Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Infect Control Hosp Epidemiol. 2020 Jan;41(1):19-30. doi: 10.1017/ice.2019.297. Epub 2019 Nov 25.
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).
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.
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.
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.
描述 2015-2017 年向疾病控制与预防中心的国家医疗保健安全网络（NHSN）报告的与医疗保健相关感染（HAI）相关的儿科患者常见病原体和抗菌药物耐药模式。
对与中心静脉导管相关血流感染（CLABSIs）、导管相关尿路感染（CAUTIs）、呼吸机相关性肺炎（VAPs）和手术部位感染（SSIs）相关的病原体的抗菌药物耐药数据进行分析。该分析仅限于从儿科患者护理场所报告的与器械相关的 HAI 和 <18 岁患者的 SSI。通过 HAI 类型、位置类型和手术类别计算对所选抗菌药物不敏感的病原体百分比（%NS）。
在此期间，NHSN 共有 2545 家医疗机构对儿科 HAI 进行了监测。金黄色葡萄球菌（15%）、大肠杆菌（12%）和凝固酶阴性葡萄球菌（12%）是与儿科 HAI 相关的报告最常见的 3 种病原体。病原体和 %NS 因 HAI 类型、位置类型和/或手术类别而异。在 CLABSIs 中，新生儿重症监护病房的 %NS 通常最低，儿科肿瘤病房的 %NS 最高。葡萄球菌属在骨科、神经外科和心脏 SSI 中尤为常见；然而，大肠杆菌在腹部 SSI 中更为常见。总体而言，儿科 HAI 中的抗菌药物不敏感性比成人 HAI 中少见。
本报告提供了儿科 HAI 中病原体分布和抗菌药物耐药模式的最新全国性总结。这些数据突出了需要继续对儿科患者进行抗菌药物耐药性监测，并应鼓励儿科医疗保健界在制定感染预防和抗菌药物管理政策时使用此类数据。
