An antibiotic-resistant type of Gram-negative bacteria is infecting an increasing number of children in the US, researchers report in the Journal of the Pediatric Infectious Diseases Society.
These findings come at a time when the issue of drug-resistant bacteria is at the forefront of public health concerns. In late 2013, the Centers for Disease Control and Prevention (CDC) issued a report that provided the first snapshot of the toll and threat such "superbugs" pose to US health.
In that report, the CDC cited use of antibiotics as the single biggest cause of drug-resistant bacteria, suggesting that up to half of all antibiotics prescribed are unnecessary.
With this latest study, researchers from the Rush University Medical Center in Chicago, IL, looked at resistance patterns in around 370,000 clinical isolates from child patients, which were collected around the US between 1999 and 2011.
They focused on prevalence of Enterobacteriaceae, drug-resistant Gram-negative bacteria that produce an enzyme - called extended-spectrum beta-lactamase (ESBL) - which hinders many strong antibiotics.
Though this type of bacterium is still uncommon, the team says it is increasingly found in children, particularly those between the ages of 1 and 5 years old. As such, concerns have been raised about a lack of treatment options in the wake of this increasing prevalence.
The majority of children infected with ESBL-producing bacteria are between the ages of 1 and 5 years old.
The team also measured susceptibility to an important type of antibiotic, known as third-generation cephalosporins, as another indicator of ESBL prevalence.
Though increasing, infection rate still low
After looking at the results, the researchers found that the prevalence of ESBL-producing bacteria increased from 0.28% in 1999 to 0.92% in 2011. Additionally, resistance to third-generation cephalosporins increased from 1.4% to 3.0% during this time.
Children of all ages around the US were found to have ESBLs, but just over half of the children with this resistance were between the ages of 1 and 5 years old.
The researchers say nearly 75% of these bacteria were resistant to several classes of antibiotics.
Lead author Dr. Latania K. Logan says:
"These antibiotic-resistant bacteria have traditionally been found in health care settings but are increasingly being found in the community, in people who have not had a significant history of health care exposure."
She adds that 51.3% of the children in the study "presented in the outpatient or ambulatory setting."
The researchers note that although the infection rate in these children is still low, these ESBL-producing bacteria can quickly spread and are linked to longer hospital stays, higher health care costs and increased mortality.
In the CDC's report from 2013 mentioned above, the organization referred to ESBLs as a "serious concern" and warned that they pose a significant public health threat.
'New drug options needed for young children'
Though Dr. Logan says more research is needed to define risk factors in children and their prevalence in different settings, she says in the case of suspected bacterial infections, physicians should obtain cultures to determine which antibiotics are best.
"Some infections in children that have typically been treated with oral antibiotics in the past may now require hospitalization, treatment with intravenous drugs, or both, as there may not be an oral option available," she adds.
In another study conducted by the same research team, findings suggest that children with neurological conditions have a higher risk for ESBL-producing bacterial infections.
In light of these findings, Dr. Logan says development of new drugs for younger patients are needed and adds:
"The overwhelming majority of current research for new pharmaceuticals against antibiotic-resistant organisms are in adults. New drug options will need to be available for young children."
Medical News Today recently reported that scientists have discovered how some persistent bacteria avoid antibiotics. Unlike drug-resistant strains, persistent bacteria have developed the ability to lie dormant and then wake up once the threat has passed.
Written by Marie Ellis