Table 2.
Antimicrobial Resistance Profiles of Selected Bloodstream Pathogens for Children ≤5 Years, by Period
| Pathogen | Time Period | Antimicrobial Resistance | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Ampicillin | Penicillin | Ceftriaxone | Chloramphenicol | Gentamicin | Co-trimoxazole | Ciprofloxacin | |||||||||
| n | % | n | % | n | % | n | % | n | % | n | % | n | % | ||
| S. pneumoniae | 1998–2002 | NT | 91/ 374 | 24.3 | 0a/ 50 | 0 | 56/ 374 | 15.0 | NT | 314/ 364 | 82.3 | NT | |||
| 2003–2007 | NT | 73/ 420 | 17.4 | 0a/ 421 | 0 | 72/ 418 | 17.2 | NT | 387/ 411 | 94.2 | NT | ||||
| 2008–2012 | NT | 29/ 164 | 17.7 | 0a/ 166 | 0 | 21/ 164 | 17.7 | NT | 153/ 166 | 92.3 | NT | ||||
| 2013–2017 | NT | 15/ 49 | 30.6 | 0a/ 48 | 0 | 15/ 49 | 30.6 | NT | 46/49 | 93.9 | NT | ||||
| S. aureus b | 1998–2002 | NT | 227/ 245 | 92.7 | NT | 97/ 241 | 40.2 | 27c/ 236 | 11.4 | 127/ 244 | 52.0 | NT | |||
| 2003–2007 | NT | 245/ 262 | 93.5 | NT | 85/ 269 | 31.6 | 28c/ 222 | 12.6 | 137/ 265 | 51.7 | NT | ||||
| 2008–2012 | NT | 47/ 57 | 82.5 | NT | 29/ 181 | 16.0 | 20c/ 160 | 12.5 | 78/ 180 | 43.3 | NT | ||||
| 2013–2017 | NT | NT | NT | 12/ 253 | 4.7 | 20c/ 224 | 8.9 | 96/ 253 | 37.9 | NT | |||||
| Enterococcus spp. | 1998–2002 | 1/ 9 | 11.1 | 16/ 27 | 59.3 | NT | 14/ 30 | 46.7 | 20/ 22 | 90.9 | 17/ 31 | 54.8 | NT | ||
| 2003–2007 | 5/ 44 | 11.4 | 28/ 32 | 87.5 | NT | 38/ 62 | 61.3 | 8/ 8 | 100 | 33/ 61 | 54.1 | NT | |||
| 2008–2012 | 17/ 38 | 44.7 | 2/ 2 | 100 | NT | 33/ 47 | 70.2 | 2/ 3 | 66.7 | 40/ 44 | 90.9 | NT | |||
| 2013–2017 | 69/ 99 | 69.7 | NT | NT | 74/ 98 | 75.5 | 1/ 1 | 100 | 73/ 98 | 74.5 | NT | ||||
| E. coli | 1998–2002 | 222/ 246 | 90.2 | NT | 4/ 36 | 11.1 | 172/ 243 | 70.8 | 48/ 244 | 19.7 | 213/ 242 | 88.0 | 0/ 113 | 0 | |
| 2003–2007 | 237/ 272 | 87.1 | NT | 14/ 237 | 5.9 | 178/ 277 | 64.3 | 74/ 274 | 27.0 | 244/ 271 | 90.0 | 9/ 275 | 3.3 | ||
| 2008–2012 | 147/ 162 | 90.7 | NT | 24/ 154 | 15.6 | 99/ 162 | 61.1 | 57/ 161 | 35.4 | 150/ 162 | 92.6 | 23/ 161 | 14.3 | ||
| 2013–2017 | 147/ 163 | 90.2 | NT | 47/ 165 | 28.5 | 72/ 165 | 43.6 | 54/ 165 | 32.7 | 160/ 165 | 97.0 | 43/ 165 | 26.0 | ||
| Klebsiella spp. | 1998–2002 | 178/ 178 | 100 | NT | 4/ 19 | 21.1 | 139/ 177 | 78.5 | 68/ 178 | 38.2 | 149/ 176 | 84.7 | 0/ 73 | 0 | |
| 2003–2007 | 136/ 140 | 97.1 | NT | 18/ 123 | 14.6 | 98/ 139 | 70.5 | 72/ 144 | 50 | 109/ 140 | 77.9 | 11/ 142 | 7.7 | ||
| 2008–2012 | 130/ 131 | 99.2 | NT | 90/ 118 | 76.3 | 85/ 129 | 65.9 | 105/ 130 | 80.8 | 116/ 131 | 88.5 | 26/ 131 | 19.8 | ||
| 2013–2017 | 316/ 316 | 100 | NT | 286/ 316 | 90.5 | 167/ 315 | 53.0 | 282/ 311 | 90.7 | 299/ 315 | 94.9 | 109/ 316 | 34.5 | ||
| Enterobacter spp. | 1998–2002 | 48/ 53 | 90.6 | NT | 100d | 34/ 57 | 59.6 | 19/ 55 | 34.5 | 36/ 56 | 64.3 | 1/ 40 | 2.5 | ||
| 2003–2007 | 95/ 122 | 77.9 | NT | 100d | 70/ 131 | 53.4 | 33/ 114 | 28.9 | 79/ 131 | 60.3 | 7/ 119 | 5.9 | |||
| 2008–2012 | 29/ 31 | 93.5 | NT | 100d | 22/ 32 | 68.8 | 21/ 32 | 65.6 | 27/ 32 | 84.4 | 18/ 32 | 56.3 | |||
| 2013–2017 | 126/132 | 95.5 | NT | 100d | 120/ 132 | 90.9 | 101/ 132 | 76.5 | 115/ 132 | 87.1 | 87/ 132 | 65.9 | |||
| Acinetobacter spp. | 1998–2002 | 55/ 83 | 66.3 | NT | 3/ 12 | 25 | 54/ 84 | 64.3 | 30/ 84 | 35.7 | 57/ 85 | 67.1 | 2/ 38 | 5.3 | |
| 2003–2007 | 70/ 95 | 73.7 | NT | 45/ 95 | 47.4 | 82/ 100 | 82 | 43/ 101 | 42.6 | 85/ 98 | 86.7 | 26/ 101 | 25.7 | ||
| 2008–2012 | 25/ 32 | 78.1 | NT | 21/ 31 | 67.7 | 30/ 34 | 88.2 | 16/ 33 | 48.5 | 27/ 35 | 77.1 | 9/ 33 | 27.3 | ||
| 2013–2017 | 45/ 59 | 76.3 | NT | 57/ 59 | 96.6 | 52 /59 | 88.1 | 26/ 59 | 44.1 | 40/ 59 | 67.8 | 27/ 59 | 45.8 | ||
| Pseudomonas spp. | 1998–2002 | NTd | NT | NT | NTe | 6/ 38 | 15.8 | NTd | 0/ 24 | 0 | |||||
| 2003–2007 | NTd | NT | NT | NTe | 20/ 55 | 36.4 | NTd | 2/ 55 | 3.6 | ||||||
| 2008–2012 | NTd | NT | NT | NTe | 8/ 31 | 25.8 | NTd | 5/ 31 | 16.1 | ||||||
| 2013–2017 | NTd | NT | NT | NTe | 12/ 49 | 24.5 | NTd | 8/ 49 | 16.3 | ||||||
| Salmonella Typhi | 1998–2002 | 4/ 7 | 57.1 | NT | 0/ 2 | 0 | 3/ 7 | 42.9 | 100f | 4/ 7 | 57.1 | 0/ 1 | 0 | ||
| 2003–2007 | 2/ 16 | 12.5 | NT | 0/ 16 | 0 | 0/ 16 | 0 | 100f | 0/ 16 | 0 | 0/ 15 | 0 | |||
| 2008–2012 | 37/ 50 | 74 | NT | 0/ 50 | 0 | 37/ 50 | 74 | 100f | 35/ 50 | 70 | 1/ 50 | 2 | |||
| 2013–2017 | 532/ 544 | 97.8 | NT | 0/ 498 | 0 | 526/ 544 | 96.7 | 100f | 533/ 544 | 98.0 | 0/ 544 | 0 | |||
| NTS | 1998–2002 | 1481/ 1603 | 92.4 | NT | 0/ 41 | 0 | 904/ 1609 | 56.1 | 100f | 1430/ 1604 | 89.2 | 1/ 1070 | 0.1 | ||
| 2003–2007 | 1382/ 1488 | 92.9 | NT | 3/ 1142 | 0.3 | 1297/ 1497 | 86.6 | 100f | 1317/ 1437 | 91.6 | 9/ 1495 | 0.6 | |||
| 2008–2012 | 459/ 527 | 87.1 | NT | 2/ 495 | 0.4 | 415/ 526 | 78.9 | 100f | 456/ 528 | 86.4 | 0/ 524 | 0 | |||
| 2013–2017 | 241/ 303 | 79.5 | NT | 3/ 302 | 1.0 | 177/ 303 | 58.4 | 100f | 238/ 303 | 78.5 | 0/ 303 | 0 | |||
| Other Entero- bacteriaceaeg | 1998–2002 | 94/ 102 | 92.2 | NT | 1/ 2 | 50 | 82/ 104 | 78.8 | 26/ 105 | 24.8 | 82/ 105 | 78.1 | 1/ 70 | 1.4 | |
| 2003–2007 | 59/ 69 | 85.5 | NT | 6/ 55 | 10.9 | 43/ 69 | 42.0 | 16/ 70 | 22.9 | 37/ 62 | 59.7 | 8/ 69 | 11.6 | ||
| 2008–2012 | 16/ 24 | 66.7 | NT | 4/ 20 | 20 | 8/ 24 | 33.3 | 6/ 21 | 28.6 | 15/ 24 | 62.5 | 5/ 23 | 21.7 | ||
| 2013–2017 | 33/ 42 | 78.6 | NT | 18/ 42 | 42.9 | 19/ 42 | 45.2 | 13/ 41 | 31.7 | 29/ 41 | 70.7 | 12/ 42 | 28.6 | ||
| Other Gram- negativesh | 1998–2002 | 105/ 145 | 72.4 | 0/ 12 | 0 | 4/ 123 | 3.3 | 75/ 161 | 46.6 | 11/ 159 | 6.9 | 141/ 158 | 89.2 | 1/ 12 | 8.3 |
| 2003–2007 | 54/ 93 | 58.1 | 4/ 23 | 17.4 | 4/ 121 | 0.3 | 64/ 122 | 52.5 | 21/ 118 | 17.8 | 85/ 109 | 78.0 | 5/ 77 | 6.5 | |
| 2008–2012 | 52/ 76 | 68.4 | 5/ 7 | 71.4 | 18/ 109 | 16.5 | 42/ 84 | 50 | 31/ 108 | 28.7 | 64/ 86 | 74.4 | 17/ 70 | 24.3 | |
| 2013–2017 | 44/ 52 | 84.6 | 4/ 9 | 44.4 | 25/ 75 | 33.3 | 31/ 63 | 49.2 | 23/ 57 | 40.4 | 38/ 50 | 76 | 10/ 50 | 20 | |
Abbreviations: NT, not tested; NTS, nontyphoidal Salmonella.
aPneumococcal isolates initially reported as ceftriaxone-resistant were re-tested and found to be susceptible. Based on these, isolates not available for re-testing (9) were considered susceptible.
bMethicillin-resistant Staphylococcus aureus isolates for these periods were: 1998–2002, 0 (0%); 2003–2007, 12 (0.3%); 2008–2012, 20 (1.0%); and 2013–2017, 35 (1.3%).
cNote that gentamicin should not be used alone for S. aureus, even if susceptible.
dAll Enterobacter isolates have been reported resistant to ceftriaxone, in line with British Society of Antimicrobial Chemotherapy (BSAC) guidance.
eAll Pseudomonas isolates have been reported not tested, as these pathogens are intrinsically resistant to ampicillin, chloramphenicol, and co-trimoxazole.
fAll Salmonella isolates have been reported resistant to gentamicin, in line with BSAC guidance.
gIncludes Citrobacter spp., Coliforms, Cronobacter spp., Escherichia spp., Hafnia spp., Kluyvera spp., Morganella spp., Pantoea spp., Proteus spp., Raoultella spp., Serratia spp., Shigella spp., and Yersinia spp.
hIncludes Aeromonas spp., Burkholderia spp., Edwardsiella spp., Flavobacteria, Gram-negative rods, Haemophilus spp., Histophilus spp., Moraxella spp., Neisseria spp., Pasteurella spp., Sphingomonas spp., Stenotrophomonas spp., Vibrio spp., and Xanthomonas spp.