Andrew Fox-LewisJunko TakataThyl MiliyaYoel LubellSona SoengPoda SarKolthida RithGregor McKellarVanaporn WuthiekanunErin McGonagleNicole StoesserCatrin E. MooreChristopher M. ParryClaudia TurnerNicholas P.J. DayBen S. CooperPaul TurnerUniversity of OxfordLiverpool School of Tropical MedicineMahidol UniversityNagasaki UniversityUniversity of Colorado Health Sciences CenterCambodia Oxford Medical Research UnitAngkor Hospital for Children2019-08-282019-08-282018-05-01Emerging Infectious Diseases. Vol.24, No.5 (2018), 841-85110806059108060402-s2.0-85045653834https://repository.li.mahidol.ac.th/handle/123456789/46731© 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.Mahidol UniversityMedicineArticleSCOPUS10.3201/eid2405.171830