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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
Title | Available evidence of antibiotic resistance from extended-spectrum β-lactamase-producing Enterobacteriaceae in paediatric patients in 20 countries: a systematic review and meta-analysis |
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Authors | |
Keywords | Neutropenia Infection Neutropenic fever Enterobacteriaceae |
Issue Date | 2019 |
Publisher | World 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? |
Abstract | Objective: 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. |
Description | Link to Open access |
Persistent Identifier | http://hdl.handle.net/10722/274527 |
ISSN | 2023 Impact Factor: 8.4 2023 SCImago Journal Rankings: 1.703 |
PubMed Central ID | |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Hu, YJ | - |
dc.contributor.author | Ogyu, A | - |
dc.contributor.author | Cowling, BJ | - |
dc.contributor.author | Fukuda, K | - |
dc.contributor.author | Pang, HH | - |
dc.date.accessioned | 2019-08-18T15:03:27Z | - |
dc.date.available | 2019-08-18T15:03:27Z | - |
dc.date.issued | 2019 | - |
dc.identifier.citation | Bulletin of the World Health Organization, 2019, v. 97, p. 486-501B | - |
dc.identifier.issn | 0042-9686 | - |
dc.identifier.uri | http://hdl.handle.net/10722/274527 | - |
dc.description | Link to Open access | - |
dc.description.abstract | Objective: 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.language | eng | - |
dc.publisher | World Health Organization (WHO): Creative Commons Attribution. The Journal's web site is located at http://www.who.int/bulletin/en/ | - |
dc.relation.ispartof | Bulletin of the World Health Organization | - |
dc.subject | Neutropenia | - |
dc.subject | Infection | - |
dc.subject | Neutropenic fever | - |
dc.subject | Enterobacteriaceae | - |
dc.title | Available evidence of antibiotic resistance from extended-spectrum β-lactamase-producing Enterobacteriaceae in paediatric patients in 20 countries: a systematic review and meta-analysis | - |
dc.type | Article | - |
dc.identifier.email | Hu, YJ: jesshu17@HKUCC-COM.hku.hk | - |
dc.identifier.email | Ogyu, A: anjuo@hku.hk | - |
dc.identifier.email | Cowling, BJ: bcowling@hku.hk | - |
dc.identifier.email | Fukuda, K: kfukuda@hku.hk | - |
dc.identifier.email | Pang, HH: herbpang@hku.hk | - |
dc.identifier.authority | Cowling, BJ=rp01326 | - |
dc.identifier.authority | Fukuda, K=rp02247 | - |
dc.identifier.authority | Pang, HH=rp01857 | - |
dc.description.nature | published_or_final_version | - |
dc.identifier.doi | 10.2471/BLT.18.225698 | - |
dc.identifier.pmid | 31258218 | - |
dc.identifier.pmcid | PMC6593334 | - |
dc.identifier.scopus | eid_2-s2.0-85069000343 | - |
dc.identifier.hkuros | 301758 | - |
dc.identifier.volume | 97 | - |
dc.identifier.spage | 486 | - |
dc.identifier.epage | 501B | - |
dc.identifier.isi | WOS:000473270300019 | - |
dc.publisher.place | Switzerland | - |
dc.identifier.issnl | 0042-9686 | - |