title: Patterns and trends of pediatric bloodstream infections: a 7-year surveillance study.
abstract: We characterize the epidemiology of pediatric bloodstream infections (BSIs) in Switzerland. We analyzed pathogen distribution and resistance patterns in monomicrobial and polymicrobial BSIs in children from 2008 to 2014 using data from the Swiss antibiotic resistance centre (ANRESIS). A confirmatory statistical analysis was performed comparing pathogens and resistance across 20 acute care hospitals. We identified 3,067 bacteremia episodes, of which 1,823 (59 %) were considered true BSI episodes. Overall, S. aureus (16.5 %, 300) was the most frequent pathogen, followed by E. coli (15.1 %, 276), coagulase-negative staphylococci (CoNS, 12.9 %, 235), S. pneumoniae (11.1 %, 202) and non-E. coli Enterobacteriaceae (8.7 %, 159). S. aureus and E. coli showed similar frequencies in all of the variables analyzed (e.g., hospital acquisition, hospital type, medical specialty). The proportion of these microorganisms did not change over time, resistance rates remained low (4.3 % methicillin resistance in S. aureus; 7.3 % third-/fourth-generation cephalosporin resistance in E. coli), and no significant resistance trends were observed. We observed a 50 % increase of CoNS BSIs from 2008 (9.8 %, 27) to 2014 (15.2 %, 46, p value for trend = 0.03). S. pneumoniae decreased from 17.5 % (48) to 6.6 % (20) during that timeframe (p for trend = 0.007). S. aureus and E. coli remained the most significant pathogens among pediatric BSIs in Switzerland, exhibiting low resistance rates. CoNS accounted for a greater proportion of BSIs over time. The decrease in bacteremic pneumococcal infections can likely be attributed to the introduction of the 13-valent conjugate vaccine in 2011.
authors.affiliation: Department of Infectious Diseases, University Hospital Bern, Freiburgstrasse 3010, Bern, Switzerland. niccolo.buetti@gmail.com.
authors.forename: N
authors.initials: N
authors.lastname: Buetti
authors.affiliation: Department of Infectious Diseases, University Hospital Bern, Freiburgstrasse 3010, Bern, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Atkinson
authors.affiliation: Department of Infectious Diseases, University Hospital Bern, Freiburgstrasse 3010, Bern, Switzerland.
authors.forename: L
authors.initials: L
authors.lastname: Kottanattu
authors.affiliation: Paediatric Pharmacology Department, University of Basel Children's Hospital Basel, Basel, Switzerland.
authors.forename: J
authors.initials: J
authors.lastname: Bielicki
authors.affiliation: Department of Infectious Diseases, University Hospital Bern, Freiburgstrasse 3010, Bern, Switzerland.
authors.forename: J
authors.initials: J
authors.lastname: Marschall
authors.affiliation: Institute for Infectious Diseases, University of Bern, Bern, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Kronenberg
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001419:Bacteria / Q000145:classification* / Q000187:drug effects / Q000302:isolation & purification*; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests; D018805:Sepsis / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology*; D013557:Switzerland / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents