Backgrounds:

Healthcare-associated infections (HAI) are a major public-health problem. The aim of this study is to compare the evolution of antibiotics used for HAI diagnosed in Paediatric Intensive Care Units (PICU) from the Spanish registry Paediatric-ENVIN-HELICS.

Methods

Multicentre, prospective and observational study of HAI diagnosed in 28 Spanish PICU, during a three-month period from 2014–2020. The ENVIN diagnostic criteria adapted to paediatrics were used, based on CDC recommendations.

Results:

Total number of patients was 10972. In 2020 the rate of antibiotics use was 67%. Comparing 2020 with 2014, this rate decreased 12% (p<0.001). The Antimicrobial Stewardship Programs (ASP) were implemented in 26 PICUs (92%) in 2020, compared with 9 (32%) in 2014.

Comparing the last and the firts year of the registry, antibiotic stewardship was 17.7% higher (p<0.001). Early suspension antibiotic rate increased (2.4%, p>0.05). Antibiotic modifications due to side effects decreased (0.9%), but modifications due to new resistances during treatment increased (0.1%), not statistically significant differences were found.

There was an increase in meropenem use compared with the previous year (p>0.05): for HAI previous PICU admission of 5.1% and for PICU HAI of 4.1%.

Conclusions/Learning Points:

The rate of antibiotics use was high, but results showed a significant decrease during 2020. Despite the implementation of ASP, the use of carbapenems for HAI increased in 2020. The improvement in antibiotic use policies is evident thanks to the increase of antibiotic de-escalation and early suspension rate. In 2020 there was a reduction on the modifications of the antibiotic regime due to adverse events, but an upturn of the emergence of new resistant microorganisms.

Backgrounds:

Healthcare-associated infections (HAI) are a major public-health problem. The aim of this study is to compare the evolution of antibiotics used for HAI diagnosed in Paediatric Intensive Care Units (PICU) from the Spanish registry Paediatric-ENVIN-HELICS.

Methods

Multicentre, prospective and observational study of HAI diagnosed in 28 Spanish PICU, during a three-month period from 2014–2020. The ENVIN diagnostic criteria adapted to paediatrics were used, based on CDC recommendations.

Results:

Total number of patients was 10972. In 2020 the rate of antibiotics use was 67%. Comparing 2020 with 2014, this rate decreased 12% (p<0.001). The Antimicrobial Stewardship Programs (ASP) were implemented in 26 PICUs (92%) in 2020, compared with 9 (32%) in 2014.

Comparing the last and the firts year of the registry, antibiotic stewardship was 17.7% higher (p<0.001). Early suspension antibiotic rate increased (2.4%, p>0.05). Antibiotic modifications due to side effects decreased (0.9%), but modifications due to new resistances during treatment increased (0.1%), not statistically significant differences were found.

There was an increase in meropenem use compared with the previous year (p>0.05): for HAI previous PICU admission of 5.1% and for PICU HAI of 4.1%.

Conclusions/Learning Points:

The rate of antibiotics use was high, but results showed a significant decrease during 2020. Despite the implementation of ASP, the use of carbapenems for HAI increased in 2020. The improvement in antibiotic use policies is evident thanks to the increase of antibiotic de-escalation and early suspension rate. In 2020 there was a reduction on the modifications of the antibiotic regime due to adverse events, but an upturn of the emergence of new resistant microorganisms.