TABLE 8.
Percent of Pathogens Reported from Pediatric Surgical Site Infections (SSIs) that Tested Resistant to Selected Antimicrobial Agents, by Type of Surgery, 2011–2014a
| Pathogen, antimicrobial |
Abdominalb |
Orthopedicc |
Neurologicald |
||||||
|---|---|---|---|---|---|---|---|---|---|
| No. of Isolates Reported |
% Testede |
% Resistantf |
No. of Isolates Reported |
% Testede |
% Resistantf |
No. of Isolates Reported |
% Testede |
% Resistantf |
|
| Escherichia coli | 448 | 50 | 17 | ||||||
| ESC4 | 73.9 | 13.9 | 86.0 | 16.3 | … | … | |||
| FQ3 | 85.9 | 14.0 | 86.0 | 7.0 | … | … | |||
| Carbapenems | 59.2 | 0.8 | 54.0 | 3.7 | … | … | |||
| MDR1 | 87.7 | 3.8 | 88.0 | 2.3 | … | … | |||
| Pseudomonas aeruginosa | 128 | 56 | 28 | ||||||
| AMINOS | 96.9 | 4.8 | 100 | 1.8 | 96.4 | 11.1 | |||
| ESC2 | 96.9 | 14.5 | 89.3 | 14.0 | 96.4 | 11.1 | |||
| FQ2 | 90.6 | 3.4 | 92.9 | 1.9 | … | … | |||
| Carbapenems | 75.8 | 7.2 | 71.4 | 0.0 | 78.6 | 4.5 | |||
| PIP/PIPTAZ | 84.4 | 4.6 | 71.4 | 0.0 | 85.7 | 12.5 | |||
| MDR2 | 97.7 | 4.0 | 92.9 | 0.0 | 96.4 | 3.7 | |||
| Staphylococcus aureus | 122 | 205 | 138 | ||||||
| OX/METH/CEFOX | 96.7 | 30.5 | 96.6 | 29.3 | 94.2 | 26.2 | |||
| Enterobacter spp | 108 | 33 | 29 | ||||||
| ESC4 | 94.4 | 35.3 | 93.9 | 22.6 | 93.1 | 22.2 | |||
| Carbapenems | 73.1 | 1.3 | 60.6 | 0.0 | 72.4 | 0.0 | |||
| MDR1 | 90.7 | 3.1 | 93.9 | 6.5 | 79.3 | 0.0 | |||
| Enterococcus faecalis | 99 | 16 | 10 | ||||||
| Ampicillin | 75.8 | 0.0 | … | … | … | … | |||
| Vancomycin | 94.9 | 0.0 | … | … | … | … | |||
| Enterococcus sppg | 80 | 6 | 1 | ||||||
| Ampicillin | 67.5 | 7.4 | … | … | … | … | |||
| Vancomycin | 77.5 | 3.2 | … | … | … | … | |||
| Klebsiella pneumoniae/oxytoca | 59 | 25 | 21 | ||||||
| ESC4 | 74.6 | 15.9 | 92.0 | 4.3 | … | … | |||
| Carbapenems | 69.5 | 4.9 | … | … | … | … | |||
| MDR1 | 89.8 | 5.7 | 96.0 | 0.0 | … | … | |||
| Enterococcus faecium | 28 | 2 | 1 | ||||||
| Ampicillin | 75 | 42.9 | … | … | … | … | |||
| Vancomycin | 85.7 | 29.2 | … | … | … | … | |||
note. AMINOS, aminoglycosides (amikacin, gentamicin, tobramycin); carbapenems (imipenem, meropenem, doripenem); ESC2, extended-spectrum cephalosporin (cefepime, ceftazidime); ESC4, extended-spectrum cephalosporin (cefepime, cefotaxime, ceftazidime, ceftriaxone); FQ2, fluoroquinolones (ciprofloxacin, levofloxacin); FQ3, fluoroquinolones (ciprofloxacin, levofloxacin, moxifloxacin); MDR1, multidrug resistance, must test either ‘I’ or ‘R’ to at least 1 drug in 3 of the 5 classes (ESC4, FQ3, AMINOS, carbapenems, and PIP/PIPTAZ); OX/METH/CEFOX, oxacillin/methicillin/cefoxitin; MDR2, multidrug resistance, must test either ‘I’ or ‘R’ to at least 1 drug in 3 of the 5 classes (ESC2, FQ2, AMINOS, carbapenems, and PIP/PIPTAZ); PIP, piperacillin; PIPTAZ, piperacillin/tazobactam.
Breast, kidney and vascular surgeries had insufficient numbers for reporting, while cardiac and ob/gyn surgeries had sufficient isolates tested for Staphylococcus aureus only: cardiac (n = 173, 95.4% tested, 21.2% resistant), ob/gyn (n = 31, 93.5% tested, 44.8% resistant).
Appendectomy, bile duct, liver, or pancreatic surgery, gallbladder surgery, colon surgery, gastric surgery, herniorrhaphy, small bowel surgery, spleen surgery, abdominal surgery, and rectal surgery.
Open reduction of fracture, hip prosthesis, knee prosthesis, limb amputation, spinal fusion, refusion of spine, and laminectomy.
Craniotomy and ventricular shunt.
If the percentage of isolates tested is <70%, caution should be used when interpreting the percent resistance.
Percent resistance is only calculated when at least 20 isolates have been tested. A (…) in percent tested and percent resistance column indicates that fewer than 20 isolates were tested.
Non-faecalis, non-faecium.