Abstrakt

Serious infection due to extended-spectrum β-lactamase producing bacteria in children.

Elham Bukhari

Background: The prevalence of Extended Spectrum β-Lactamase (ESBL) producing bacteremia is increasing worldwide. The emergence ESBL-producing bacteria in children with severe infection like bacteremia and CNS infection needs further study. Here, we determine and characterize ESBL-producing bacteria in hospitalized children. Methods: Clinical and laboratory data of hospitalized pediatric patients aged 0-14 years diagnosed with ESBL-producing bacteria and serious infection (bacteremia and CNS infection) were collected over one year at King Khalid University Hospital. Results: We identified 20 episodes of ESBL-bacteremia among pediatric patients. Most patients were boys (n=17). Most 11 (55%) were 2-11 months of age, and preterm babies were almost half of the patient (50%). Two cases had serious CNS infection (brain abscess) caused by ESBL E. coli. Other examples include 14 K. pneumoniae (70%) isolates, 5 E. coli (25%) isolates and one Enterobacter aerogenes (5%). Bacteremia was diagnosed predominantly with K. pneumoniae (12 episodes) followed by E. coli (4 episodes) and E. aerogenes (1 episode). The ESBL-bacteremia documented in preterm babies was late-onset bacteremia. Three patients (15%) had underlying renal anomalies. Only one patient died (5%). Twelve patients (60%) were treated successfully with meropenem with or without amikacin. There was two dominant risk factor that occurred in all of the patient, Intensive care admission and prior usage of antibiotics. Conclusion: ESBL-producing bacteria tended to increase infection rates of both gramnegative bacteremia and brain abscesses in pediatric populations.