Multidrug-Resistant Bacteria in Hospitalized Children: A 5-Year Multicenter Study

[摘要] OBJECTIVE. The objective of this study was to determine the incidence of multidrug-resistant bacteria in hospitalized childrenMETHODS. This multicenter study was conducted in 5 hospitals in the Paris area from 1999 to 2003. We recorded all isolations of multidrug-resistant bacteria from clinical samples that were obtained from hospitalized children. Strains that were isolated during systematic screening for carriers were excluded.RESULTS. The mean incidences were 0.9 per 1000 hospitalization-days for methicillin-resistant Staphylococcus aureus , 0.45 for extended-spectrum β-lactamase–producing Klebsiella pneumoniae , 0.32 for extended-spectrum β-lactamase–producing Enterobacteriaceae other than Klebsiella pneumoniae , 0.40 for Enterobacter species with derepressed cephalosporinase, and 0.01 for vancomycin-resistant Enterococcus . The incidences per 1000 hospitalization-days of methicillin-resistant Staphylococcus aureus , extended-spectrum β-lactamase–producing Klebsiella pneumoniae , extended-spectrum β-lactamase–producing Enterobacteriaceae other than Klebsiella pneumoniae , and Enterobacter species with derepressed cephalosporinase decreased significantly from 1999 to 2003, whereas the incidence of vancomycin-resistant Enterococcus remained very low. The proportion of resistant strains within the species did not vary significantly for methicillin-resistant Staphylococcus aureus (11% to 9.6%), extended-spectrum β-lactamase–producing Enterobacteriaceae other than Klebsiella pneumoniae (1.1%), and vancomycin-resistant Enterococcus (0.03% to 0.023%). In contrast, the frequency of extended-spectrum β-lactamase–producing Klebsiella pneumoniae decreased from 31.6% to 7.4%, and that of Enterobacter species with derepressed cephalosporinase decreased from 38.8% to 18.5%.CONCLUSIONS. We report significant decreases in the incidence of methicillin-resistant Staphylococcus aureus , extended-spectrum β-lactamase–producing Klebsiella pneumoniae , extended-spectrum β-lactamase–producing Enterobacteriaceae other than Klebsiella pneumoniae , and Enterobacter species with derepressed cephalosporinase in hospitalized children during a 5-year period.

[学科分类] 儿科学