Slocker Barrio, MaríaLópez-Herce Cid, JesúsBustinza Arriortúa, AmayaFresán Ruiz, ElenaJordán García, IolandaDe Carlos Vicente, Juan CarlosMorteruel Arizcuren, ElviraGarcía Soler, PatriciaNieto Moro, MontserratSchüffelmann, CristinaBelda Hofheinz, SylviaHerrera Castillo, Laura XimenaUriona Tuma, Sonia MaríaPinós Tella, LaiaPeña López, Yolanda2024-11-192024-11-192023-11-14Slocker-Barrio, M.; López-Herce-Cid, J.; Bustinza-Arriortúa, A.; Fresán-Ruiz, E.; Jordán-García, I.; de Carlos-Vicente, J.C.; Morteruel-Arizcuren, E.; García-Soler, P.; Nieto-Moro, M.; Schüffelmann, C.; et al. Increase in Incidence Rates and Risk Factors for Multidrug Resistant Bacteria in Septic Children: A Nationwide Spanish Cohort Study (2013–2019). Antibiotics 2023, 12, 1626. https://doi.org/10.3390/antibiotics121116262079-638210.3390/antibiotics12111626https://hdl.handle.net/20.500.14352/1107592023 Descuento MDPIThe 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.engAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/journal articlehttps://doi.org/10.3390/antibiotics12111626https://www.mdpi.com/2079-6382/12/11/1626open access616.94616-053.2Drug-resistant bacteriaExtended-spectrum beta-lactamase (ESBL)SepsisPICUSurveillanceMedicina32 Ciencias Médicas