ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2024
Characterization of Gram-negative Bloodstream Infections in Hospitalized Australian Children and Their Clinical Outcomes.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Empirical Antibiotic Activity and Outcomes in Pediatric Gram-negative Bloodstream Infections: A Rank-based Composite Outcome Analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Antimicrobial Resistance in Pediatric Infections: Current Status, Challenges, and Future Directions.Antibiotics (Basel, Switzerland) · 2026Review
- Comparative evaluation of BacT/ALERT PF Plus and PF pediatric blood culture bottles: A dual in vitro and clinical retrospective study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Gram-negative bloodstream infections in pediatric patients: antimicrobial resistance and factors associated with mortality.Frontiers in pediatrics · 2026Article
- Molecular determinants ofFrontiers in cellular and infection microbiology · 2026Article
- Neonatal and pediatric sepsis: Microbiological insights, diagnostic innovations, and antimicrobial challenges.World journal of clinical pediatrics · 2025Review
- Drug-resistant gram-negative bacterial infections in children in the Oceania region: review of the epidemiology, antimicrobial availability, treatment, clinical trial and pharmacokinetic data, and key evidence gaps.The Lancet regional health. Western Pacific · 2025Review
- Clinical and microbiological characteristics of bacteremia in pediatric intensive care unit: a retrospective analytical observational study.BMC pediatrics · 2025Observational
- COVID-19 pandemic increased ESKAPEEc bloodstream infections and amplified carbapenem resistance in Chinese children: a multicenter surveillance study (2016-2023).Frontiers in cellular and infection microbiology · 2025Article
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21 authors.
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Abstract
backgroundGram-negative bloodstream infections (GNBSIs) more commonly occur in children with comorbidities and are increasingly associated with antimicrobial resistance. There are few large studies of GNBSIs in children that relate the clinical presentation, pathogen characteristics, and outcomes.
methodsA 3-year prospective study of GNBSIs in children aged <18 years was conducted in 5 Australian children's hospitals between 2019 and 2021. The clinical characteristics, disease severity, and outcomes were recorded. Causative pathogens underwent antibiotic susceptibility testing and whole genome sequencing.
resultsThere were 931 GNBSI episodes involving 818 children. Median age was 3 years (interquartile range, 0.6-8.5). A total of 576/931 episodes (62%) were community onset, though 661/931 (71%) occurred in children with comorbidities and a central venous catheter was present in 558/931 (60%). Central venous catheter (145/931) and urinary tract (149/931) were the most common sources (16% each). One hundred of 931 (11%) children required intensive care unit admission and a further 11% (105/931) developed GNBSIs in intensive care unit. A total of 659/927 (71%) isolates were Enterobacterales, of which 22% (138/630) were third-generation cephalosporin resistant (3GCR). Extended spectrum beta-lactamase genes were confirmed in 65/138 (47%) 3GCR Enterobacterales. Most common extended spectrum beta-lactamase genes were blaCTX-M-15 (34/94, 36%) and blaSHV-12 (10/94, 11%). There were 48 deaths overall and 30-day in-hospital mortality was 3% (32/931). Infections with 3GCR Enterobacterales were independently associated with higher mortality (adjusted odds ratio, 3.2; 95% confidence interval, 1.6-6.4).
conclusionsGNBSIs in children are frequently healthcare associated and affect children younger than age 5 years. Infections with 3GCR Enterobacterales were associated with worse outcomes. These findings will inform optimal management guidelines and help prioritize future antimicrobial clinical trials.
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