Antimicrobial Resistance Patterns Among Healthcare-Associated Infections in a Pediatric Referral Center in Lima-Peru, 2015-2023
Medalit Luna-Vilchez, Mitsi Santiago-Abal, Jorge OsadaAbstract
Background
Healthcare-associated infections (HAIs) results in increased morbidity and mortality rates, prolonged hospitalization and higher health care costs. While the surveillance of antibiotic-resistant bacteria involved in HAIs is important, there is limited data available in Latin America. The present study aimed to describe common pathogens and antimicrobial resistance patterns for HAIs among patients in a pediatric referral center.
Methods
Cross-sectional descriptive period study. Epidemiological surveillance data of HAIs were collected from hospitalized patients at the Instituto Nacional de Salud del Niño San Borja in Lima, Peru (2015-2023). Antimicrobial resistance data were analyzed for pathogens implicated in central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs) and ventilator-associated pneumonias (VAPs). The dataset included comprehensive information on the clinical and epidemiological characteristics of patients, bacteria isolation sites and identification, as well as resistance profiles to antibiotics.
Results
We included 1065 bacterial isolates from pediatric patients hospitalized with HAIs, of which 57.56% were male (n=613). The median age of the patients was 12 months (IQR: 2.04 – 60). Most of the isolates were collected from hospitalization (n=682, 64.04%). The most frequent type of HAIs was CLABSI (61.88%). Staphylococcus epidermidis (31%), Pseudomonas aeruginosa (19%), Klebsiella pneumoniae (15%) and Escherichia coli (12%) were the most commonly reported pathogens associated with pediatric HAIs. We observed that the resistance to piperacillin-tazobactam and carbapenems increased over the years in Pseudomonas aeruginosa, Klebsiella penumoniae and Escherichia coli. The resistance to quinolones (ciprofloxacin, levofloxacin, norfloxacin and nalidixic acid) increased over the years in Klebsiella penumoniae. In the evaluation of Gram-positive bacteria, there was a trend of increased resistance in Staphylococcus epidemidis to oxacillin and trimethoprim sulfamethoxazole.
Conclusion
Implementation of effective infection prevention and antimicrobial stewardship strategies to combat the emergence of antibiotic resistance are urgently needed.