Healthcare-associated infections (HCAI) are a worldwide threat in intensive care units particularly in the pediatric intensive care units with a major cause of morbidity and mortality among this age group. The aim of the study is to determine the prevalence and risk factors predisposing to multidrug-resistant organisms (MDROs) infections among pediatric intensive care unit (PICU) patients at Ain Shams Pediatric University Hospitals as well as determining mortality and morbidity rates along with the length of stay at PICU. Culture results revealed that of the 282 patients evaluated, only 26 (9.2%) were MDROs (half of the affected patients had Acinetobacter species (50%) and the rest of them were free, 256 (90.8%). Our study revealed that the majority of MDROs were isolated from sputum in more than half of the patients 19/32 (59.3%) followed by whole blood in 10/32 (31.2%) and urine in 3/32 (9.4%). Pulmonary system was the most common affected site and was mainly colonized by MDR Acinetobacter (71.4%) followed by MDR Klebsiella (41.6%). Regarding MDR risk factors in our PICU, multivariate logistic regression analyses showed significant relationship between MDROs and age under 1 year (odds ratio [OR] 2.4554; 95% confidence interval [95% CI] (1.072–5.625); p = 0.043) and underlying pulmonary disease (OR 2.417; 95% CI (1.014–5.761); p = 0.592). A statistically significant higher mortality was detected in patients colonized with MDROs 9/26 (34.6%) versus MDROs non-colonized patients 32/256 (12.5%) [P=0.002]. Moreover, MDROs infection has negative significant risk with discharged patients ([OR] 0.269; [95% CI] (0.111–0.656); p = 0.002). Additionally, patients infected with MDROs did have significantly greater PICU stay than those non-infected [median (IQR), 16.5 (10.7–22), 5 (4–8), P=0.00] and have longer ventilation [median (IQR), 15.5 (10–18), 3 (2–10), P=0.00]. Prevalence of MDROs (9.2%) was low among PICU cases at Ain Shams University Hospitals. Most common MDROs were Acinetobacter and Klebsiella followed by pseudomonas species. The frequency of gram-negative organisms is much more common than gram-positive organisms. An increasing rate of antimicrobial resistance with increasing mortality and morbidity among PICU patients is observed worldwide; even for new categories, so, strict infection control programs should be implemented.

中文翻译：

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新出现的多重耐药菌的发生率及其对儿科重症监护结果的影响

医疗保健相关感染 (HCAI) 是重症监护病房的全球威胁，尤其是儿科重症监护病房，是该年龄段发病率和死亡率的主要原因。该研究的目的是确定艾因夏姆斯儿科大学医院儿科重症监护病房 (PICU) 患者中易患多重耐药菌 (MDRO) 感染的患病率和危险因素，并确定死亡率和发病率以及病程长短。留在PICU。培养结果显示，在接受评估的 282 名患者中，只有 26 名 (9.2%) 是 MDRO（受影响的患者中有一半患有不动杆菌属（50%），其余的患者是游离的，256 名（90.8%）。我们的研究表明，大多数 MDRO 是从超过一半患者的痰液中分离出来的 19/32 (59. 3%)，其次是全血 10/32 (31.2%) 和尿液 3/32 (9.4%)。肺系统是最常见的感染部位，主要定植于耐多药不动杆菌 (71.4%)，其次是耐多药克雷伯菌 (41.6%)。关于我们 PICU 中的 MDR 风险因素，多变量逻辑回归分析显示 MDRO 与 1 岁以下年龄之间存在显着关系（优势比 [OR] 2.4554；95% 置信区间 [95% CI] (1.072–5.625)；p = 0.043）和潜在的肺部疾病（OR 2.417；95% CI (1.014–5.761)；p = 0.592）。MDROs 9/26 (34.6%) 定植患者与 MDROs 非定植患者 32/256 (12.5%) 相比，死亡率具有统计学意义[P=0.002]。此外，MDROs 感染对出院患者具有显着负风险（[OR] 0.269；[95% CI] (0.111–0.656)；p = 0.002）。此外，感染 MDRO 的患者确实比未感染患者的 PICU 停留时间显着更长 [中值 (IQR)，16.5 (10.7-22)，5 (4-8)，P=0.00] 并且通气时间更长[中值 (IQR)，15.5 (10–18), 3 (2–10), P=0.00]。在艾因夏姆斯大学医院的 PICU 病例中，MDRO 的患病率 (9.2%) 较低。最常见的 MDRO 是不动杆菌属和克雷伯菌属，其次是假单胞菌属。革兰氏阴性生物的频率比革兰氏阳性生物要常见得多。在全球范围内观察到，随着 PICU 患者死亡率和发病率的增加，抗菌素耐药性的比率不断增加；即使是新类别，也应实施严格的感染控制计划。5 (10–18), 3 (2–10), P=0.00]。在艾因夏姆斯大学医院的 PICU 病例中，MDRO 的患病率 (9.2%) 较低。最常见的 MDRO 是不动杆菌属和克雷伯菌属，其次是假单胞菌属。革兰氏阴性生物的频率比革兰氏阳性生物要常见得多。在全球范围内观察到，随着 PICU 患者死亡率和发病率的增加，抗菌素耐药性的比率不断增加；即使是新类别，也应实施严格的感染控制计划。5 (10–18), 3 (2–10), P=0.00]。在艾因夏姆斯大学医院的 PICU 病例中，MDRO 的患病率 (9.2%) 较低。最常见的 MDRO 是不动杆菌属和克雷伯菌属，其次是假单胞菌属。革兰氏阴性生物的频率比革兰氏阳性生物要常见得多。在全球范围内观察到，随着 PICU 患者死亡率和发病率的增加，抗菌素耐药性的比率不断增加；即使是新类别，也应实施严格的感染控制计划。在全球范围内观察到，随着 PICU 患者死亡率和发病率的增加，抗菌素耐药性的比率不断增加；即使是新类别，也应实施严格的感染控制计划。在全球范围内观察到，随着 PICU 患者死亡率和发病率的增加，抗菌素耐药性的比率不断增加；即使是新类别，也应实施严格的感染控制计划。