1355. Resistance in Gram-Negative Bacteria in the Pediatric Patient Population by Age and Sex

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Open Forum Infectious Diseases


Background. Previous research within the Beaumont Infectious Diseases Research Program found an overall increase in antibiotic resistance in adult males versus females. Furthermore, there is a peak in resistance in 18-29-year-old males, not seen in females. The origin of this early peak of antibiotic resistance in adults is unclear. This study examines these trends in the pediatric patient population. Methods. Resistance data for all Gram-negative bacterial clinical isolates from Beaumont Health System’s clinical microbiology lab between October 1st, 2010, and December 31st, 2014 was analyzed. The pediatric isolates were categorized into sextiles (0-2, 3-5, 6-8, 9-11, 12-14, 15-17) and the sensitivities for each antibiotic were compared based on gender and age and separated by urine isolates vs. non-urine isolates to account for potential bias based on an abundance of urine samples in females. Results. There were 7878 pediatric Gram-negative bacterial isolates in the database, and 96 duplicate samples were removed, leaving 7782 isolates to be analyzed. There were more female isolates (n=6888) than male isolates (n=890) due to the preponderance of urine cultures in females. At most age ranges, antibiotic resistance was significantly higher in males than females. In males, antibiotic resistance was highest between 12-14 and 15-17 years old. When analyzing the cultures based on sample type, the peak in resistance in males is seen in urine isolates, but the patterns of resistance are chaotic in non-urine isolates. This is likely attributable to a low number of isolates. Conclusion. Sex is an important factor in determining antibiotic resistance in the pediatric patient population, as males exhibit higher resistance. The peak in antibiotic resistance initially noted in 18-29-year-old males in previous research originates in the pediatric age group and appears to develop between 12-17 years old. Further research is needed to determine the cause of the observed gender bias, to ascertain if it is modifiable in order to reduce antibiotic resistance




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