| Title |
Factors influencing antimicrobial resistance and outcome of Gram-negative bloodstream infections in children
|
|---|---|
| Published in |
Infection, November 2015
|
| DOI | 10.1007/s15010-015-0857-8 |
| Pubmed ID | |
| Authors |
Balázs Ivády, Éva Kenesei, Péter Tóth-Heyn, Gabriella Kertész, Klára Tárkányi, Csaba Kassa, Enikő Ujhelyi, Borbála Mikos, Erzsébet Sápi, Krisztina Varga-Heier, Gábor Guóth, Dóra Szabó |
| Abstract |
The aim of this study was to collect data about pediatric Gram-negative bloodstream infections (BSI) to determine the factors that influence multidrug resistance (MDR), clinical course and outcome of children affected by Gram-negative sepsis. In this observational, prospective, multicenter study we collected cases of pediatric Gram-negative BSI during a 2-year period. We analyzed epidemiological, microbiological and clinical factors that associated with acquisition of MDR infections and outcome. One-hundred and thirty-five BSI episodes were analyzed. Median age of children was 0.5 years (IQR 0.1-6.17, range 0-17 years). Predominant bacteria were Enterobacteriaceae (68.3 %), and Pseudomonas spp. (17.9 %). Multidrug resistance was detected in 45/134 cases (33.6 %), with the highest rates in Escherichia coli, Enterobacter and Pseudomonas spp. Acquisition of MDR pathogens was significantly associated with prior cephalosporin treatment, older age, admission to hemato-oncology unit, polymicrobial infections, higher rate of development of septic shock, and multiple organ failures. All-cause mortality was 17.9 %. Presence of septic shock at presentation and parenteral nutrition were associated with higher mortality. Pseudomonas spp., and Enterobacter spp. BSIs had the highest rate of mortality. Inappropriate empiric antibiotic therapy was more frequent in MDR patients, although not significantly associated with poor outcome. Rates of multidrug resistance and mortality in children with Gram-negative bloodstream infections remain high in our settings. Empiric broad-spectrum antibiotics and combination therapy could be recommended, especially in children with malignant diseases, patients admitted to the PICU, and for cases with septic shock, who have higher mortality risk. |
X Demographics
The data shown below were collected from the profiles of 6 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 1 | 17% |
| United Kingdom | 1 | 17% |
| Unknown | 4 | 67% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 5 | 83% |
| Practitioners (doctors, other healthcare professionals) | 1 | 17% |
Mendeley readers
The data shown below were compiled from readership statistics for 81 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 1 | 1% |
| Unknown | 80 | 99% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 18 | 22% |
| Student > Postgraduate | 10 | 12% |
| Other | 8 | 10% |
| Student > Ph. D. Student | 7 | 9% |
| Student > Bachelor | 6 | 7% |
| Other | 16 | 20% |
| Unknown | 16 | 20% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 35 | 43% |
| Nursing and Health Professions | 8 | 10% |
| Immunology and Microbiology | 5 | 6% |
| Biochemistry, Genetics and Molecular Biology | 2 | 2% |
| Pharmacology, Toxicology and Pharmaceutical Science | 2 | 2% |
| Other | 6 | 7% |
| Unknown | 23 | 28% |
Attention Score in Context
This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 09 November 2015.
All research outputs
#7,411,390
of 22,832,057 outputs
Outputs from Infection
#404
of 1,402 outputs
Outputs of similar age
#95,954
of 285,670 outputs
Outputs of similar age from Infection
#5
of 14 outputs
Altmetric has tracked 22,832,057 research outputs across all sources so far. This one has received more attention than most of these and is in the 67th percentile.
So far Altmetric has tracked 1,402 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.5. This one has gotten more attention than average, scoring higher than 70% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 285,670 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 66% of its contemporaries.
We're also able to compare this research output to 14 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 64% of its contemporaries.