Abstract
The incidence of severe infections caused by multidrug-resistant (MDR) pathogens is
currently rising worldwide, and increasing numbers of neonates and children with serious
bloodstream infections due to resistant bacteria are being reported. Severe sepsis
and septic shock due to gram-negative bacteria represent a significant cause of morbidity
and mortality, and contribute to high health care costs. Antimicrobial resistance
among Enterobacteriaceae represents a major problem in both health care-associated
and community-acquired infections, with extended-spectrum β-lactamases (ESBLs) and
carbapenem-resistant Enterobacteriaceae (CRE) now presenting the main threat. These
infections in adult populations have been associated with poor clinical outcomes,
but very limited data have been published so far about risk factors and clinical outcome
of ESBL-associated and CRE sepsis in the pediatric population. The treatment of these
infections in neonates and children is particularly challenging due to the limited
number of available effective antimicrobials. Evidence-based use of new and older
antibiotics based on both strategic and regulatory clinical trials is paramount to
improve management of these severe infections in neonates and children.
Keywords
sepsis - pediatrics - neonate - drug resistance - bacterial - gram-negative bacteria
