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Abstract

Background

Increasing resistance to antibiotics poses medical challenges worldwide. Prospective data on carriage prevalence of multidrug resistant organisms (MDRO) in children at hospital admission are limited and associated risk factors are poorly defined.

Aim

To determine prevalence of MDRO carriage in children at admission to our paediatric hospital in Hamburg and to identify MDRO carriage risk factors.

Methods

We prospectively obtained and cultured nasal/throat and inguinal/anal swabs from children (≤ 18 years) at admission between September 2018 and May 2019 to determine prevalence of meticillin-resistant (MRSA), multidrug-resistant Gram-negative bacteria (MRGN) and vancomycin-resistant enterococcus (VRE) and associated species. We collected medical histories using a questionnaire and evaluated 31 risk factors using logistic regression models.

Results

MDRO carriage prevalence of 3,964 children was 4.31% (95% confidence interval (CI): 3.69–5.00). MRSA carriage prevalence was 0.68% (95% CI: 0.44–0.99), MRGN prevalence was 3.64% (95% CI: 3.07–4.28) and VRE prevalence 0.08% (95% CI: 0.02–0.22). MDRO carriage was associated with MRGN history (odds ratio (OR): 6.53; 95% CI: 2.58–16.13), chronic condition requiring permanent care (OR: 2.67; 95% CI: 1.07–6.13), antibiotic therapy (OR: 1.92, 95% CI: 1.24–2.94), living in a care facility (OR: 3.34; 95% CI: 0.72–12.44) and refugee status in previous 12 months (OR: 1.91; 95% CI: 0.27–8.02). Compared to established practice, screening using risk-factors had better diagnostic sensitivity (86.13%; 95% CI: 80.89–91.40) and specificity (73.54%; 95% CI: 72.12–74.97).

Conclusion

MRGN carriage was higher than MRSA and VRE. Extended risk-factor-based admission screening system seems warranted.

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2022-04-14
2024-12-22
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High prevalence of multidrug-resistant Gram-negative bacteria carriage in children screened prospectively for multidrug resistant organisms at admission to a paediatric hospital, Hamburg, Germany, September 2018 to May 2019
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Safiullah+Najem&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Najem Safiullah</a>, <a href="/search?value1=Doroth%C3%A9e+Eick&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Eick Dorothée</a>, <a href="/search?value1=Johannes+Boettcher&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Boettcher Johannes</a>, <a href="/search?value1=Annette+Aigner&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Aigner Annette</a>, <a href="/search?value1=Mona+Aboutara&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Aboutara Mona</a>, <a href="/search?value1=Ines+Fenner&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Fenner Ines</a>, <a href="/search?value1=Konrad+Reinshagen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Reinshagen Konrad</a>, <a href="/search?value1=Ingo+Koenigs&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Koenigs Ingo</a></span>. High prevalence of multidrug-resistant Gram-negative bacteria carriage in children screened prospectively for multidrug resistant organisms at admission to a paediatric hospital, Hamburg, Germany, September 2018 to May 2019. <a href="/content/ecdc">Euro Surveill.</a> 2022;27(15):pii=2001567. <a href="https://doi.org/10.2807/1560-7917.ES.2022.27.15.2001567" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2022.27.15.2001567</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 17 Aug 2020;&nbsp;&nbsp; <span class="generated">Accepted</span>: 19 Apr 2021 </span> </p>
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