Superbugs on the rise in kids

Rates of third-generation cephalosporin-resistant (G3CR) and extended-spectrum ß-lactamase (ESBL)–producing Enterobacteriaceae infections are on the rise in kids, in both inpatient and outpatient settings across the country, according to a new study.

Latania K. Logan, MD, from the Rush University Medical Center in Chicago, Illinois, and colleagues studied 368,398 pediatric (from patients aged up to 18 years) isolates of Klebsiella pneumoniae, Escherichia coli, and Proteus mirabilis from approximately 300 laboratories participating in the Surveillance Network between January 1999 and December 2011. They identified 1.97% of the isolates as G3CR and 0.47% as ESBL producers. In the period 1999-2001, the prevalence of both, respectively, was 1.39% and 0.28%.

The researchers found the highest proportion of the isolates-just over half-in the 1- to 5-year-old age group, but the prevalence of the antibiotic-resistant bugs increased across all the demographic and age groups studied, including in outpatient populations.

The investigators found that about two-thirds of both the G3CR and ESBL isolates were E coli (67.8% and 65.2%, respectively, and three-quarters (74%) of the ESBLs were resistant to 3 or more antibiotic classes.

The researchers concluded, “The identification of host factors and exposures leading to infection in children is essential.”

The study comes at a time when drug resistance is of utmost concern. Late last year, the Centers for Disease Control and Prevention issued a “threat” report on the subject and cited improper use of antibiotics as the leading cause of the problem. The investigators declared that up to half of all antibiotics prescribed are unnecessary.

The American Academy of Pediatrics made the subject part of its “Choose Wisely” list and a new online learning module.

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