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Patterns and trends of pediatric bloodstream infections: a 7-year surveillance study

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Abstract

We characterize the epidemiology of pediatric bloodstream infections (BSIs) in Switzerland. We analyzed pathogen distribution and resistance patterns in monomicrobial and polymicrobial BSIs in children from 2008 to 2014 using data from the Swiss antibiotic resistance centre (ANRESIS). A confirmatory statistical analysis was performed comparing pathogens and resistance across 20 acute care hospitals. We identified 3,067 bacteremia episodes, of which 1,823 (59 %) were considered true BSI episodes. Overall, S. aureus (16.5 %, 300) was the most frequent pathogen, followed by E. coli (15.1 %, 276), coagulase-negative staphylococci (CoNS, 12.9 %, 235), S. pneumoniae (11.1 %, 202) and non-E. coli Enterobacteriaceae (8.7 %, 159). S. aureus and E. coli showed similar frequencies in all of the variables analyzed (e.g., hospital acquisition, hospital type, medical specialty). The proportion of these microorganisms did not change over time, resistance rates remained low (4.3 % methicillin resistance in S. aureus; 7.3 % third-/fourth-generation cephalosporin resistance in E. coli), and no significant resistance trends were observed. We observed a 50 % increase of CoNS BSIs from 2008 (9.8 %, 27) to 2014 (15.2 %, 46, p value for trend = 0.03). S. pneumoniae decreased from 17.5 % (48) to 6.6 % (20) during that timeframe (p for trend = 0.007). S. aureus and E. coli remained the most significant pathogens among pediatric BSIs in Switzerland, exhibiting low resistance rates. CoNS accounted for a greater proportion of BSIs over time. The decrease in bacteremic pneumococcal infections can likely be attributed to the introduction of the 13-valent conjugate vaccine in 2011.

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Acknowledgements

We thank all the microbiology laboratories participating in the ANRESIS network: Institute for Laboratory Medicine, Cantonal Hospital Aarau; Central Laboratory, Microbiology Section, Cantonal Hospital Baden; Clinical Microbiology, University Hospital Basel; Viollier AG, Basel; Laboratory Medicine EOLAB, Department of Microbiology, Bellinzona; Institute for Infectious Diseases, University Bern; Microbiology Laboratory, Unilabs, Coppet; Central Laboratory, Cantonal Hospital Graubünden; Microbiology Laboratory, Hospital Thurgau; Microbiology Laboratory Hôpital Fribourgeois, Fribourg; Bacteriology Laboratory, Geneva University Hospitals, Geneva; ADMED Microbiology, La Chaux-de-Fonds; Institute for Microbiology, Université de Lausanne; Centre for Laboratory Medicine, Cantonal Hospital Luzern; Centre for Laboratory Medicine, Cantonal Hospital Schaffhausen; Centre for Laboratory Medicine Dr Risch, Schaan; Central Institute, Hôpitaux Valaisans (ICHV), Sitten; Centre of Laboratory Medicine St Gallen; Institute for Medical Microbiology, University Hospital Zürich; Laboratory for Infectious Diseases, University Children’s Hospital Zürich

We also thank the steering committee of the ANRESIS network.

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    Authors and Affiliations

    1. Department of Infectious Diseases, University Hospital Bern, Freiburgstrasse 3010, Bern, Switzerland

      N. Buetti, A. Atkinson, L. Kottanattu & J. Marschall

    2. Paediatric Pharmacology Department, University of Basel Children’s Hospital Basel, Basel, Switzerland

      J. Bielicki

    3. Institute for Infectious Diseases, University of Bern, Bern, Switzerland

      A. Kronenberg

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    1. N. Buetti
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    2. A. Atkinson
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    3. L. Kottanattu
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    Consortia

    the Swiss Centre for Antibiotic resistance (ANRESIS)

    • R. Auckenthaler
    • , A. Cherkaoui
    • , M. Dolina
    • , O. Dubuis
    • , R. Frei
    • , D. Koch
    • , A. Kronenberg
    • , S. Leib
    • , S. Luyet
    • , P. Nordmann
    • , V. Perreten
    • , J. -C. Piffaretti
    • , G. Prod’hom
    • , J. Schrenzel
    •  & A. F. Widmer

    Corresponding author

    Correspondence to N. Buetti.

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    Funding

    The ANRESIS database is funded by the Federal Office of Public Health, the Conference of Cantonal Health Ministers, and the University of Bern, Switzerland.

    Conflicts of interest

    The authors declare that they have no conflicts of interest

    Ethical approval

    This analysis was carried out on routinely collected, anonymous, nongenetic surveillance data; thus, ethical consent was not required according to the Swiss law for research on humans.

    Informed consent

    No clinical data were included

    Additional information

    J. Marschall and A. Kronenberg contributed equally to this work

    Electronic supplementary material

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    Swiss Centre for Antibiotic resistance (ANRESIS)

    Swiss Centre for Antibiotic resistance (ANRESIS)

    R. Auckenthaler, Synlab Suisse, Switzerland; A. Cherkaoui, Bacteriology Laboratory, Geneva University Hospitals, Switzerland; M. Dolina, Department of Microbiology, EOLAB, Bellinzona, Switzerland; O. Dubuis, Viollier AG, Basel, Switzerland; R. Frei, Clinical Microbiology Laboratory, University Hospital Basel, Switzerland; D. Koch, Federal Office of Public Health, Bern, Switzerland; A. Kronenberg, Institute for Infectious Diseases, University of Bern, Switzerland; S. Leib, Institute for Infectious Diseases, University of Bern, Switzerland; S. Luyet, Swiss Conference of the Cantonal Ministers of Public Health, Switzerland; P. Nordmann, Molecular and Medical Microbiology, Department of Medicine, University Fribourg, Switzerland; V. Perreten, Institute of Veterinary Bacteriology, University of Bern, Switzerland; J.-C. Piffaretti, Interlifescience, Massagno, Switzerland; G. Prod’hom, Institute of Microbiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; J. Schrenzel, Bacteriology Laboratory, Geneva University Hospitals, Geneva, Switzerland; A.F. Widmer, Division of Infectious Diseases and Hospital Epidemiology, University of Basel, Switzerland; G. Zanetti, Service of Hospital Preventive Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; R. Zbinden, Institute of Medical Microbiology, University of Zürich, Switzerland.

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    Buetti, N., Atkinson, A., Kottanattu, L. et al. Patterns and trends of pediatric bloodstream infections: a 7-year surveillance study. Eur J Clin Microbiol Infect Dis 36, 537–544 (2017). https://doi.org/10.1007/s10096-016-2830-6

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