 2012. The proportion of both MDR and CR P. aeruginosa increased each year by 4 percent.

The results of the study underscore the need for aggressive prevention strategies, including bacterial surveillance and antimicrobial stewardship programs in pediatric settings.

According to co-author and CDDEP Fellow Sumanth Gandra, “Pseudomonas infections are quickly becoming resistant to our last line of defense, the carbapenems. As these infections become more difficult to treat, they will bring significantly higher costs for hospitals and communities, and more importantly, increase the risk of death.”

The study in The Journal of the Pediatric Infectious Diseases Society can be found here: http://jpids.oxfordjournals.org/lookup/doi/10.1093/jpids/piw064

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About the Center for Disease Dynamics, Economics & Policy 
The Center for Disease Dynamics, Economics & Policy (CDDEP) produces independent, multidisciplinary research to advance the health and wellbeing of human populations around the world.  CDDEP projects are global in scope, spanning Africa, Asia, and North America and include scientific studies and policy engagement.  The CDDEP team is experienced in addressing country-specific and regional issues, as well as the local and global aspects of global challenges, such as antibiotic resistance and pandemic influenza. CDDEP research is notable for innovative approaches to design and analysis, which are shared widely through publications, presentations and web-based programs.  CDDEP has offices in Washington, D.C. and New Delhi and relies on a distinguished team of scientists, public health experts and economists.

Study authors: Latania K. Logan, Sumanth Gandra, Siddhartha Mandal, Eili Y. Klein, Jordan Levinson, Robert A. Weinstein, and Ramanan Laxminarayan.