ArticleFrontiers in pediatrics2026
Gram-negative bloodstream infections in pediatric patients: antimicrobial resistance and factors associated with mortality.
Article in Frontiers in pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Gram-negative bloodstream infections (BSIs) are associated with substantial morbidity and mortality in pediatric patients, particularly among critically ill children. Increasing antimicrobial resistance among Gram-negative pathogens has further complicated empirical treatment strategies and limited therapeutic options. This study aimed to evaluate antimicrobial resistance patterns and factors associated with mortality in pediatric patients with Gram-negative BSIs. Methods: This retrospective cohort study included pediatric patients aged 0-18 years with laboratory-confirmed Gram-negative BSIs diagnosed between January 2022 and September 2025 at a tertiary care center. Demographic characteristics, invasive procedures, laboratory findings, antimicrobial susceptibility profiles, treatment-related variables, and clinical outcomes were analyzed. Factors associated with all-cause in-hospital mortality were evaluated using an exploratory multivariable logistic regression model. Results: A total of 252 pediatric patients were included. Klebsiella spp. (46.4%) and Acinetobacter spp. (28.6%) were the most frequently isolated pathogens. High resistance rates were observed for gentamicin (58.3%), ciprofloxacin (57.1%), imipenem (56.0%), and meropenem (48.4%). Ceftazidime-avibactam resistance was significantly associated with study year ( Conclusions: Gram-negative BSIs in pediatric patients were associated with substantial antimicrobial resistance and considerable all-cause in-hospital mortality. The increase in ceftazidime-avibactam resistance should be interpreted cautiously because molecular characterization was not performed. Continuous local surveillance, antimicrobial stewardship, and infection prevention strategies are important, particularly in high-risk neonatal and pediatric intensive care populations.
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