Rates of Multidrug-Resistant Gram-Negative Bacterial Infections in Hospitalized Non-Immunocompromised Pediatric Patients: A 9-Year Retrospective Study at a Lebanese Tertiary Medical Center

Ramia Zakhour,1,2,* Sarah Khafaja,1,2,* Rawan Korman,1,* Celina F Boutros,1 Zeinab El Zein,1– 3 Ahmad Chmaisse,1 Magda Haj,1 Amani Haddara,1 Zeina El-Houry,1 Malak Jbahi,1 Sarah Chamseddine,1 Samer Bou Karroum,1 Dana Al Oweini,1 Yolla Salama Youssef,1 Nour Youssef,1,2 Mayse N...

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Main Authors: Zakhour R, Khafaja S, Korman R, Boutros CF, El Zein Z, Chmaisse A, Haj M, Haddara A, El-Houry Z, Jbahi M, Chamseddine S, Bou Karroum S, Al Oweini D, Youssef YS, Youssef N, Nasser M, Fayad D, Abi Farraj F, El Nakib C, Isaac I, Lteif M, Araj GF, Dbaibo GS
Format: Article
Language:English
Published: Dove Medical Press 2025-01-01
Series:Infection and Drug Resistance
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Online Access:https://www.dovepress.com/rates-of-multidrug-resistant-gram-negative-bacterial-infections-in-hos-peer-reviewed-fulltext-article-IDR
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author Zakhour R
Khafaja S
Korman R
Boutros CF
El Zein Z
Chmaisse A
Haj M
Haddara A
El-Houry Z
Jbahi M
Chamseddine S
Bou Karroum S
Al Oweini D
Youssef YS
Youssef N
Nasser M
Fayad D
Abi Farraj F
El Nakib C
Isaac I
Lteif M
Araj GF
Dbaibo GS
author_facet Zakhour R
Khafaja S
Korman R
Boutros CF
El Zein Z
Chmaisse A
Haj M
Haddara A
El-Houry Z
Jbahi M
Chamseddine S
Bou Karroum S
Al Oweini D
Youssef YS
Youssef N
Nasser M
Fayad D
Abi Farraj F
El Nakib C
Isaac I
Lteif M
Araj GF
Dbaibo GS
author_sort Zakhour R
collection DOAJ
description Ramia Zakhour,1,2,* Sarah Khafaja,1,2,* Rawan Korman,1,* Celina F Boutros,1 Zeinab El Zein,1– 3 Ahmad Chmaisse,1 Magda Haj,1 Amani Haddara,1 Zeina El-Houry,1 Malak Jbahi,1 Sarah Chamseddine,1 Samer Bou Karroum,1 Dana Al Oweini,1 Yolla Salama Youssef,1 Nour Youssef,1,2 Mayse Nasser,1 Danielle Fayad,1 Farida Abi Farraj,1 Clara El Nakib,1 Imad Isaac,1 Mireille Lteif,1 George F Araj,1,4 Ghassan S Dbaibo1– 3 1Center for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon; 2Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon; 3Division of Pediatric Infectious Diseases, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon; 4Clinical Microbiology Laboratory, Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon*These authors contributed equally to this workCorrespondence: Ghassan S Dbaibo, Center for Infectious Diseases Research (CIDR), Division of Pediatric Infectious Diseases, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, 1107, Lebanon, Email gdbaibo@aub.edu.lbIntroduction: Multidrug resistant (MDR) Gram-negative bacterial infections are considered a major public health threat. The objectives of this study were to describe the epidemiology, potential contributing factors, and antimicrobial resistance patterns associated with infections caused by MDR Gram-negative bacteria (GNB) in non-immunocompromised children and adolescents.Methods: This was a retrospective observational study conducted at the American University of Beirut Medical Center (AUBMC) from 2009 to 2017. The study included non-immunocompromised patients 18 years of age or younger with infections caused by GNB isolated from a sterile site or nonsterile site in the setting of clinical infection.Results: A total of 810 episodes of infection with GNB in 674 pediatric patients were identified. The most common pathogens were Enterobacterales followed by Pseudomonas. MDR GNB infections represented 47.8% of the episodes, with alarming MDR rates among Escherichia coli (64.3%), Klebsiella pneumoniae (59.1%) and Acinetobacter species (70.6%). Previous infection with the same organism during the previous 12 months, urinary catheter or cardiac catheterization in the past 30 days had high percentages of infections with MDR GNB. The carbapenem resistance rates were 1.7% in Enterobacterales, 19.8% in Pseudomonas species and 64.7% in Acinetobacter species.Conclusion: High prevalence of infections with MDR GNB was detected in non-immunocompromised pediatric patients in Lebanon. This poses a significant threat to the pediatric population and underscores the importance of implementing antimicrobial stewardship programs and infection control policies, which are crucial to cope with the burden of these infections, especially in the presence of other ongoing challenges such as the current economic collapse and ongoing war leading to severe antimicrobial shortages.Keywords: adolescents, antimicrobial resistance, children, gram-negative bacteria, multidrug resistance
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spelling doaj-art-76e0ef89049d424c8e9d92bf134e9e6d2025-01-21T16:58:06ZengDove Medical PressInfection and Drug Resistance1178-69732025-01-01Volume 1836337699402Rates of Multidrug-Resistant Gram-Negative Bacterial Infections in Hospitalized Non-Immunocompromised Pediatric Patients: A 9-Year Retrospective Study at a Lebanese Tertiary Medical CenterZakhour RKhafaja SKorman RBoutros CFEl Zein ZChmaisse AHaj MHaddara AEl-Houry ZJbahi MChamseddine SBou Karroum SAl Oweini DYoussef YSYoussef NNasser MFayad DAbi Farraj FEl Nakib CIsaac ILteif MAraj GFDbaibo GSRamia Zakhour,1,2,* Sarah Khafaja,1,2,* Rawan Korman,1,* Celina F Boutros,1 Zeinab El Zein,1– 3 Ahmad Chmaisse,1 Magda Haj,1 Amani Haddara,1 Zeina El-Houry,1 Malak Jbahi,1 Sarah Chamseddine,1 Samer Bou Karroum,1 Dana Al Oweini,1 Yolla Salama Youssef,1 Nour Youssef,1,2 Mayse Nasser,1 Danielle Fayad,1 Farida Abi Farraj,1 Clara El Nakib,1 Imad Isaac,1 Mireille Lteif,1 George F Araj,1,4 Ghassan S Dbaibo1– 3 1Center for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon; 2Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon; 3Division of Pediatric Infectious Diseases, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon; 4Clinical Microbiology Laboratory, Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon*These authors contributed equally to this workCorrespondence: Ghassan S Dbaibo, Center for Infectious Diseases Research (CIDR), Division of Pediatric Infectious Diseases, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, 1107, Lebanon, Email gdbaibo@aub.edu.lbIntroduction: Multidrug resistant (MDR) Gram-negative bacterial infections are considered a major public health threat. The objectives of this study were to describe the epidemiology, potential contributing factors, and antimicrobial resistance patterns associated with infections caused by MDR Gram-negative bacteria (GNB) in non-immunocompromised children and adolescents.Methods: This was a retrospective observational study conducted at the American University of Beirut Medical Center (AUBMC) from 2009 to 2017. The study included non-immunocompromised patients 18 years of age or younger with infections caused by GNB isolated from a sterile site or nonsterile site in the setting of clinical infection.Results: A total of 810 episodes of infection with GNB in 674 pediatric patients were identified. The most common pathogens were Enterobacterales followed by Pseudomonas. MDR GNB infections represented 47.8% of the episodes, with alarming MDR rates among Escherichia coli (64.3%), Klebsiella pneumoniae (59.1%) and Acinetobacter species (70.6%). Previous infection with the same organism during the previous 12 months, urinary catheter or cardiac catheterization in the past 30 days had high percentages of infections with MDR GNB. The carbapenem resistance rates were 1.7% in Enterobacterales, 19.8% in Pseudomonas species and 64.7% in Acinetobacter species.Conclusion: High prevalence of infections with MDR GNB was detected in non-immunocompromised pediatric patients in Lebanon. This poses a significant threat to the pediatric population and underscores the importance of implementing antimicrobial stewardship programs and infection control policies, which are crucial to cope with the burden of these infections, especially in the presence of other ongoing challenges such as the current economic collapse and ongoing war leading to severe antimicrobial shortages.Keywords: adolescents, antimicrobial resistance, children, gram-negative bacteria, multidrug resistancehttps://www.dovepress.com/rates-of-multidrug-resistant-gram-negative-bacterial-infections-in-hos-peer-reviewed-fulltext-article-IDRadolescentsantimicrobial resistancechildrengram-negative bacteriamultidrug resistance.
spellingShingle Zakhour R
Khafaja S
Korman R
Boutros CF
El Zein Z
Chmaisse A
Haj M
Haddara A
El-Houry Z
Jbahi M
Chamseddine S
Bou Karroum S
Al Oweini D
Youssef YS
Youssef N
Nasser M
Fayad D
Abi Farraj F
El Nakib C
Isaac I
Lteif M
Araj GF
Dbaibo GS
Rates of Multidrug-Resistant Gram-Negative Bacterial Infections in Hospitalized Non-Immunocompromised Pediatric Patients: A 9-Year Retrospective Study at a Lebanese Tertiary Medical Center
Infection and Drug Resistance
adolescents
antimicrobial resistance
children
gram-negative bacteria
multidrug resistance.
title Rates of Multidrug-Resistant Gram-Negative Bacterial Infections in Hospitalized Non-Immunocompromised Pediatric Patients: A 9-Year Retrospective Study at a Lebanese Tertiary Medical Center
title_full Rates of Multidrug-Resistant Gram-Negative Bacterial Infections in Hospitalized Non-Immunocompromised Pediatric Patients: A 9-Year Retrospective Study at a Lebanese Tertiary Medical Center
title_fullStr Rates of Multidrug-Resistant Gram-Negative Bacterial Infections in Hospitalized Non-Immunocompromised Pediatric Patients: A 9-Year Retrospective Study at a Lebanese Tertiary Medical Center
title_full_unstemmed Rates of Multidrug-Resistant Gram-Negative Bacterial Infections in Hospitalized Non-Immunocompromised Pediatric Patients: A 9-Year Retrospective Study at a Lebanese Tertiary Medical Center
title_short Rates of Multidrug-Resistant Gram-Negative Bacterial Infections in Hospitalized Non-Immunocompromised Pediatric Patients: A 9-Year Retrospective Study at a Lebanese Tertiary Medical Center
title_sort rates of multidrug resistant gram negative bacterial infections in hospitalized non immunocompromised pediatric patients a 9 year retrospective study at a lebanese tertiary medical center
topic adolescents
antimicrobial resistance
children
gram-negative bacteria
multidrug resistance.
url https://www.dovepress.com/rates-of-multidrug-resistant-gram-negative-bacterial-infections-in-hos-peer-reviewed-fulltext-article-IDR
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