%0 Journal Article
%A Slocker Barrio, María
%A López-Herce Cid, Jesús
%A Bustinza Arriortúa, Amaya
%A Fresán Ruiz, Elena
%A Jordán García, Iolanda
%A De Carlos Vicente, Juan Carlos
%A Morteruel Arizcuren, Elvira
%A García Soler, Patricia
%A Nieto Moro, Montserrat
%A Schüffelmann, Cristina
%A Belda Hofheinz, Sylvia
%A Herrera Castillo, Laura Ximena
%A Uriona Tuma, Sonia María
%A Pinós Tella, Laia
%A Peña López, Yolanda
%T Increase in Incidence Rates and Risk Factors for Multidrug Resistant Bacteria in Septic Children: A Nationwide Spanish Cohort Study (2013–2019)
%D 2023
%@ 2079-6382
%U https://hdl.handle.net/20.500.14352/110759
%X The emergence of multidrug-resistant (MDR) bacteria in children is a growing concern, particularly among septic patients, given the need for first-right dosing. Our aim was to determine the incidence rates and factors associated with MDR-sepsis in the pediatric intensive care unit (PICU), using data from the Spanish ENVIN-HELICS PICU registry between 2013 and 2019. The rate of MDR bacteria among septic children ranged between 5.8 and 16.2% throughout this study period, with a significant increase since 2015 (p = 0.013). MDR-gram-negative bacteria (92%), particularly EBL-Enterobacterales (63.7%), were the most frequent causative microorganisms of MDR-sepsis. During this study period, sixteen MDR-sepsis (32.6%) corresponded to intrahospital infections, and 33 (67.4%) had community-onset sepsis, accounting for 10.5% of the overall community-onset sepsis. Independent risk factors associated with MDR-sepsis were antibiotics 48 h prior to PICU admission (OR 2.38) and PICU onset of sepsis (OR 2.58) in >1 year-old children, and previous malnourishment (OR 4.99) in <1 year-old children. Conclusions: There was an alarming increase in MDR among septic children in Spain, mainly by gram-negative (ESBL-Enterobacterales), mostly coming from the community setting. Malnourished infants and children on antibiotics 48 h prior to PICU are at increased risk and therefore require closer surveillance.
%~