Prevalence and Associated Mortality of Infections by Multidrug-Resistant Organisms in Pediatric Intensive Care Units in Argentina (PREV-AR-P)

<b>Background/Objectives:</b> Data on multidrug-resistant organism (MDRO) infections in children are scarce, especially in resource-limited regions. This study aimed to estimate the prevalence of MDRO infections in pediatric intensive care units (PICUs) and characterize their epidemiolog...

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Main Authors: Wanda Cornistein, Carina Balasini, Yanina Nuccetelli, Viviana M. Rodriguez, Norma Cudmani, Maria Virginia Roca, Graciela Sadino, Martín Brizuela, Analía Fernández, Soledad González, Damián Águila, Alejandra Macchi, Maria Inés Staneloni, Elisa Estenssoro
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Antibiotics
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Online Access:https://www.mdpi.com/2079-6382/14/5/493
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author Wanda Cornistein
Carina Balasini
Yanina Nuccetelli
Viviana M. Rodriguez
Norma Cudmani
Maria Virginia Roca
Graciela Sadino
Martín Brizuela
Analía Fernández
Soledad González
Damián Águila
Alejandra Macchi
Maria Inés Staneloni
Elisa Estenssoro
author_facet Wanda Cornistein
Carina Balasini
Yanina Nuccetelli
Viviana M. Rodriguez
Norma Cudmani
Maria Virginia Roca
Graciela Sadino
Martín Brizuela
Analía Fernández
Soledad González
Damián Águila
Alejandra Macchi
Maria Inés Staneloni
Elisa Estenssoro
author_sort Wanda Cornistein
collection DOAJ
description <b>Background/Objectives:</b> Data on multidrug-resistant organism (MDRO) infections in children are scarce, especially in resource-limited regions. This study aimed to estimate the prevalence of MDRO infections in pediatric intensive care units (PICUs) and characterize their epidemiologic and clinical features. <b>Methods:</b> A national, multicenter, point-prevalence study was conducted in 50 PICUs in Argentina over 24 h between 24 and 28 November 2023. The primary study outcome was the prevalence of ICU infections caused by MDROs. Secondary outcomes included the prevalence of carbapenemase-producing <i>Enterobacterales</i> (CPE) colonization, ICU mortality, and ICU length of stay (LOS<sub>ICU</sub>). <b>Results:</b> 304 patients were included. The overall prevalence of infection was 45.1% (137/304); of these, 50.3% (69/137) were hospital-acquired. Among the 137 patients with reported infections, 49.6% (<i>n</i> = 68) were classified as definite (microbiologically confirmed) and 50.4% (<i>n</i> = 69) as probable (no confirmatory microbiology). Among definite infections, 20.6% (<i>n</i> = 14) were due to MDROs. The overall prevalence of MDRO infections was 4.6% (14/304). Extended-spectrum β-lactamase (ESBL)-producing organisms were the most commonly identified microorganisms (42.9%), followed by CPE (28.6%). Ventilator-associated pneumonia (VAP) was the most frequent location of MDRO infections. The prevalence of CPE colonization was 13.2%. Mortality was low (5.3%) and similar in patients with MDRO and non-MDRO infections. LOS<sub>ICU</sub> was longer in patients with MDRO infections compared to patients with non-MDRO infections (81 [22–150] vs. 25 [12–27] days, respectively, <i>p</i> = 0.0007). <b>Conclusions:</b> Among 304 PICU patients, the prevalence of MDRO infections and colonization was relatively low. MDRO infections were not associated with increased mortality but were associated with longer ICU stays, compared to patients with non-MDRO infections.
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spelling doaj-art-88cc4a7b5e4e42fdb813dc055d10c8ec2025-08-20T01:56:17ZengMDPI AGAntibiotics2079-63822025-05-0114549310.3390/antibiotics14050493Prevalence and Associated Mortality of Infections by Multidrug-Resistant Organisms in Pediatric Intensive Care Units in Argentina (PREV-AR-P)Wanda Cornistein0Carina Balasini1Yanina Nuccetelli2Viviana M. Rodriguez3Norma Cudmani4Maria Virginia Roca5Graciela Sadino6Martín Brizuela7Analía Fernández8Soledad González9Damián Águila10Alejandra Macchi11Maria Inés Staneloni12Elisa Estenssoro13Hospital Universitario Austral, Buenos Aires 1629, ArgentinaArgentinian Society for Critical Care (SATI), Buenos Aires 1414, ArgentinaArgentinian Society of Infectious Diseases (SADI), Buenos Aires 1414, ArgentinaArgentinian Society of Infectious Diseases (SADI), Buenos Aires 1414, ArgentinaArgentinian Society of Infectious Diseases (SADI), Buenos Aires 1414, ArgentinaArgentinian Society of Infectious Diseases (SADI), Buenos Aires 1414, ArgentinaArgentinian Society of Infectious Diseases (SADI), Buenos Aires 1414, ArgentinaArgentinian Society of Infectious Diseases (SADI), Buenos Aires 1414, ArgentinaArgentinian Society for Critical Care (SATI), Buenos Aires 1414, ArgentinaArgentinian Society of Infectious Diseases (SADI), Buenos Aires 1414, ArgentinaArgentinian Society of Infectious Diseases (SADI), Buenos Aires 1414, ArgentinaArgentinian Society of Infectious Diseases (SADI), Buenos Aires 1414, ArgentinaArgentinian Society of Infectious Diseases (SADI), Buenos Aires 1414, ArgentinaArgentinian Society for Critical Care (SATI), Buenos Aires 1414, Argentina<b>Background/Objectives:</b> Data on multidrug-resistant organism (MDRO) infections in children are scarce, especially in resource-limited regions. This study aimed to estimate the prevalence of MDRO infections in pediatric intensive care units (PICUs) and characterize their epidemiologic and clinical features. <b>Methods:</b> A national, multicenter, point-prevalence study was conducted in 50 PICUs in Argentina over 24 h between 24 and 28 November 2023. The primary study outcome was the prevalence of ICU infections caused by MDROs. Secondary outcomes included the prevalence of carbapenemase-producing <i>Enterobacterales</i> (CPE) colonization, ICU mortality, and ICU length of stay (LOS<sub>ICU</sub>). <b>Results:</b> 304 patients were included. The overall prevalence of infection was 45.1% (137/304); of these, 50.3% (69/137) were hospital-acquired. Among the 137 patients with reported infections, 49.6% (<i>n</i> = 68) were classified as definite (microbiologically confirmed) and 50.4% (<i>n</i> = 69) as probable (no confirmatory microbiology). Among definite infections, 20.6% (<i>n</i> = 14) were due to MDROs. The overall prevalence of MDRO infections was 4.6% (14/304). Extended-spectrum β-lactamase (ESBL)-producing organisms were the most commonly identified microorganisms (42.9%), followed by CPE (28.6%). Ventilator-associated pneumonia (VAP) was the most frequent location of MDRO infections. The prevalence of CPE colonization was 13.2%. Mortality was low (5.3%) and similar in patients with MDRO and non-MDRO infections. LOS<sub>ICU</sub> was longer in patients with MDRO infections compared to patients with non-MDRO infections (81 [22–150] vs. 25 [12–27] days, respectively, <i>p</i> = 0.0007). <b>Conclusions:</b> Among 304 PICU patients, the prevalence of MDRO infections and colonization was relatively low. MDRO infections were not associated with increased mortality but were associated with longer ICU stays, compared to patients with non-MDRO infections.https://www.mdpi.com/2079-6382/14/5/493Argentinapediatric intensive care unitscarbapenem-resistant <i>Enterobacterales</i>colonizationinfectionprevalence
spellingShingle Wanda Cornistein
Carina Balasini
Yanina Nuccetelli
Viviana M. Rodriguez
Norma Cudmani
Maria Virginia Roca
Graciela Sadino
Martín Brizuela
Analía Fernández
Soledad González
Damián Águila
Alejandra Macchi
Maria Inés Staneloni
Elisa Estenssoro
Prevalence and Associated Mortality of Infections by Multidrug-Resistant Organisms in Pediatric Intensive Care Units in Argentina (PREV-AR-P)
Antibiotics
Argentina
pediatric intensive care units
carbapenem-resistant <i>Enterobacterales</i>
colonization
infection
prevalence
title Prevalence and Associated Mortality of Infections by Multidrug-Resistant Organisms in Pediatric Intensive Care Units in Argentina (PREV-AR-P)
title_full Prevalence and Associated Mortality of Infections by Multidrug-Resistant Organisms in Pediatric Intensive Care Units in Argentina (PREV-AR-P)
title_fullStr Prevalence and Associated Mortality of Infections by Multidrug-Resistant Organisms in Pediatric Intensive Care Units in Argentina (PREV-AR-P)
title_full_unstemmed Prevalence and Associated Mortality of Infections by Multidrug-Resistant Organisms in Pediatric Intensive Care Units in Argentina (PREV-AR-P)
title_short Prevalence and Associated Mortality of Infections by Multidrug-Resistant Organisms in Pediatric Intensive Care Units in Argentina (PREV-AR-P)
title_sort prevalence and associated mortality of infections by multidrug resistant organisms in pediatric intensive care units in argentina prev ar p
topic Argentina
pediatric intensive care units
carbapenem-resistant <i>Enterobacterales</i>
colonization
infection
prevalence
url https://www.mdpi.com/2079-6382/14/5/493
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