Antimicrobial-resistant pathogens differ for adult, pediatric healthcare-associated infections

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By Will Boggs MD

NEW YORK (Reuters Health) - Antimicrobial-resistant pathogens implicated in healthcare-associated infections (HAIs) differ for adults and children and for different healthcare settings, according to two summaries of data reported to the National Healthcare Safety Network (NHSN).

"It is important for healthcare providers, especially those involved in infection-prevention and antimicrobial-stewardship efforts, to use the national data presented in these reports, alongside their hospital-specific data, to inform clinical practices aimed at reducing the spread of resistant organisms," said Lindsey M. Weiner-Lastinger of the Centers for Disease Control and Prevention (CDC), in Atlanta.

"These reports should serve as an urgent call to action for healthcare providers and public-health agencies to intensify their antimicrobial-stewardship and infection-prevention efforts, particularly those physicians serving vulnerable patient populations," she told Reuters Health by email.

Both summaries appear online November 25 in Infection Control and Hospital Epidemiology.

Weiner-Lastinger and colleagues describe common pathogens and antimicrobial resistance patterns for healthcare-associated infections in adults and children during 2015-2017 that were reported to the CDC's NHSN.

The three most frequently reported pathogens differed between adult and pediatric populations. Among adults, Escherichia coli (18%), Staphylococcus aureus (12%), and Klebsiella species (9%) predominated.

Staphylococcus aureus (15%), Escherichia coli (12%), and coagulase-negative staphylococci (12%) topped the list of antimicrobial-resistant causes of pediatric HAIs.

For both adults and children, the leading pathogens differed by infection site and hospital setting. For example, E. coli and viridans-group streptococci were reported more commonly in association with central-line-associated bloodstream infection (CLABSI) in adult and pediatric oncology units than in non-oncology settings.

Among adult patients, the percentages of pathogens with nonsusceptibility to selected antimicrobials for most pathogens was significantly higher among device-associated HAIs than among surgical-site infections (SSIs) and among pathogens from long-term acute-care hospitals than from general hospital wards.

In the pediatric population, nonsusceptibility rates were generally lowest in neonatal intensive-care units and highest in pediatric oncology units, and overall antimicrobial nonsusceptibility was less prevalent in pediatric HAIs than in adult HAIs.

"Differences in the pathogen distributions and resistance patterns across patient populations and infection types suggest that targeted prevention efforts are needed for distinct populations," Weiner-Lastinger said. "Healthcare facility staff should be closely reviewing their local data to understand the common pathogens and resistance patterns associated with infections, and use these data to improve policies and practices within their facilities."

"CDC remains committed to monitoring antimicrobial-resistant infections and publishing national data to support the healthcare community in their efforts to protect patients and prevent infections," she added. "More information about CDC’s efforts to combat antimicrobial resistance can be found here: https://www.cdc.gov/drugresistance/. "

SOURCE: https://bit.ly/2KXOJi8 and https://bit.ly/2OUQEFs

Infect Control Hosp Epidemiol 2019.

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