Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Nov 24;6(4):352-359.
doi: 10.1093/jpids/piw064.

Multidrug- and Carbapenem-Resistant Pseudomonas aeruginosa in Children, United States, 1999-2012

Latania K Logan  1   2   3 , Sumanth Gandra  4 , Siddhartha Mandal  5 , Eili Y Klein  4   6 , Jordan Levinson  4 , Robert A Weinstein  7   3 , Ramanan Laxminarayan  4   5   8 ; Prevention Epicenters Program, US Centers for Disease Control and Prevention
Affiliations

Multidrug- and Carbapenem-Resistant Pseudomonas aeruginosa in Children, United States, 1999-2012

Latania K Logan et al. J Pediatric Infect Dis Soc. .

Abstract

Background: Pseudomonas aeruginosa is a common cause of healthcare-associated infection. Multidrug-resistant (MDR) (>3 classes) and carbapenem-resistant (CR) P aeruginosa are significant threats globally. We used a large reference-laboratory database to study the epidemiology of P aeruginosa in children in the United States.

Methods: Antimicrobial susceptibility data from the Surveillance Network were used to phenotypically identify MDR and CR P aeruginosa isolates in children aged 1 to 17 years between January 1999 and July 2012. Logistic regression analysis was used to calculate trends in the prevalence of MDR and CR P aeruginosa. Isolates from infants (<1 year old) and patients with cystic fibrosis were excluded.

Results: Among the isolates tested, the crude proportion of MDR P aeruginosa increased from 15.4% in 1999 to 26% in 2012, and the proportion of CR P aeruginosa increased from 9.4% in 1999 to 20% in 2012. The proportion of both MDR and CR P aeruginosa increased each year by 4% (odds ratio [OR], 1.04 [95% confidence interval (CI), 1.03-1.04] and 1.04 [95% CI, 1.04-1.05], respectively). In multivariable analysis, both MDR and CR P aeruginosa were more common in the intensive care setting, among children aged 13 to 17 years, in respiratory specimens, and in the West North Central region. In addition, resistance to other antibiotic classes (aminoglycosides, fluoroquinolones, cephalosporins, and piperacillin-tazobactam) often used to treat P aeruginosa increased.

Conclusions: Rates of MDR and CR P aeruginosa infection in children are rising nationally. Aggressive prevention strategies, including instituting antimicrobial stewardship programs in pediatric settings, are essential for combating antimicrobial resistance.

Keywords: Pseudomonas aeruginosa; carbapenems; child; drug resistance; epidemiology.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
National trends in prevalence of carbapenem-resistant (CR) and multidrug-resistant (MDR) Pseudomonas aeruginosa isolates from children >1 year old (data are from the Surveillance Network Database–USA database, 1999–2012). The proportion of MDR and CR P aeruginosa isolates increased significantly by 4% every year (odds ratios, 1.04 [95% confidence interval (CI), 1.03–1.04] [P for trend < .001] and 1.04 [95% CI, 1.04–1.05] [P for trend < .001], respectively).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Kung VL, Ozer EA, Hauser AR. The accessory genome of Pseudomonas aeruginosa. Microbiol Mol Biol Rev 2010; 74:621–41. - PMC - PubMed
    1. Hauser AR. The type III secretion system of Pseudomonas aeruginosa: infection by injection. Nat Rev Microbiol 2009; 7:654–65. - PMC - PubMed
    1. Howell HA, Logan LK, Hauser AR. Type III secretion of ExoU is critical during early Pseudomonas aeruginosa pneumonia. mBio 2013; 4:e00032–13. - PMC - PubMed
    1. Bonomo RA, Szabo D. Mechanisms of multidrug resistance in Acinetobacter species and Pseudomonas aeruginosa. Clin Infect Dis 2006; 43(Suppl 2):S49–56. - PubMed
    1. Centers for Disease Control and Prevention. Antibiotic resistance threats in the United States. Atlanta, GA: Center for Disease Control and Prevention; 2013: pp 1–114.