Resistance to antibiotics tied to patient age, healthcare setting: analysis

Antibiotic drug resistance isn't universal — it varies by the age of the patient and the healthcare setting, according to a study published Jan. 2 in JAC-Antimicrobial Resistance.

With an eye on 22 of the most antibiotic-resistant bacterial pathogens and the 41 antibiotic drugs available to treat them, researchers at Kansas City, Mo.-based Children's Mercy Hospital analyzed EHR data on antimicrobial susceptibility reported by 144 healthcare facilities between 2012 and 2017, according to CIDRAP News.

Researchers analyzed the resistance levels of each pathogen and related antibiotic in four groups: adults, children under 17, youth in pediatric settings, and youth in facilities that treat all ages of patients. Researchers reported the antibiotic resistance rates in children and adults were influenced by healthcare setting and age. 

An example of how a pathogen responds differently in varying age categories and treatment centers can be found in an analysis of Enterobacter cloacae, a bacterial infection known to be resistant to ertapenem. Isolates in children who took ertapenem to treat Enterobacter cloacae increased considerably over the study period as compared with adults (0.7 percent to 9.8 percent for children versus 2.1 percent to 2.8 percent for adults). Additionally, isolates in the children treated in pediatric healthcare facilities increased significantly compared with facilities treating patients of all ages (0.1 percent to 27.1 percent versus 0.9 percent to 3.8 percent).

"These patterns highlight the growing problem of bacteria developing resistance to first-line therapies segmented by age and the type of care setting," the study authors wrote. "These trends are especially concerning for emergency department providers, because they are often the first point of contact for individuals presenting with these diseases and must make empirical antibiotic selections. Failure to identify and properly treat these organisms can have a devastating impact on patient outcomes."

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