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Article: Available evidence of antibiotic resistance from extended-spectrum β-lactamase-producing Enterobacteriaceae in paediatric patients in 20 countries: a systematic review and meta-analysis

TitleAvailable evidence of antibiotic resistance from extended-spectrum β-lactamase-producing Enterobacteriaceae in paediatric patients in 20 countries: a systematic review and meta-analysis
Authors
KeywordsNeutropenia
Infection
Neutropenic fever
Enterobacteriaceae
Issue Date2019
PublisherWorld Health Organization (WHO): Creative Commons Attribution. The Journal's web site is located at http://www.who.int/bulletin/en/
Citation
Bulletin of the World Health Organization, 2019, v. 97, p. 486-501B How to Cite?
AbstractObjective: To make a systematic review of risk factors, outcomes and prevalence of extended-spectrum β-lactamase-associated infection in children and young adults in South-East Asia and the Western Pacific. Methods: Up to June 2018 we searched online databases for published studies of infection with extended-spectrum β-lactamase-producing Enterobacteriaceae in individuals aged 0–21 years. We included case–control, cohort, cross-sectional and observational studies reporting patients positive and negative for these organisms. For the meta-analysis we used random-effects modelling of risk factors and outcomes for infection, and meta-regression for analysis of subgroups. We mapped the prevalence of these infections in 20 countries and areas using available surveillance data. Findings: Of 6665 articles scanned, we included 40 studies from 11 countries and areas in the meta-analysis. The pooled studies included 2411 samples testing positive and 2874 negative. A higher risk of infectionwith extended-spectrum β-lactamase-producing bacteria was associated with previous hospital care, notably intensive care unit stays (pooled odds ratio, OR: 6.5; 95% confidence interval, CI: 3.04 to 13.73); antibiotic exposure (OR: 4.8; 95% CI: 2.25 to 10.27); and certain co-existing conditions. Empirical antibiotic therapy was protective against infection (OR: 0.29; 95% CI: 0.11 to 0.79). Infected patients had longer hospital stays (26 days; 95% CI: 12.81 to 38.89) and higher risk of death (OR: 3.2; 95% CI: 1.82 to 5.80). The population prevalence of infection was high in these regions and surveillance data for children were scarce. Conclusion: Antibiotic stewardship policies to prevent infection and encourage appropriate treatment are needed in South-East Asia and the Western Pacific.
DescriptionLink to Open access
Persistent Identifierhttp://hdl.handle.net/10722/274527
ISSN
2017 Impact Factor: 6.361
2015 SCImago Journal Rankings: 2.819
PubMed Central ID

 

DC FieldValueLanguage
dc.contributor.authorHu, YJ-
dc.contributor.authorOgyu, A-
dc.contributor.authorCowling, BJ-
dc.contributor.authorFukuda, K-
dc.contributor.authorPang, HH-
dc.date.accessioned2019-08-18T15:03:27Z-
dc.date.available2019-08-18T15:03:27Z-
dc.date.issued2019-
dc.identifier.citationBulletin of the World Health Organization, 2019, v. 97, p. 486-501B-
dc.identifier.issn0042-9686-
dc.identifier.urihttp://hdl.handle.net/10722/274527-
dc.descriptionLink to Open access-
dc.description.abstractObjective: To make a systematic review of risk factors, outcomes and prevalence of extended-spectrum β-lactamase-associated infection in children and young adults in South-East Asia and the Western Pacific. Methods: Up to June 2018 we searched online databases for published studies of infection with extended-spectrum β-lactamase-producing Enterobacteriaceae in individuals aged 0–21 years. We included case–control, cohort, cross-sectional and observational studies reporting patients positive and negative for these organisms. For the meta-analysis we used random-effects modelling of risk factors and outcomes for infection, and meta-regression for analysis of subgroups. We mapped the prevalence of these infections in 20 countries and areas using available surveillance data. Findings: Of 6665 articles scanned, we included 40 studies from 11 countries and areas in the meta-analysis. The pooled studies included 2411 samples testing positive and 2874 negative. A higher risk of infectionwith extended-spectrum β-lactamase-producing bacteria was associated with previous hospital care, notably intensive care unit stays (pooled odds ratio, OR: 6.5; 95% confidence interval, CI: 3.04 to 13.73); antibiotic exposure (OR: 4.8; 95% CI: 2.25 to 10.27); and certain co-existing conditions. Empirical antibiotic therapy was protective against infection (OR: 0.29; 95% CI: 0.11 to 0.79). Infected patients had longer hospital stays (26 days; 95% CI: 12.81 to 38.89) and higher risk of death (OR: 3.2; 95% CI: 1.82 to 5.80). The population prevalence of infection was high in these regions and surveillance data for children were scarce. Conclusion: Antibiotic stewardship policies to prevent infection and encourage appropriate treatment are needed in South-East Asia and the Western Pacific.-
dc.languageeng-
dc.publisherWorld Health Organization (WHO): Creative Commons Attribution. The Journal's web site is located at http://www.who.int/bulletin/en/-
dc.relation.ispartofBulletin of the World Health Organization-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectNeutropenia-
dc.subjectInfection-
dc.subjectNeutropenic fever-
dc.subjectEnterobacteriaceae-
dc.titleAvailable evidence of antibiotic resistance from extended-spectrum β-lactamase-producing Enterobacteriaceae in paediatric patients in 20 countries: a systematic review and meta-analysis-
dc.typeArticle-
dc.identifier.emailHu, YJ: jesshu17@HKUCC-COM.hku.hk-
dc.identifier.emailOgyu, A: anjuo@hku.hk-
dc.identifier.emailCowling, BJ: bcowling@hku.hk-
dc.identifier.emailFukuda, K: kfukuda@hku.hk-
dc.identifier.emailPang, HH: herbpang@hku.hk-
dc.identifier.authorityCowling, BJ=rp01326-
dc.identifier.authorityFukuda, K=rp02247-
dc.identifier.authorityPang, HH=rp01857-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.2471/BLT.18.225698-
dc.identifier.pmid31258218-
dc.identifier.pmcidPMC6593334-
dc.identifier.scopuseid_2-s2.0-85069000343-
dc.identifier.hkuros301758-
dc.identifier.volume97-
dc.identifier.spage486-
dc.identifier.epage501B-
dc.publisher.placeSwitzerland-

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