Background: Antibiotic resistance is a worldwide problem associated with increased morbidity and mortality. Patients at risk for carriage of resistant pathogens are screened upon admission to inpatient care. Our aim was to evaluate the screening protocol for resistant pathogens at Ruth Rappaort Children`s Hospital, Rambam Medical Center.
Methods: All patients under 18 years old admitted to our center between 2015-2016, from whom cultures were obtained, were included. Patients were divided into groups according to: residence (Israel, Palestinian authority, Syria, and foreign patients); indications for screening (transfer from ICUs, admission to high-risk departments, recent carriage of resistant pathogens, transfer from other hospitals, and recent hospitalization); and the isolated pathogen (ESBL, CRE, MRSA, and VRE). Data was analyzed per patient and per sample.
Result: During the study period 193/2632 (7.3%) positive cultures were obtained from 725 patients. Of these, 165 (22.7%) patients were positive for at least one pathogen. Significantly less Israeli residents (120/615; 19.5%) were positive for at least one pathogen vs. non-Israeli residents (45/110, 40.9%; p<0.001). Past isolation was the only screening indication found to be significant (25/61, 41% p<0.001), vs. others. CRE, VRE, MRSA and ESBL prevalence rates were 0.6% (5/771), 0.5% (3/560) 0.5%, 4.2% (37/888) and 33.7% (139/413), respectively. Among non-ESBL carriers, MRSA was predominant, 24/34 (70.6%) were Israeli patients.
Conclusion: Non-Israeli residents, as well as patients with past isolation, are at higher risk for resistant pathogens. Indications used to identify high-risk patients for drug resistant pathogens were efficacious, but more efforts are needed to reduce excessive sampling.
