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

Authors

• Ramia Zakhour
• Sarah Khafaja
• Rawan Korman
• Celina F Boutros
• Zeinab El Zein
• Ahmad Chmaisse
• Magda Haj
• Amani Haddara
• Zeina El-Houry
• Malak Jbahi
• Sarah Chamseddine
• Samer Bou Karroum
• Dana Al Oweini
• Yolla Salama Youssef
• Nour Youssef
• Mayse Nasser
• Danielle Fayad
• Farida Abi Farraj
• Clara El Nakib
• Imad Isaac
• Mireille Lteif
• George F Araj
• Ghassan S Dbaibo

Publication Date

1-1-2025

Journal

Infection and Drug Resistance

DOI

10.2147/IDR.S488436

PMID

39867287

PMCID

PMC11759581

PubMedCentral® Posted Date

1-20-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Introduction: 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

Published Open-Access

yes

Recommended Citation

Zakhour, Ramia; Khafaja, Sarah; Korman, Rawan; et al., "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" (2025). Faculty, Staff and Student Publications. 4175.
https://digitalcommons.library.tmc.edu/uthmed_docs/4175