Published online April 2, 2007
PEDIATRICS Vol. 119 No. 4 April 2007, pp. e798-e803 (doi:10.1542/peds.2006-1384)
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ARTICLE

Multidrug-Resistant Bacteria in Hospitalized Children: A 5-Year Multicenter Study

Josette Raymond, MD, PhDa, Patrice Nordmann, MD, PhDb, Catherine Doit, MDc, Hoang Vu Thien, MDd, Michèle Guibert, MDe, Agnès Ferroni, MDf and Yannick Aujard, MDg

a Service de Bactériologie, Hôpital Cochin-Saint Vincent de Paul, Paris, France
b Service de Microbiologie, Hôpital de Bicêtre, Kremlin-Bicêtre, France
c Service de Microbiologie
g Service de Néonatologie, Hôpital Robert Debré, Paris, France
d Service de Microbiologie, Hôpital Trousseau, Paris, France
e Service de Microbiologie, Hôpital Antoine Béclère, Clamart, France
f Service de Microbiologie, Hôpital Necker Enfants-Malades, Paris, France

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 ß-lactamase–producing Klebsiella pneumoniae, 0.32 for extended-spectrum ß-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 ß-lactamase–producing Klebsiella pneumoniae, extended-spectrum ß-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 ß-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 ß-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 ß-lactamase–producing Klebsiella pneumoniae, extended-spectrum ß-lactamase–producing Enterobacteriaceae other than Klebsiella pneumoniae, and Enterobacter species with derepressed cephalosporinase in hospitalized children during a 5-year period.

Key Words: multidrug-resistant bacteria • children • nosocomial infections

Abbreviations: MDRB—multidrug-resistant bacteria • MRSA—methicillin-resistant Staphylococcus aureus • VRE—vancomycin-resistant Enterococcus • ESBL—extended-spectrum ß-lactamase • ESBLKp—extended-spectrum ß-lactamase–producing Klebsiella pneumoniae • UTI—urinary tract infection • ESBLE—extended-spectrum ß-lactamase–producing Enterobacteriaceae other than K pneumoniae • HD—hospitalization-days

Accepted Oct 11, 2006.