Cornistein Wanda, Balasini Carina, Nuccetelli Yanina, Rodriguez Viviana M, Cudmani Norma, Roca Maria Virginia, Sadino Graciela, Brizuela Martín, Fernández Analía, González Soledad, Águila Damián, Macchi Alejandra, Staneloni Maria Inés, Estenssoro Elisa
Hospital Universitario Austral, Buenos Aires 1629, Argentina.
Argentinian Society of Infectious Diseases (SADI), Buenos Aires 1414, Argentina.
Antibiotics (Basel). 2025 May 11;14(5):493. doi: 10.3390/antibiotics14050493.
Data on multidrug-resistant organism (MDRO) infections in children are scarce, especially in resource-limited regions. This study aimed to estimate the prevalence of MDRO infections in pediatric intensive care units (PICUs) and characterize their epidemiologic and clinical features. A national, multicenter, point-prevalence study was conducted in 50 PICUs in Argentina over 24 h between 24 and 28 November 2023. The primary study outcome was the prevalence of ICU infections caused by MDROs. Secondary outcomes included the prevalence of carbapenemase-producing (CPE) colonization, ICU mortality, and ICU length of stay (LOS). 304 patients were included. The overall prevalence of infection was 45.1% (137/304); of these, 50.3% (69/137) were hospital-acquired. Among the 137 patients with reported infections, 49.6% ( = 68) were classified as definite (microbiologically confirmed) and 50.4% ( = 69) as probable (no confirmatory microbiology). Among definite infections, 20.6% ( = 14) were due to MDROs. The overall prevalence of MDRO infections was 4.6% (14/304). Extended-spectrum β-lactamase (ESBL)-producing organisms were the most commonly identified microorganisms (42.9%), followed by CPE (28.6%). Ventilator-associated pneumonia (VAP) was the most frequent location of MDRO infections. The prevalence of CPE colonization was 13.2%. Mortality was low (5.3%) and similar in patients with MDRO and non-MDRO infections. LOS was longer in patients with MDRO infections compared to patients with non-MDRO infections (81 [22-150] vs. 25 [12-27] days, respectively, = 0.0007). Among 304 PICU patients, the prevalence of MDRO infections and colonization was relatively low. MDRO infections were not associated with increased mortality but were associated with longer ICU stays, compared to patients with non-MDRO infections.
关于儿童多重耐药菌（MDRO）感染的数据很少，尤其是在资源有限的地区。本研究旨在估计儿科重症监护病房（PICU）中MDRO感染的患病率，并描述其流行病学和临床特征。2023年11月24日至28日期间，在阿根廷的50个PICU进行了一项全国性、多中心的现患率研究。主要研究结果是MDRO引起的ICU感染患病率。次要结果包括产碳青霉烯酶（CPE）定植的患病率、ICU死亡率和ICU住院时间（LOS）。共纳入304例患者。感染的总体患病率为45.1%（137/304）；其中，50.3%（69/137）为医院获得性感染。在报告感染的137例患者中，49.6%（=68）被分类为确诊（微生物学确诊），50.4%（=69）为疑似（无确诊微生物学检查）。在确诊感染中，20.6%（=14）是由MDRO引起的。MDRO感染的总体患病率为4.6%（14/304）。产超广谱β-内酰胺酶（ESBL）的微生物是最常见的鉴定微生物（42.9%），其次是CPE（28.6%）。呼吸机相关性肺炎（VAP）是MDRO感染最常见的部位。CPE定植的患病率为13.2%。死亡率较低（5.3%），MDRO感染患者和非MDRO感染患者的死亡率相似。与非MDRO感染患者相比，MDRO感染患者的LOS更长（分别为81[22-150]天和25[12-27]天，P=0.0007）。在304例PICU患者中，MDRO感染和定植的患病率相对较低。与非MDRO感染患者相比，MDRO感染与死亡率增加无关，但与ICU住院时间延长有关。
