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Title: Antimicrobial resistance in invasive bacterial infections in hospitalized children, Cambodia, 2007–2016
Authors: Andrew Fox-Lewis
Junko Takata
Thyl Miliya
Yoel Lubell
Sona Soeng
Poda Sar
Kolthida Rith
Gregor McKellar
Vanaporn Wuthiekanun
Erin McGonagle
Nicole Stoesser
Catrin E. Moore
Christopher M. Parry
Claudia Turner
Nicholas P.J. Day
Ben S. Cooper
Paul Turner
University of Oxford
Liverpool School of Tropical Medicine
Mahidol University
Nagasaki University
University of Colorado Health Sciences Center
Cambodia Oxford Medical Research Unit
Angkor Hospital for Children
Keywords: Medicine
Issue Date: 1-May-2018
Citation: Emerging Infectious Diseases. Vol.24, No.5 (2018), 841-851
Abstract: © 2018, Centers for Disease Control and Prevention (CDC). All rights reserved. To determine trends, mortality rates, and costs of antimicrobial resistance in invasive bacterial infections in hospitalized children, we analyzed data from Angkor Hospital for Children, Siem Reap, Cambodia, for 2007-2016. A total of 39,050 cultures yielded 1,341 target pathogens. Resistance rates were high; 82% each of Escherichia coli and Klebsiella pneumoniae isolates were multidrug resistant. Hospital-acquired isolates were more often resistant than community-acquired isolates; resistance trends over time were heterogeneous. K. pneumoniae isolates from neonates were more likely than those from nonneonates to be resistant to ampicillin-gentamicin and third-generation cephalosporins. In patients with community-acquired gram-negative bacteremia, third-generation cephalosporin resistance was associated with increased mortality rates, increased intensive care unit admissions, and 2.26-fold increased healthcare costs among survivors. High antimicrobial resistance in this setting is a threat to human life and the economy. In similar low-resource settings, our methods could be reproduced as a robust surveillance model for antimicrobial resistance.
ISSN: 10806059
Appears in Collections:Scopus 2018

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