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April 9, 2014
A Type of Resistant Bacterial Infection Is on the
Rise in Children

Chicago—Infections caused by extended-spectrum beta-lactamase (ESBL) bacteria are increasing in U.S. children, and a new study raises an alarm about the declining effectiveness of oral antibiotics to treat the condition.

Researchers from Rush University Medical Center said the resistant bacteria remain rare, but pediatric cases are on the rise, especially in children 1-5 years old. The report was published recently in the Journal of the Pediatric Infectious Diseases Society.

“Some infections in children that have typically been treated with oral antibiotics in the past may now require hospitalization, treatment with intravenous drugs, or both, as there may not be an oral treatment option available,” said lead author Latania K. Logan, MD.

For the study, researchers analyzed resistance patterns in about 370,000 bacterial cultures collected nationwide from pediatric patients nationwide between 1999 and 2011.

Overall, the study found that ESBL-producing bacteria increased from 0.28% to 0.92% from 1999 to 2011, with resistance to third-generation cephalosporins rising from 1.4% to 3.0%. While ESBLs were detected in children of all ages and in all regions of the United States, slightly more than half of samples were found in toddlers 1-5 years old. Nearly three-quarters, 74.4%, were resistant to multiple classes of antibiotics.

The authors point out that, while the overall rate of these infections in children is still low, ESBL-producing bacteria spreads rapidly and has been linked to longer hospital stays, higher health care costs, and increased mortality. In 2013, the national Centers for Disease Control and Prevention called ESBLs a “serious concern” and a significant threat to public health.

“These antibiotic-resistant bacteria have traditionally been found in healthcare settings but are increasingly being found in the community, in people who have not had a significant history of health care exposure,” Logan said. “In our study, though previous medical histories of the subjects were unknown, 51.3% of the children with these infections presented in the outpatient or ambulatory setting.”

A companion study by several of the same researchers, also published in the Journal of the Pediatric Infectious Diseases Society, suggests that children with neurologic conditions are at higher risk for infections caused by ESBL-producing bacteria.





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