title: Prevalence of Multidrug-Resistant Organisms in Hospitalized Pediatric Refugees in an University Children's Hospital in Germany 2015-2016.
abstract: OBJECTIVE To determine the prevalence of multidrug-resistant organisms (MDROs) colonizing in pediatric refugees admitted to a University Children Hospital in Germany. DESIGN Retrospective observational study. SETTING General pediatric and pediatric surgery units. PATIENTS In Germany, recommendations for MDRO screening of pediatric refugees were recently published. According to these and institutional recommendations, all hospitalized pediatric refugees were screened for MDROs between October 2015 and March 2016. METHODS Using electronic surveillance data, we performed a chart review to identify the prevalence of MDROs among and the clinical diagnoses of pediatric refugees. RESULTS Among 325 patients hospitalized for various causes, most frequently gastroenteritis (30.9%), MDROs were detected in 33.8%. Most of these patients were colonized with multidrug-resistant Gram-negative (MRGN) bacteria (113 isolates), mostly 2MRGN/ESBL (87 isolates); some patients were colonized with methicillin-resistant Staphylococcus aureus (MRSA, 22 isolates); and 1 patient was colonized with vancomycin-resistant enterococci (VRE). Among 110 refugee patients, we detected single colonization with an MDRO in 84 patients (76.4%), co-colonization with 2 pathogens in 23 patients (20.9%), and triple colonization in 3 patients (2.7%). However, infections with MDROs occurred in only 3.6% of pediatric refugees. The peak of positive MDRO screening results in 2015 correlated with an increased hospitalization rate. CONCLUSION Implementation of infection control measures among pediatric refugees is challenging. Due to the high frequency of MDROs in these patients, current screening, isolation, and treatment strategies may have to be adapted. Infect Control Hosp Epidemiol 2016;1-5.
authors: 1Pediatric Infectious Diseases,University Children's Hospital Mannheim,Heidelberg University,Mannheim,Germany.
authors: Tobias
authors: T
authors: Tenenbaum
authors: 2Administrative Department of Hygiene, Medical Faculty Mannheim,Heidelberg University,Mannheim,Germany.
authors: Klaus-Peter
authors: KP
authors: Becker
authors: 2Administrative Department of Hygiene, Medical Faculty Mannheim,Heidelberg University,Mannheim,Germany.
authors: Bettina
authors: B
authors: Lange
authors: 4Institute for Medical Microbiology, Medical Faculty Mannheim,Heidelberg University,Mannheim,Germany.
authors: Anka
authors: A
authors: Martin
authors: 5Public Health Department Mannheim,Mannheim,Germany.
authors: Peter
authors: P
authors: Schäfer
authors: 1Pediatric Infectious Diseases,University Children's Hospital Mannheim,Heidelberg University,Mannheim,Germany.
authors: Stefan
authors: S
authors: Weichert
authors: 1Pediatric Infectious Diseases,University Children's Hospital Mannheim,Heidelberg University,Mannheim,Germany.
authors: Horst
authors: H
authors: Schroten
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D003141:Communicable Diseases / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D024901:Drug Resistance, Multiple, Bacterial; D005243:Feces / Q000382:microbiology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000302:isolation & purification; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D008297:Male; D015995:Prevalence; D012036:Refugees; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents