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Volume 24, Number 5—May 2018
Synopsis

Antimicrobial Resistance in Invasive Bacterial Infections in Hospitalized Children, Cambodia, 2007–2016

Andrew Fox-LewisComments to Author , Junko Takata, Thyl Miliya, Yoel Lubell, Sona Soeng, Poda Sar, Kolthida Rith, Gregor McKellar, Vanaporn Wuthiekanun, Erin McGonagle, Nicole Stoesser, Catrin E. Moore, Christopher M. Parry, Claudia Turner, Nicholas P.J. Day, Ben S. Cooper, and Paul Turner
Author affiliations: University of Oxford, Oxford, UK (A. Fox-Lewis, J. Takata, Y. Lubell, N. Stoesser, C.E. Moore, C. Turner, N.P.J. Day, B.S. Cooper, P. Turner); Angkor Hospital for Children, Siem Reap, Cambodia (A. Fox-Lewis, T. Miliya, S. Soeng, P. Sar, K. Rith, G. McKellar, C. Turner, P. Turner); Cambodia-Oxford Medical Research Unit, Siem Reap (A. Fox-Lewis, T. Miliya, S. Soeng, P. Sar, K. Rith, C. Turner, P. Turner); Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand (Y. Lubell, V. Wuthiekanun, C.E. Moore, N.P.J. Day, B.S. Cooper); University of Colorado, Aurora, Colorado, USA (E. McGonagle); Liverpool School of Tropical Medicine, Liverpool, UK (C.M. Parry); Nagasaki University, Nagasaki, Japan (C.M. Parry)

Main Article

Table 3

Logistic regression analysis of resistance trends for the gram-negative Global Antimicrobial Resistance Surveillance System pathogens Klebsiella pneumoniae and Escherichia coli isolated from children at Angkor Hospital for Children, Siem Reap, Cambodia, 2007–2016*

Pathogen, resistance type, predictor variable
 Univariable analysis
Multivariable analysis
OR (95% CI)
 p value
 OR (95% CI)
 p value
Klebsiella pneumoniae
AMP–GEN
Year of isolation
2007–2008 Ref Ref Ref Ref
2009–2010 2.00 (0.42–10.03) 0.384 1.31 (0.23–7.88) 0.765
2011–2012 5.52 (1.41–22.90) 0.015 2.61 (0.58–12.45) 0.213
2013–2014 1.95 (0.51–7.80) 0.329 0.59 (0.12–2.85) 0.504
2015–2016 0.21 (0.03–1.12) 0.075 0.06 (0.01–0.41) 0.006
Patient age
Nonneonate Ref Ref Ref Ref
Neonate† 5.63 (2.61–13.10) <0.001 7.30 (2.75–22.47) <0.001
Infection type‡
Community-acquired Ref Ref Ref Ref
Hospital-acquired 3.87 (1.81–8.51) <0.001 3.62 (1.42–9.58) 0.008
3GC
Years of isolation
2007–2008 Ref Ref Ref Ref
2009–2010 1.22 (0.20–7.02) 0.823 0.87 (0.13–5.60) 0.881
2011–2012 3.13 (0.57–14.69 0.156 1.37 (0.23–7.16) 0.716
2013–2014 2.78 (0.49–13.93) 0.218 0.97 (0.15–5.58) 0.973
2015–2016 0.20 (0.03–0.94) 0.052 0.06 (0.01–0.39) 0.005
Patient age
Nonneonate Ref Ref Ref Ref
Neonate 6.41 (2.32–22.70) 0.001 7.50 (2.16–35.00) 0.004
Infection type
Community-acquired Ref Ref Ref Ref
Hospital-acquired
 4.04 (1.76–9.44)
 0.001
3.51 (1.27–10.12)
 0.017
Escherichia coli
AMP–GEN
Years of isolation
2007–2008 Ref Ref Ref Ref
2009–2010 2.67 (0.63–12.75) 0.194 2.86 (0.66–14.13) 0.174
2011–2012 1.23 (0.28–5.86) 0.785 0.95 (0.20–4.75) 0.947
2013–2014 2.62 (0.67–11.63) 0.179 2.25 (0.53–10.72) 0.282
2015–2016 1.38 (0.33–6.50) 0.665 1.03 (0.22–5.11) 0.975
Patient age
Nonneonate Ref Ref Ref Ref
Neonate 1.04 (0.42–2.57) 0.924 0.75 (0.27–2.01) 0.568
Infection type
Community-acquired Ref Ref Ref Ref
Hospital-acquired 2.33 (1.04–5.33) 0.041 2.92 (1.21–7.44) 0.020
3GC
Years of isolation
2007–2008 Ref Ref Ref Ref
2009–2010 3.00 (0.68–16.38) 0.165 4.04 (0.79–26.54) 0.112
2011–2012 3.30 (0.74–18.21) 0.134 2.47 (0.45–16.60) 0.319
2013–2014 3.43 (0.83–17.83) 0.105 3.07 (0.60–19.99) 0.201
2015–2016 3.60 (0.82–19.73) 0.106 2.44 (0.45–16.13) 0.319
Patient age
Nonneonate Ref Ref Ref Ref
Neonate 0.92 (0.37–2.27) 0.861 0.41 (0.12–1.26) 0.131
Infection type
Community-acquired Ref Ref Ref Ref
Hospital-acquired 7.50 (3.09–20.01) <0.001 10.14 (3.70–32.14) <0.001

*3GC, third-generation cephalosporin; AMP–GEN, resistance to both ampicillin and gentamicin; OR, odds ratio; ref, referent.
†Neonate, 0–28 d of age.
‡Isolates were defined as hospital-acquired if taken >48 hours after admission.

Main Article

Page created: April 17, 2018
Page updated: April 17, 2018
Page reviewed: April 17, 2018
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