Rates of Multidrug-Resistant Gram-Negative Bacterial Infections in Hospitalized Non-Immunocompromised Pediatric Patients: A 9-Year Retrospective Study at a Lebanese Tertiary Medical Center.

Introduction: Multidrug resistant (MDR) Gram-negative bacterial infections are considered a major public health threat. The objectives of this study were to describe the epidemiology, potential contributing factors, and antimicrobial resistance patterns associated with infections caused by MDR Gram-negative bacteria (GNB) in non-immunocompromised children and adolescents.

Methods: This was a retrospective observational study conducted at the American University of Beirut Medical Center (AUBMC) from 2009 to 2017. The study included non-immunocompromised patients 18 years of age or younger with infections caused by GNB isolated from a sterile site or nonsterile site in the setting of clinical infection.

Results: A total of 810 episodes of infection with GNB in 674 pediatric patients were identified. The most common pathogens were followed by . MDR GNB infections represented 47.8% of the episodes, with alarming MDR rates among (64.3%), (59.1%) and species (70.6%). Previous infection with the same organism during the previous 12 months, urinary catheter or cardiac catheterization in the past 30 days had high percentages of infections with MDR GNB. The carbapenem resistance rates were 1.7% in , 19.8% in species and 64.7% in species.

Conclusion: High prevalence of infections with MDR GNB was detected in non-immunocompromised pediatric patients in Lebanon. This poses a significant threat to the pediatric population and underscores the importance of implementing antimicrobial stewardship programs and infection control policies, which are crucial to cope with the burden of these infections, especially in the presence of other ongoing challenges such as the current economic collapse and ongoing war leading to severe antimicrobial shortages.