To evaluate trends in antimicrobial resistance (AMR) among children with bloodstream infections (BSI) over a 20-year period and to analyze changes in antimicrobial prescription patterns at Karolinska University Hospital.
Approach:
Case Identification: Retrospective analysis of pediatric patients aged 0–17 years with positive blood cultures from July 1, 1998, to July 30, 2018, at Karolinska University Hospital.
Antimicrobial Susceptibility Testing: Susceptibility testing was performed using the disk diffusion method, following Swedish and EUCAST guidelines for detection of resistance.
Key Findings:
AMR has increased in Sweden over the last two decades despite a low overall prevalence.
The highest burden of infections with antibiotic-resistant bacteria occurs in infants aged < 1 year.
Outpatient antibiotic sales for children have declined, but overall antibiotic consumption in hospitalized children has increased.
Interpretation:
The study indicates a need for improved surveillance and understanding of AMR trends in pediatric populations, highlighting differences in resistance patterns compared to adults.
Limitations:
Data on pediatric AMR and antibiotic use in hospitalized children in Sweden remain limited.
The study is retrospective and may have inherent biases.
Conclusion:
The findings highlight the importance of monitoring AMR trends and antibiotic prescribing practices in pediatric patients.
