Title: Infection prevention and its impact on antimicrobial resistance in critically ill children
Funder: Action Medical Research

Abstract: Background_x000D_ Antibiotics are heavily used to treat suspected infections in children who are very ill, for example, those receiving mechanical breathing support in intensive care units. There is widespread concern about how this might affect levels of antibiotic resistance. 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. Many healthcare-associated infections arise from bacteria in the gut, and a new treatment that uses non-absorbable antibiotics to stop bacterial growth in the digestive tract appears to be beneficial in critically ill adults. This treatment, called selective decontamination of the digestive tract (SDD), has not been tested in critically ill children. These researchers believe SDD might reduce infection rates, but they want to make sure it does not increase the risk of antibiotic resistance compared to standard intensive care. _x000D_ _x000D_ The research project_x000D_ The team will examine levels of antibiotic-resistant bacteria using gene sequencing in stool and mouth swab samples from critically ill children in intensive care units. These children will already be enrolled in a pilot study of SDD compared to standard care. This Action-funded project aims to establish if SDD is associated with a significant and persistent problem of antibiotic-resistant bacteria in the gut. Even if SDD reduces infection rates, any significant increase in antibiotic resistance would have serious implications for these critically ill children. The researchers expect that this study will provide information about the bacterial population in the gut, which will inform future research on SDD. They also plan to use data from this study in further work to investigate the use of probiotics to restore a healthy population of gut bacteria in children recovering from critical illness._x000D_ _x000D_ Humanimal Trust is kindly helping to support this research.

Lay abstract: Background_x000D_ Antibiotics are heavily used to treat suspected infections in children who are very ill, for example, those receiving mechanical breathing support in intensive care units. There is widespread concern about how this might affect levels of antibiotic resistance. 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. Many healthcare-associated infections arise from bacteria in the gut, and a new treatment that uses non-absorbable antibiotics to stop bacterial growth in the digestive tract appears to be beneficial in critically ill adults. This treatment, called selective decontamination of the digestive tract (SDD), has not been tested in critically ill children. These researchers believe SDD might reduce infection rates, but they want to make sure it does not increase the risk of antibiotic resistance compared to standard intensive care. _x000D_ _x000D_ The research project_x000D_ The team will examine levels of antibiotic-resistant bacteria using gene sequencing in stool and mouth swab samples from critically ill children in intensive care units. These children will already be enrolled in a pilot study of SDD compared to standard care. This Action-funded project aims to establish if SDD is associated with a significant and persistent problem of antibiotic-resistant bacteria in the gut. Even if SDD reduces infection rates, any significant increase in antibiotic resistance would have serious implications for these critically ill children. The researchers expect that this study will provide information about the bacterial population in the gut, which will inform future research on SDD. They also plan to use data from this study in further work to investigate the use of probiotics to restore a healthy population of gut bacteria in children recovering from critical illness._x000D_ _x000D_ Humanimal Trust is kindly helping to support this research.

Research activity codes: 2.2 FACTORS RELATING TO PHYSICAL ENVIRONMENT;5.1 PHARMACEUTICALS
Health categories: INFECTION