1095. Pediatric Antimicrobial Susceptibility Trends across the United States
Session: Poster Abstract Session: Surveillance of HAIs: Implementation and National Perspectives
Friday, October 4, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • Antibiogram.pdf (518.6 kB)
  • Background:

    Antimicrobial susceptibility patterns across United States pediatric healthcare institutions are unknown. A national pooled pediatric antibiogram 1) identifies nationwide trends in antimicrobial resistance, 2) allows across-hospital benchmarking, and 3) provides guidance for empiric antimicrobial regimens for institutions unable to generate pediatric antibiograms.

    Methods:

    In January 2012, a request for submission of pediatric antibiograms between 2005-2011 was sent to 233 United States hospitals. A summary antibiogram was compiled from participating institutions to generate proportions of antimicrobial susceptibility. Temporal and regional comparisons were evaluated using chi-square tests.

    Results:

    Of 200 (85%) institutions responding to our survey, 78 (39%) reported generating pediatric antibiograms, and 55 (71%) submitted antibiograms.  Carbapenems had the highest activity against the majority of Gram-negative organisms tested, but no antibiotic had >90% activity for Pseudomonas aeruginosa. Approximately 50% of all Staphylococcus aureus isolates were methicillin-resistant. Overall S. aureus resistance to clindamycin was 21%.  Susceptibility of Enterococcus faecium to ampicillin (25%) and vancomycin (45%) was low but improved over time (p<0.01), and 8% of E. faecium were resistant to linezolid.  Western hospitals had significantly higher proportions of S. aureus that were methicillin-susceptible (66%) compared to all other regions tested and southern hospitals reported E. faecium with significantly higher susceptibilities to ampicillin, vancomycin, and linezolid compared to the other three regions (p<0.01). 

    Conclusion:

    A pooled, pediatric antibiogram can identify nationwide antimicrobial resistance patterns for common pathogens, and might serve as a useful tool for benchmarking resistance and informing national prescribing guidelines for children.

    Pranita Tamma, MD, MHS, Pediatrics, The Johns Hopkins Medical Institution, Columbia, MD, Gwen Robinson, MPH, University of Maryland School of Medicine, Baltimore, MD, Jeffrey Gerber, MD, PhD, Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, Jason Newland, MD, Children's Mercy Hospital and Clinics, Kansas City, MO, Chloe Delisle, Johns Hopkins Medical Institutions, Baltimore, MD, Theoklis Zaoutis, MD, MSCE, Division of Infectious Diseases, Center for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia, Philadelphia, PA, The Children's Hospital of Philadelphia, Philadelphia, PA and Aaron M. Milstone, MD, MHS, Pediatrics, The Johns Hopkins Medical Institutions, Baltimore, MD

    Disclosures:

    P. Tamma, None

    G. Robinson, None

    J. Gerber, None

    J. Newland, Pfizer: Grant Investigator, Research grant

    C. Delisle, None

    T. Zaoutis, None

    A. M. Milstone, Sage Products, Inc.: Grant Investigator, Research support and Salary

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.