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Pediatric Antimicrobial Susceptibility Trends across the United States

Part of: SHEA Research Network Collection

Published online by Cambridge University Press:  02 January 2015

Pranita D. Tamma ,
Gwen L. Robinson ,
Jeffrey S. Gerber ,
Jason G. Newland ,
Chloe M. DeLisle ,
Theoklis E. Zaoutis  and
Aaron M. Milstone
Pranita D. Tamma*
Affiliation:
Johns Hopkins University School of Medicine, Baltimore, Maryland
Gwen L. Robinson
Affiliation:
University of Maryland School of Medicine, Baltimore, Maryland
Jeffrey S. Gerber
Affiliation:
Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
Jason G. Newland
Affiliation:
Children's Mercy Hospital, Kansas City, Missouri
Chloe M. DeLisle
Affiliation:
Johns Hopkins University School of Medicine, Baltimore, Maryland
Theoklis E. Zaoutis
Affiliation:
Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
Aaron M. Milstone
Affiliation:
Johns Hopkins University School of Medicine, Baltimore, Maryland
*
Johns Hopkins Medical Institutions, Department of Pediatrics, Division of Infectious Diseases, 200 North Wolfe Street, Suite 3155, Baltimore, MD 21287 (ptammal@jhmi.edu)
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Abstract

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Objective.

Antimicrobial susceptibility patterns across US pediatric healthcare institutions are unknown. A national pooled pediatric antibiogram (1) identifies nationwide trends in antimicrobial resistance, (2) allows across-hospital benchmarking, and (3) provides guidance for empirical antimicrobial regimens for institutions unable to generate pediatric antibiograms.

Methods.

In January 2012, a request for submission of pediatric antibiograms between 2005 and 2011 was sent to 233 US hospitals. A summary antibiogram was compiled from participating institutions to generate proportions of antimicrobial susceptibility. Temporal and regional comparisons were evaluated using χ² tests and logistic regression, respectively.

Results.

Of 200 institutions (85%) responding to our survey, 78 (39%) reported generating pediatric antibiograms, and 55 (71%) submitted antibiograms. Carbapenems had the highest activity against the majority of gram-negative organisms tested, but no antibiotic had more than 90% activity against Pseudomonas aeruginosa. Approximately 50% of all Staphylococcus aureus isolates were methicillin resistant. Western hospitals had significantly lower proportions of S. aureus that were methicillin resistant compared with all other regions tested. Overall, 21% of S. aureus isolates had resistance to clindamycin. Among Enterococcus faecium isolates, the prevalence of susceptibility to ampicillin (25%) and vancomycin (45%) was low but improved over time (P < .01), and 8% of E. faecium isolates were resistant to linezolid. Southern hospitals reported significantly higher prevalence of E. faecium with susceptibilities to ampicillin, vancomycin, and linezolid compared with the other 3 regions (P < .01).

Conclusions.

A pooled, pediatric antibiogram can identify nationwide antimicrobial resistance patterns for common pathogens and might serve as a useful tool for benchmarking resistance and informing national prescribing guidelines for children.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 34 , Issue 12 , December 2013 , pp. 1244 - 1251
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013

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