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KMID : 1040320210280020082
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Pediatric Infection & Vaccine
2021 Volume.28 No. 2 p.82 ~ p.91
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The Impact of Antibiotic Burden on the Selective Resistance of Gram Negative Bacteria in Children
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Park Se-Ra
Lee Eun-Taek
So Hye-Jin
Yoo Ree-Nar
Lee Jin-A
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Abstract
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Background: The purpose of this study was to investigate the association between antibiotic use and the antimicrobial resistance of gram-negative bacteria isolated from blood cultures in a pediatric population.
Methods: From January 2014 to June 2018, the antibiotic resistance pattern of Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa obtained from bacteremic patients aged ≤18 years hospitalized at Asan Medical Center Children's Hospital was analyzed and the parenteral antibiotic consumption data were retrieved.
Results: During the study period, the blood culture was positive for K. pneumoniae (6.4%; 105/1,628), E. coli (5.6%; 91/1,628), P. aeruginosa (3.3%; 54/1,628), and A. baumannii (2.5%; 41/1,628), and the extended-spectrum antibiotic resistance rate of gram-negative bacteria was consistently high. The overall resistance rate of E. coli and K. pneumoniae to extended-spectrum cephalosporin was 49.3% and 54.4%, respectively. Carbapenem-resistant E. coli was first detected in 2014; its overall resistance rate to carbapenem was 5.3%. There was a linear correlation between the usage of 3rd generation cephalosporin and the resistance of A. baumannii (r2=0.96, P=0.004) and carbapenem usage and the resistance of K. pneumoniae (r2=0.79, P=0.045).
Conclusions: A positive linear correlation was observed between antibiotic resistance and the corresponding antibiotic usage in 3rd generation cephalosporin resistant A. baumannii and carbapenem resistant K. pneumoniae. The judicious use of antibiotics in healthcare settings is important to minimize selection for extended-spectrum β-lactamase (ESBL) and carbapenem resistance in gram-negative bacteria.
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KEYWORD
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Gram negative bacteria, Bacteremia, Drug resistance, bacterial, Anti-bacterial agents
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