National Hospital Admissions and Microbiological Databases

Background. Hospital-acquired bloodstream infection (HA-BSI) requires immediate effective antibiotic treatment. However, there are no published national data for England that describe the pathogen profile and antibiotic resistance rates of HA-BSI in children. Methods. Probabilistic matching methods were used to link national data on microbiologically confirmed BSI to hospital in-patient admissions data for the period of January 2009–March 2010. HA-BSI was defined as a positive blood culture drawn from a child aged 1 month–18 years 2 or more days after admission (and before discharge). Results. A total of 8718 episodes of BSI was reported during the study period. Linkage allowed 82 % of records to be matched, of which 23 % (1734) were HA-BSI, giving a rate of 4.74 per 1000 admissions. The median age of infection was 1 year, and 54 % of infections were in males. Methicillin resistance was seen in 83 % and 17 % of coagulase-negative staphylococci and Staphylococcus aureus, respectively. Penicillin resistance was rare in pyogenic streptococci but more common in viridans streptococci (39%). Among Gram-positive organisms, only 3 % were vancomycin-resistant. The overall proportion of Gram-negative bacteria resistant to recommended empirical antibiotics (meropenem or piperacillin/tazobactam) was 5 % and 16%, respectively, but <4 % of isolates were resistant when either of these drugs were combined with gentamicin. Conclusions. This study provides the first national estimates of the proportion of pediatric BSI that i