Multidrug-resistant bacteria in hospitalized children: a 5-year multicenter study.
OBJECTIVE
The objective of this study was to determine the incidence of multidrug-resistant bacteria in hospitalized children.


METHODS
This multicenter study was conducted in 5 hospitals in the Paris area from 1999 to 2003. We recorded all isolations of multidrug-resistant bacteria from clinical samples that were obtained from hospitalized children. Strains that were isolated during systematic screening for carriers were excluded.


RESULTS
The mean incidences were 0.9 per 1000 hospitalization-days for methicillin-resistant Staphylococcus aureus, 0.45 for extended-spectrum beta-lactamase-producing Klebsiella pneumoniae, 0.32 for extended-spectrum beta-lactamase-producing Enterobacteriaceae other than Klebsiella pneumoniae, 0.40 for Enterobacter species with derepressed cephalosporinase, and 0.01 for vancomycin-resistant Enterococcus. The incidences per 1000 hospitalization-days of methicillin-resistant Staphylococcus aureus, extended-spectrum beta-lactamase-producing Klebsiella pneumoniae, extended-spectrum beta-lactamase-producing Enterobacteriaceae other than Klebsiella pneumoniae, and Enterobacter species with derepressed cephalosporinase decreased significantly from 1999 to 2003, whereas the incidence of vancomycin-resistant Enterococcus remained very low. The proportion of resistant strains within the species did not vary significantly for methicillin-resistant Staphylococcus aureus (11% to 9.6%), extended-spectrum beta-lactamase-producing Enterobacteriaceae other than Klebsiella pneumoniae (1.1%), and vancomycin-resistant Enterococcus (0.03% to 0.023%). In contrast, the frequency of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae decreased from 31.6% to 7.4%, and that of Enterobacter species with derepressed cephalosporinase decreased from 38.8% to 18.5%.


CONCLUSIONS
We report significant decreases in the incidence of methicillin-resistant Staphylococcus aureus, extended-spectrum beta-lactamase-producing Klebsiella pneumoniae, extended-spectrum beta-lactamase-producing Enterobacteriaceae other than Klebsiella pneumoniae, and Enterobacter species with derepressed cephalosporinase in hospitalized children during a 5-year period.
Raymond
Josette
J
Service de Bactériologie, Hôpital Cochin-Saint Vincent de Paul, 27 rue du faubourg Saint-Jacques, 75679 Paris Cedex 14, France. j.raymond@svp.ap-hop-paris.fr
Nordmann
Patrice
P
Doit
Catherine
C
Vu Thien
Hoang
H
Guibert
Michèle
M
Ferroni
Agnès
A
Aujard
Yannick
Y
D017677:Age Distribution; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D018432:Drug Resistance, Multiple; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D005602:France / Q000453:epidemiology; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D006760:Hospitalization / Q000706:statistics & numerical data; D006776:Hospitals, Pediatric; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000379:methods; D016014:Linear Models; D008297:Male; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D017678:Sex Distribution
D000900:Anti-Bacterial Agents