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Preventing infections and reducing the risk of antibiotic-resistant infections in critically ill children

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Around 20,000 children are admitted to intensive care units in the UK each year.1 Many will receive life-saving antibiotics to treat suspected infections that may be a cause or complication of their illness. Dr Nazima Pathan of the University of Cambridge is studying a new type of infection control treatment that aims to reduce the need for strong antibiotics, by reducing the risk of hospital-acquired infections in critically ill children. High exposure to antibiotics in intensive care is known to increase the risk of children carrying antibiotic-resistant bacteria, which can have serious consequences. She aims to build crucial knowledge about whether the new treatment affects the risk of antibiotic-resistant infections in these vulnerable children, which could lead to new ways to improve their recovery in the future.

How are children’s lives affected now?

Most critically ill patients will receive antibiotics to treat suspected infections and this undoubtedly saves many lives. But the heavy use of antibiotics is of growing concern as it may lead to the development of resistant strains of bacteria.

“Some critically ill children have long-term or complex health problems and infection by antibiotic-resistant bacteria could make them much sicker and reduce their chances of survival,” says Dr Pathan.

Most infections that occur when a child is receiving intensive care are caused by bacteria growing inside their digestive tract. A potential new treatment known as selective decontamination of the digestive tract (SDD), which involves the use of non-absorbable antibiotics, appears to be of benefit to adults receiving intensive care – reducing infections and improving survival.

“However, even if SDD also reduces infections in critically ill children, we need to make sure it doesn’t increase the risk of antibiotic resistance compared to standard intensive care,” says Dr Pathan.

How could this research help?

“As part of an ongoing pilot study involving critically ill children in six intensive care units across the UK, we are aiming to establish whether SDD is associated with a significant and persistent problem of antibiotic-resistant bacteria in the digestive tract,” says Dr Pathan.

The team will use sophisticated DNA sequencing and data analysis to examine the diversity of bacteria and antibiotic resistance genes in stool and mouth swab samples collected before and after treatment – comparing the results from children receiving SDD with those having standard intensive care.

“Our results will help establish the risk of antibiotic-resistant infections in children receiving SDD, providing guidance on if and how the treatment should be further tested in larger trials,” says Dr Pathan.

The results will also provide vital information about the gut bacterial population during and after a child’s critical illness, which could help pave the way for the development of probiotic treatments to help restore their gut health – and hopefully, improve recovery.

References

  1. Paediatric Intensive Care Audit Network, Annual Report 2018 Tables and Figures: https://www.picanet.org.uk/wp-content/uploads/sites/25/2018/12/PICANet_2018_Annual_Report_Tables_and_Figures_v3.0-compressed.pdf

 

 

 

Project Leader Dr Nazima Pathan, FRCPCH PhD
Project Team Professor Nigel Klein, FRCPCH PhDProfessor Mike Sharland FRCPCH MDProfessor Mark Peters, FRCPCH PhDProfessor Julian Parkhill, FRS PhDProfessor Stephen Baker, PhDDr M Estee Torok, FRCPath FRCP PhDDr Liam Shaw, MPhys MRes PhD
Project Location Department of Paediatrics, University of Cambridge
Project Location Other Infectious Disease and Immunology, UCL Great Ormond Street Institute of Child Health Paediatric Infectious Diseases, St George’s University of LondonPaediatric Intensive Care, Great Ormond Street HospitalPathogen Genomics, Wellcome Trust Sanger InstituteDepartment of Medicine, University of CambridgeComputational Biology, University College London
Project duration 3 years
Date awarded 31 December 2018
Provisional start date 1 June 2019
Project end date 31 March 2022
Grant amount £192,758
Grant code GN2751

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