Abstract
Background: To identify the potential risk factors for multiantibiotic-resistant infections and provide sufficient evidence for multiantibiotic resistance prevention and control.Materials and Methods: We conducted a retrospective study of all patients in pediatric orthopedics, pediatric heart surgery, and pediatric general surgery at a level 3, grade A children's hospital from January to December 2016. The clinical laboratory information monitoring system and the medical record system were used to collect patient information regarding age, surgery type, preoperative length of stay, admission season, incision type, preoperative infection, intraoperative blood loss, postoperative use of invasive equipment, duration of catheter drainage, and timepoint of intraoperative prophylactic antibiotics administration. We used logistic univariate and multivariate regression analysis to analyze the potential risk factors for multiantibiotic-resistant infections among pediatric surgical patients. SPSS 21.0 and Excel software packages were used for the statistical analysis.Results: In total, 2,973 patients met the inclusion criteria: 1,247 patients in pediatric orthopedics, 1,089 patients in pediatric heart surgery, and 637 patients in pediatric general surgery. At the end of the study, 113 patients were multiantibiotic-resistant infection cases; the rate of multiantibiotic-resistant infections was 3.80%, and the detection rate was 84.79%. Multivariate analysis indicated that the multiantibiotic-resistant infection cases were influenced by age, department, admission season, incision type, preoperative infection, and duration of catheter drainage.Conclusions: Age, department, admission season, incision type, preoperative infection, and duration of catheter drainage may provide possible evidence for prevention and control strategies of multiantibiotic-resistant infections.
Highlights
Evidence suggests the prevalence of multiantibioticresistant bacteria that are difficult to treat with first-line antibiotics has become a growing health care concern and is increasing worldwide,[1,2,3] which can occur among children and enables the selection and spread of clones that carry antibiotic-resistance genes.[4]
Many studies have reported that the increasing incidence of serious infections acquired in health care settings are associated with antimicrobial drug resistance, which constitutes a serious threat to global public health.[25]
In China, various multiantibiotic-resistant infections seem to be on an uninterrupted incline,[26,27,28] and recent data suggest that multiantibiotic-resistant infections are increasing in children.[29]
Summary
Evidence suggests the prevalence of multiantibioticresistant bacteria that are difficult to treat with first-line antibiotics has become a growing health care concern and is increasing worldwide,[1,2,3] which can occur among children and enables the selection and spread of clones that carry antibiotic-resistance genes.[4]. Numerous single-institution studies have emphasized specific types of multiantibiotic-resistant pathogens such as methicillin-resistant Staphylococcus aureus (MRSA), inducible clindamycin resistance,[8,9,10] ESBL,[11] and Pseudomonas aeruginosa,[9] and so on, that are partly attributable to surgical site infections (SSIs).[11,12] These infections are the most common complication after surgery and account for >20% of all health care-associated infections in surgical patients.[13] And there are known host factors (e.g., advanced age, obesity, and diabetes) and procedural factors (e.g., wound class, duration of procedures, and surgical technique) associated with increased risk of SSIs.[14,15,16,17]. Multivariate analysis indicated that the multiantibiotic-resistant infection cases were influenced by age, department, admission season, incision type, preoperative infection, and duration of catheter drainage. Conclusions: Age, department, admission season, incision type, preoperative infection, and duration of catheter drainage may provide possible evidence for prevention and control strategies of multiantibiotic-resistant infections
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