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. 2020 Jan;41(1):19-30.
doi: 10.1017/ice.2019.297. Epub 2019 Nov 25.

Antimicrobial-resistant pathogens associated with pediatric healthcare-associated infections: Summary of data reported to the National Healthcare Safety Network, 2015-2017

Lindsey M Weiner-Lastinger  1 , Sheila Abner  1 , Andrea L Benin  1 , Jonathan R Edwards  1 , Alexander J Kallen  1 , Maria Karlsson  1 , Shelley S Magill  1 , Daniel Pollock  1 , Isaac See  1 , Minn M Soe  1 , Maroya S Walters  1 , Margaret A Dudeck  1
Affiliations

Antimicrobial-resistant pathogens associated with pediatric healthcare-associated infections: Summary of data reported to the National Healthcare Safety Network, 2015-2017

Lindsey M Weiner-Lastinger et al. Infect Control Hosp Epidemiol. 2020 Jan.

Abstract

Objective: To describe common pathogens and antimicrobial resistance patterns for healthcare-associated infections (HAIs) among pediatric patients that occurred in 2015-2017 and were reported to the Centers for Disease Control and Prevention's National Healthcare Safety Network (NHSN).

Methods: Antimicrobial resistance data were analyzed for pathogens implicated in central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), ventilator-associated pneumonias (VAPs), and surgical site infections (SSIs). This analysis was restricted to device-associated HAIs reported from pediatric patient care locations and SSIs among patients <18 years old. Percentages of pathogens with nonsusceptibility (%NS) to selected antimicrobials were calculated by HAI type, location type, and surgical category.

Results: Overall, 2,545 facilities performed surveillance of pediatric HAIs in the NHSN during this period. Staphylococcus aureus (15%), Escherichia coli (12%), and coagulase-negative staphylococci (12%) were the 3 most commonly reported pathogens associated with pediatric HAIs. Pathogens and the %NS varied by HAI type, location type, and/or surgical category. Among CLABSIs, the %NS was generally lowest in neonatal intensive care units and highest in pediatric oncology units. Staphylococcus spp were particularly common among orthopedic, neurosurgical, and cardiac SSIs; however, E. coli was more common in abdominal SSIs. Overall, antimicrobial nonsusceptibility was less prevalent in pediatric HAIs than in adult HAIs.

Conclusion: This report provides an updated national summary of pathogen distributions and antimicrobial resistance patterns among pediatric HAIs. These data highlight the need for continued antimicrobial resistance tracking among pediatric patients and should encourage the pediatric healthcare community to use such data when establishing policies for infection prevention and antimicrobial stewardship.

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Conflict of interest statement

Conflicts of interest. All other authors report no conflicts of interest relevant to this article.

References

    1. Hocevar SN, Weiner LM, Edwards JR, et al. Pathogen distribution and selected resistance profiles of central line-associated bloodstream infection isolates reported to the National Healthcare Safety Network from pediatric and neonatal intensive care units, 2011–2013. In: Program and abstracts of the annual IDWeek Meeting; October 8–12, 2014; Philadelphia, PA. Abstract no. 45238.
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    1. Bloodstream infection event (central line-associated bloodstream infection and non-central line-associated bloodstream infection). Centers for Disease Control and Prevention (CDC) website. http://www.cdc.gov/nhsn/PDFs/pscManual/4PSC_CLABScurrent.pdf. Updated January 2019. Accessed June 3, 2019.
    1. Urinary tract infection (catheter-associated urinary tract infection [CAUTI] and non-catheter-associated urinary tract infection [UTI]) and other urinary system infection [USI]) events. Centers for Disease Control and Prevention (CDC) website. http://www.cdc.gov/nhsn/PDFs/pscManual/7pscCAUTIcurrent.pdf. Updated January 2019. Accessed June 3, 2019.
    1. Pneumonia (ventilator-associated [VAP] and non-ventilator-associated pneumonia [PNEU]) events. Centers for Disease Control and Prevention (CDC) website. https://www.cdc.gov/nhsn/pdfs/pscmanual/6pscvapcurrent.pdf. Updated January 2019. Accessed June 17, 2019.

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