Progress towards a coordinated, national paediatric antimicrobial resistance surveillance programme: Staphylococcus aureus, enterococcal and Gram-negative bacteraemia in Australia

Blyth, C.C., Bowen, A.C., Carapetis, J.R., Coombs, G.W.ORCID: 0000-0003-1635-6506, Pang, S., Bell, J.M., Daley, D.A. and Campbell, A.J. (2020) Progress towards a coordinated, national paediatric antimicrobial resistance surveillance programme: Staphylococcus aureus, enterococcal and Gram-negative bacteraemia in Australia. Journal of Antimicrobial Chemotherapy, 75 (6). pp. 1639-1644.

Abstract

Background
There is increasing knowledge of antimicrobial usage in children yet limited availability of nationally representative paediatric-specific data on antimicrobial resistance.

Objectives
Paediatric data from this national surveillance programme are presented to explore differences between childhood and adult bloodstream infections and antimicrobial resistance surveillance.

Methods
Using information collected from a prospective coordinated antimicrobial resistance surveillance programme, children ≤18 years and adults >18 years with a positive blood culture for Staphylococcus aureus, Enterococcus spp. or Gram-negative spp. presenting to one of 34 Australian hospitals during 2013–16 were evaluated. Consistent methodologies for key sepsis pathogens were employed and a comparative analysis between children and adults was conducted.

Results
There are stark contrasts between children and adults in this national antimicrobial resistance (AMR) data set. Notable differences include lower rates of AMR, different clinical and molecular phenotypes and lower mortality amongst children. The burden of Gram-negative resistance is disproportionately experienced in children, with higher odds of death with an ESBL versus non-ESBL bacteraemia in comparison with adults.

Conclusions
These data support that children are not just ‘little adults’ in the AMR era, and analyses by age group are important to detect differences in antibiotic susceptibility, clinical phenotype and genetic virulence factors. Antimicrobial surveillance incorporated into routine laboratory practice is vital to inform an array of wider applications including antimicrobial guidelines, stewardship and direction for prioritization of novel antimicrobial development.

Item Type:	Journal Article
Murdoch Affiliation(s):	Antimicrobial Resistance and Infectious Disease Laboratory
Publisher:	Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy
Copyright:	© 2020 The Authors
URI:	http://researchrepository.murdoch.edu.au/id/eprint/56161

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