Table 10.
Percentage of Pathogens Reported from Pediatric Central Line-Associated Bloodstream Infections (CLABSIs) that Tested Nonsusceptiblea (NS) to Selected Antimicrobial Agents by Location Type,b 2015–2017
| Pathogen, Antimicrobial | NICUsb | Pediatric ICUs | Pediatric Oncology Units | Pediatric Wardsb | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| No. Reported | % Tested | % NSa | No. Reported | % Tested | % NSa | No. Reported | % Tested | % NSa | No. Reported | % Tested | % NSa | |
| Staphylococcus aureus | 1,381 | 420 | 266 | 313 | ||||||||
| OX/CEFOX/METH (MRSA) | 92.8 | 27.6 | 90.2 | 31.1 | 91.0 | 23.6 | 92.7 | 26.2 | ||||
| Enterococcus faecium | 12 | 92 | 117 | 63 | ||||||||
| Vancomycin (VRE) | 91.7 | . . . | 91.3 | 42.9 | 98.3 | 54.8* | 85.7 | 33.3 | ||||
| Enterococcus faecalis | 483 | 492 | 179 | 264 | ||||||||
| Vancomycin (VRE) | 92.8 | 0.2 | 90.0 | 0.2 | 90.5 | 0.6 | 90.2 | 0.0 | ||||
| Selected Klebsiella spp | 408 | 368 | 374 | 375 | ||||||||
| ESCs | 85.5 | 6.6* | 88.6 | 13.2 | 88.5 | 22.7* | 86.7 | 12.0 | ||||
| Carbapenems (CRE) | 76.2 | 0.0 | 82.1 | 3.3* | 80.2 | 3.0* | 73.9 | 0.7 | ||||
| MDR | 90.4 | 1.6 | 92.1 | 6.5 | 90.6 | 10.3* | 91.2 | 4.1 | ||||
| Escherichia coli | 596 | 151 | 429 | 205 | ||||||||
| ESCs | 84.6 | 7.5* | 91.4 | 22.5 | 93.5 | 33.7* | 82.4 | 22.5 | ||||
| Carbapenems (CRE) | 74.0 | 0.5 | 84.1 | 2.4 | 87.4 | 1.1 | 75.6 | 0.6 | ||||
| FQs | 78.2 | 22.7 | 85.4 | 25.6 | 87.4 | 38.1* | 84.9 | 26.4 | ||||
| MDR | 90.8 | 3.3* | 92.7 | 12.1 | 93.5 | 20.0* | 88.8 | 9.3 | ||||
| Enterobacter spp | 229 | 278 | 218 | 191 | ||||||||
| Cefepime | 70.7 | 4.9 | 85.3 | 9.3 | 77.5 | 14.2 | 79.1 | 9.9 | ||||
| Carbapenems (CRE) | 82.5 | 1.6 | 85.6 | 3.4 | 83.0 | 5.0 | 77.0 | 2.7 | ||||
| MDR-2 | 89.5 | 0.5* | 92.4 | 2.7 | 88.5 | 6.7 | 92.1 | 5.1 | ||||
| Pseudomonas aeruginosa | 156 | 167 | 173 | 78 | ||||||||
| AMINOs | 91.7 | 7.0 | 94.6 | 10.8 | 96.0 | 4.2* | 94.9 | 12.2 | ||||
| ESCs-2 | 91.0 | 7.0* | 94.6 | 22.2 | 95.4 | 15.8 | 91.0 | 16.9 | ||||
| FQs-2 | 76.3 | 1.7* | 88.6 | 11.5 | 86.1 | 13.4 | 91.0 | 11.3 | ||||
| Carbapenems-2 | 75.6 | 5.1 | 85.0 | 19.7 | 90.2 | 16.7 | 79.5 | 11.3 | ||||
| PIP/PIPTAZ | 85.9 | 5.2 | 83.8 | 19.3 | 89.6 | 15.5 | 83.3 | 12.3 | ||||
| MDR-3 | 91.0 | 2.8 | 94.6 | 12.0 | 96.0 | 6.0 | 93.6 | 5.5 | ||||
| Acinetobacter spp | 47 | 43 | 24 | 29 | ||||||||
| Carbapenems-2 | 72.3 | 0.0 | 90.7 | 2.6 | 70.8 | . . . | 72.4 | 0.0 | ||||
| MDR-4 | 87.2 | 4.9 | 100.0 | 9.3 | 95.8 | 13.0 | 86.2 | 8.0 | ||||
Note. Selected Klebsiella spp, K. oxytoca and K. pneumoniae; NICUs, neonatal intensive care units; ICUs, intensive care units; OX/CEFOX/METH, oxacillin, cefoxitin, or methicillin; MRSA, methicillin-resistant Staphylococcus aureus; VRE, vancomycin-resistant Enterococcus; ESCs, extended-spectrum cephalosporins (cefepime, cefotaxime, ceftazidime, or ceftriaxone); CRE, carbapenem-resistant Enterobacteriaceae (imipenem, meropenem, doripenem, or ertapenem); MDR, multidrug-resistant (NS to 1 drug in at least 3 of the following classes: ESCs, FQs, AMINOs, carbapenems (R only), PIPTAZ); MDR-2, multidrug-resistant (NS to 1 drug in at least 3 of the following classes: cefepime, FQs, AMINOs, carbapenems (R only), PIPTAZ); FQs, fluoroquinolones (ciprofloxacin, levofloxacin, or moxifloxacin); AMINOs, aminoglycosides (amikacin, gentamicin, or tobramycin); ESCs-2, extended-spectrum cephalosporins (cefepime or ceftazidime); FQs-2, fluoroquinolones (ciprofloxacin or levofloxacin); PIP, piperacillin; PIPTAZ, piperacillin/tazobactam; Carbapenems-2, imipenem, meropenem, or doripenem; MDR-3, multidrug-resistant (NS to 1 drug in at least 3 of the following classes: ESCs-2, FQs-2, AMINOs, carbapenems-2, PIP/PIPTAZ); MDR-4, multidrug-resistant (NS to 1 drug in at least 3 of the following classes: ESCs-2, FQs-2, AMINOs, carbapenems-2, PIP/PIPTAZ, ampicillin/sulbactam).
Statistically significantly different than %NS in pediatric wards; P < .05.
MRSA, VRE, and CRE data are presented as %R (ie, includes only those pathogens that tested resistant). All other phenotypes are shown as %NS (ie, includes pathogens that tested intermediate or resistant). This metric is only calculated when at least 20 isolates have been tested.
Location types are mutuallyexclusive. NICUs are classified by NHSN location codes as level II/III and level III NICUs. ‘Pediatric wards’ includes step-down units, mixed acuityunits, and specialty care areas.