Sophie Wen (Australia)
Queensland Children's Hospital Infection Management Prevention ServiceAuthor Of 1 Presentation
EPIDEMIOLOGY AND CLINICAL OUTCOMES OF GRAM-NEGATIVE BLOODSTREAM INFECTIONS IN HOSPITALISED AUSTRALIAN CHILDREN
Abstract
Backgrounds:
Gram-negative bloodstream infections (GNBSI) in children are of increasing concern, being associated with significant mortality and antimicrobial resistance. There are few population-based data to describe the risk factors and clinical outcomes from GNBSI in children. We established a surveillance study of GNBSI through the Australian Paediatric Active Enhanced Disease Surveillance (PAEDS) network. Here are the findings from the first 2 years (2019-2020).
Methods
Active surveillance commenced in five Australian tertiary paediatric hospitals in January 2019. Patients aged <18 years with a pathogenic Gram-negative organism in blood culture and suspicion of systemic infection were included. Clinical features, risk factors, antimicrobial therapy and outcomes including length of hospital and intensive care unit (ICU) stay, 30-day and in-hospital mortality, and complications associated with hospitalisation were recorded.
Results:
From January 2019 to December 2020, there were 639 episodes of GNBSIs in 565 children, and 679 isolates identified. The median age was 2.9 years (IQR 0.5-7.7 years) and 59% were male. 53% were community onset and 72% occurred in children with comorbidities. Malignancy was the most common comorbidity (36%). Intravascular device was the source for 26%. Microbiology is shown in Figure 1. 13% were already in ICU at time of GNBSI onset with an additional 13% requiring ICU admission. Median duration of hospitalisation was 14 days (IQR 8-35 days). There were 42 deaths from all causes (7%) during admission, with GNBSI contributory to 60% of deaths. Nine deaths occurred within 30-days (1.4%), with no significant differences in those with/without comorbidities (1.3% vs 1.8% p-value=0.71).
Conclusions/Learning Points:
GNBSI in children are associated with significant mortality and over half are healthcare associated, with a notable proportion requiring ICU admission.
Presenter of 1 Presentation
EPIDEMIOLOGY AND CLINICAL OUTCOMES OF GRAM-NEGATIVE BLOODSTREAM INFECTIONS IN HOSPITALISED AUSTRALIAN CHILDREN
Abstract
Backgrounds:
Gram-negative bloodstream infections (GNBSI) in children are of increasing concern, being associated with significant mortality and antimicrobial resistance. There are few population-based data to describe the risk factors and clinical outcomes from GNBSI in children. We established a surveillance study of GNBSI through the Australian Paediatric Active Enhanced Disease Surveillance (PAEDS) network. Here are the findings from the first 2 years (2019-2020).
Methods
Active surveillance commenced in five Australian tertiary paediatric hospitals in January 2019. Patients aged <18 years with a pathogenic Gram-negative organism in blood culture and suspicion of systemic infection were included. Clinical features, risk factors, antimicrobial therapy and outcomes including length of hospital and intensive care unit (ICU) stay, 30-day and in-hospital mortality, and complications associated with hospitalisation were recorded.
Results:
From January 2019 to December 2020, there were 639 episodes of GNBSIs in 565 children, and 679 isolates identified. The median age was 2.9 years (IQR 0.5-7.7 years) and 59% were male. 53% were community onset and 72% occurred in children with comorbidities. Malignancy was the most common comorbidity (36%). Intravascular device was the source for 26%. Microbiology is shown in Figure 1. 13% were already in ICU at time of GNBSI onset with an additional 13% requiring ICU admission. Median duration of hospitalisation was 14 days (IQR 8-35 days). There were 42 deaths from all causes (7%) during admission, with GNBSI contributory to 60% of deaths. Nine deaths occurred within 30-days (1.4%), with no significant differences in those with/without comorbidities (1.3% vs 1.8% p-value=0.71).
Conclusions/Learning Points:
GNBSI in children are associated with significant mortality and over half are healthcare associated, with a notable proportion requiring ICU admission.