title: Antibiotic resistance of gram-negative bacilli isolated from pediatric patients with nosocomial bloodstream infections in a Mexican tertiary care hospital.
abstract: BACKGROUND
  Gram-negative bacilli are the most common bacteria causing nosocomial bloodstream infections (NBSIs) in Latin American countries.
  
  
  METHODS
  The antibiotic resistance profiles of Gram-negative bacilli isolated from blood cultures in pediatric patients with NBSIs over a 3-year period in a tertiary care pediatric hospital in Mexico City were determined using the VITEK-2 system. Sixteen antibiotics were tested to ascertain the resistance rate and the minimum inhibitory concentration using the Clinical Laboratory Standards Institute (CLSI) broth micro-dilution method as a reference.
  
  
  RESULTS
  A total of 931 isolates were recovered from 847 clinically significant episodes of NBSI. Of these, 477 (51.2%) were caused by Gram-negative bacilli. The most common Gram-negative bacilli found were Klebsiella pneumoniae (30.4%), Escherichia coli (18.9%), Enterobacter cloacae (15.1%), Pseudomonas aeruginosa (9.9%), and Acinetobacter baumannii (4.6%). More than 45 and 60% of the K. pneumoniae and E. coli isolates, respectively, were resistant to cephalosporins, and 64% of the E. coli isolates were resistant to fluoroquinolones. A. baumannii exhibited low rates of resistance to antibiotics tested. In the E. cloacae and P. aeruginosa isolates, no rates of resistance higher than 38% were observed.
  
  
  CONCLUSIONS
  In this study, we found that the proportion of NBSIs due to antibiotic-resistant organisms is increasing in a tertiary care pediatric hospital of Mexico.
authors.affiliation: Laboratorio de Microbiología Clínica, Unidad Médica de Alta Especialidad, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Ares
authors.forename: Maria Dolores
authors.initials: MD
authors.lastname: Alcántar-Curiel
authors.forename: César
authors.initials: C
authors.lastname: Jiménez-Galicia
authors.forename: Nora
authors.initials: N
authors.lastname: Rios-Sarabia
authors.forename: Sabino
authors.initials: S
authors.lastname: Pacheco
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: De la Cruz
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016470:Bacteremia / Q000188:drug therapy* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology; D024881:Drug Resistance, Bacterial; D005260:Female; D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008800:Mexico; D008826:Microbial Sensitivity Tests; D011446:Prospective Studies; D062606:Tertiary Care Centers
chemical_list: D000900:Anti-Bacterial Agents