Childhood bacteremia in Israel: Antibiotic susceptibility profiles

Because antibiotic therapy for childhood bacteremia is usually started empirically, knowledge of the antibiotic susceptibility profiles of organisms causing bacteremia is crucial. We studied 355 microorganisms isolated in 339 episodes of childhood bacteremia. Overall, the 158 nosocomial isolates were more resistant to most antimicrobial agents than were the 197 community acquired isolates. Methicillin resistance was found in 15% and 37% of community-acquired and nosocomial S. aureus bacteremia, respectively. The resistance of S. epidermidis to methicillin was higher, reaching 76% in nosocomial bacteremias. Penicillin resistance was noted in 27% of S. pmeumoniae. Among gram negative bacteria, E. coli showed 80% and 55% resistance to ampicillin and trimethoprim-sulfamethoxazole, respectively, but was susceptible to most other relevant antibiotics. P. aeruginosa and Acinetobacter showed an alarming resistance to many antimicrobial agents. The resistance rate differed among the various pediatric divisions, being highest in the pediatric intensive care unit and quite high in pediatric surgery, hematology/oncology, and neonatal intensive care units. Over the years 1988 to 1990, an increasing resistance to several antimicrobial agents was noted. These data should be implemented clinically for appropriate initial treatment of suspected bacteremia.