Current Tropical Medicine Reports

, Volume 5, Issue 1, pp 5–15 | Cite as

Prevention Strategies to Combat Antimicrobial Resistance in Children in Resource-Limited Settings

  • Alejandro Diaz
  • Stella Antonara
  • Theresa Barton
Pediatric Global Health (D Nguyen and A Mandalakas, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Pediatric Global Health


Purpose of Review

This review summarizes major antimicrobial-resistant pathogens emerging globally, including mechanisms of resistance and factors leading to acquisition of drug resistance in children. It further seeks to answer what steps should be taken in resource-limited settings to curb spread of these resistant pathogens.

Recent Findings

Prevalence of drug resistance bacteria is increasing in children. Resistance is primarily driven by antibiotic overuse and misuse, amplified in developing countries by poor regulation and limited treatment options. The World Health Organization has outlined a comprehensive approach to reduce antimicrobial resistance. Data among children in the developing world are incomplete, but suggest this is a problem with huge healthcare costs.


Prevention methods include classic sanitation, infection control, antimicrobial stewardship, as well as development of new technologies and improved surveillance. Future research should focus on population benefits, cost effectiveness of different approaches, and applying new technologies in a regulated way to the developing world.


Antimicrobial resistance Infection control Antimicrobial stewardship Carbapenemase ESBL 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Ahmed M, Moremi N, Mirambo MM, Hokororo A, Mushi MF, Seni J, et al. Multi-resistant gram negative enteric bacteria causing urinary tract infection among malnourished under-fives admitted at a tertiary hospital, northwestern, Tanzania. Ital J Pediatr. 2015;41(1):44. Scholar
  2. 2.
    Albert H, Nathavitharana RR, Isaacs C, Pai M, Denkinger CM, Boehme CC. Development, roll-out and impact of Xpert MTB/RIF for tuberculosis: what lessons have we learnt and how can we do better? Eur Respir J. 2016;48(2):516–25. Scholar
  3. 3.
    Alsan M, Schoemaker L, Eggleston K, Kammili N, Kolli P, Bhattacharya J. Out-of-pocket health expenditures and antimicrobial resistance in low-income and middle-income countries: an economic analysis. Lancet Infect Dis. 2015;15(10):1203–10. Scholar
  4. 4.
    Alshara M. Uropathogens and their susceptibility patterns in children at Princess Rhmah Hospital, Jordan. Jordan Med J. 2011;45(1):44–50.Google Scholar
  5. 5.
    Álvarez-Moreno CA, Valderrama-Beltrán SL, Rosenthal VD, Mojica-Carreño BE, Valderrama-Márquez IA, Matta-Cortés L, et al. Multicenter study in Colombia: impact of a multidimensional International Nosocomial Infection Control Consortium (INICC) approach on central line-associated bloodstream infection rates. Am J Infect Control. 2016;44(11):e235–41. Scholar
  6. 6.
    Balsells E, Guillot L, Nair H, Kyaw MH. Serotype distribution of Streptococcus pneumoniae causing invasive disease in children in the post-PCV era: a systematic review and meta-analysis. PLoS One. 2017;12(5):e0177113. Scholar
  7. 7.
    Bebell LM, Muiru AN. Antibiotic use and emerging resistance: how can resource-limited countries turn the tide? Glob Heart. 2014;9(3):347–58. CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Berezin EN, Solorzano F. Gram-negative infections in pediatric and neonatal intensive care units of Latin America. J Infect Dev Ctries. 2014;8(8):942–53. Scholar
  9. 9.
    Brown J, Cairncross S, Ensink JHJ. Water, sanitation, hygiene and enteric infections in children. Arch Dis Child. 2013;98(8):629–34. Scholar
  10. 10.
    Bryce A, Hay AD, Lane IF, Thornton HV, Wootton M, Costelloe C. Global prevalence of antibiotic resistance in paediatric urinary tract infections caused by Escherichia coli and association with routine use of antibiotics in primary care: systematic review and meta-analysis. BMJ. 2016;352
  11. 11.
    •• Buchan BW, Ledeboer NA. Emerging technologies for the clinical microbiology laboratory. Clin Microbiol Rev. 2014;27(4):783–822. Detailed overview of emerging diagnostic tests, useful as alternatives to culture-based microbiology diagnosis in LMIC. Scholar
  12. 12.
    •• Butler MS, Blaskovich MA, Cooper MA. Antibiotics in the clinical pipeline in 2013. J Antibiot. 2013;66(10):571–91. Overview of new antibiotics approved for human use during the last two decades. Scholar
  13. 13.
    Byarugaba DK. A view on antimicrobial resistance in developing countries and responsible risk factors. Int J Antimicrob Agents. 2004;24(2):105–10. Scholar
  14. 14.
    Cantey JB, Lopez-Medina E, Nguyen S, Doern C, Garcia C. Empiric antibiotics for serious bacterial infection in young infants: opportunities for stewardship. Pediatr Emerg Care. 2015;31(8):568–71. Scholar
  15. 15.
    Carattoli A. Plasmids and the spread of resistance. Int J Med Microbiol: IJMM. 2013;303(6–7):298–304. CrossRefPubMedGoogle Scholar
  16. 16.
    Castro-Orozco R, Villafane-Ferrer LM, Alvarez-Rivera E, De Arco MM, Rambaut-Donado CL, Vitola-Heins GV. Methicillin-resistant Staphylococcus aureus in children attending school in Cartagena, Colombia. Rev Salud Publica (Bogota, Colombia). 2010;12(3):454–63. Scholar
  17. 17.
    CDC. Centers for Disease Control and Prevention, US Department of Health and Human Services. Antibiotic resistance threats in the United States. Atlanta: CDC. 2013. Accessed 28 Oct 2017.
  18. 18.
    • Center for Disease Dynamics Economics & Policy, CDDEP. ResistanceMap. 2017. Accessed 25 Oct 2017. Interactive map which shows antibiotic resistance patterns around the world.
  19. 19.
    Chiabi A, Djoupomb M, Mah E, Nguefack S, Mbuagbaw L, Zafack J, et al. The clinical and bacteriogical spectrum of neonatal sepsis in a tertiary Hospital in Yaounde, Cameroon. Iran J Pediatr. 2011;21(4):441–8.PubMedPubMedCentralGoogle Scholar
  20. 20.
    Chioro A, Coll-Seck AM, Høie B, Moeloek N, Motsoaledi A, Rajatanavin R, et al. Antimicrobial resistance: a priority for global health action. Bull World Health Organ. 2015;93(7):439. CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Cifuentes Y, Ruiz AI, Leal AL, Munoz LC, Herrera MT, Jimenez LM. Microbiological profiling of isolates from the neonatal unit of a third-level hospital in Bogota, Colombia. Rev Salud Publica (Bogota, Colombia). 2005;7(2):191–200.Google Scholar
  22. 22.
    Couto RC, Carvalho EA, Pedrosa TM, Pedroso ER, Neto MC, Biscione FM. A 10-year prospective surveillance of nosocomial infections in neonatal intensive care units. Am J Infect Control. 2007;35(3):183–9. Scholar
  23. 23.
    • Crump JA, Sjolund-Karlsson M, Gordon MA, Parry CM. Epidemiology, clinical presentation, laboratory diagnosis, antimicrobial resistance, and antimicrobial management of invasive Salmonella infections. Clin Microbiol Rev. 2015;28(4):901–37. Detailed review about Salmonella infections, including antimicrobial resistance. Scholar
  24. 24.
    Darmstadt GL, Saha SK, Choi Y, El Arifeen S, Ahmed NU, Bari S, et al. Population-based incidence and etiology of community-acquired neonatal bacteremia in Mirzapur, Bangladesh: an observational study. J Infect Dis. 2009;200(6):906–15. Scholar
  25. 25.
    de Cellès MD, Pons-Salort M, Varon E, Vibet MA, Ligier C, Letort V, et al. Interaction of vaccination and reduction of antibiotic use drives unexpected increase of pneumococcal meningitis. Sci Rep. 2015;5(1):11293. Scholar
  26. 26.
    de Man P, Verhoeven BA, Verbrugh HA, Vos MC, van den Anker JN. An antibiotic policy to prevent emergence of resistant bacilli. Lancet. 2000;355(9208):973–8. Scholar
  27. 27.
    Diaz A, Ortiz DC, Trujillo M, Garces C, Jaimes F, Restrepo AV. Clinical characteristics of Carbapenem-resistant Klebsiella pneumoniae infections in ill and colonized children in Colombia. Pediatr Infect Dis J. 2016;35(3):237–41. Scholar
  28. 28.
    Endimiani A, Jacobs MR. The changing role of the clinical microbiology laboratory in defining resistance in gram-negatives. Infect Dis Clin N Am. 2016;30(2):323–45. Scholar
  29. 29.
    Escandon-Vargas K, Reyes S, Gutierrez S, Villegas MV. The epidemiology of carbapenemases in Latin America and the Caribbean. Expert Rev Anti-Infect Ther. 2017;15(3):277–97. Scholar
  30. 30.
    Eurosurveillance Editorial Team. WHO member states adopt global action plan on antimicrobial resistance. Euro Surveill. 2015;20(21). Available from
  31. 31.
    Geyesus T, Moges F, Eshetie S, Yeshitela B, Abate E. Bacterial etiologic agents causing neonatal sepsis and associated risk factors in Gondar, Northwest Ethiopia. BMC Pediatr. 2017;17(1):137. Scholar
  32. 32.
    Gladstone RA, Jefferies JM, Tocheva AS, Beard KR, Garley D, Chong WW, et al. Five winters of pneumococcal serotype replacement in UK carriage following PCV introduction. Vaccine. 2015;33(17):2015–21. Scholar
  33. 33.
    Guyomard-Rabenirina S, Dartron C, Falord M, Sadikalay S, Ducat C, Richard V, et al. Resistance to antimicrobial drugs in different surface waters and wastewaters of Guadeloupe. PLoS One. 2017;12(3):e0173155. Scholar
  34. 34.
    Hamer DH, Darmstadt GL, Carlin JB, Zaidi AK, Yeboah-Antwi K, Saha SK, et al. Etiology of bacteremia in young infants in six countries. Pediatr Infect Dis J. 2015;34(1):e1–8. Scholar
  35. 35.
    Hammoud MS, Al-Taiar A, Thalib L, Al-Sweih N, Pathan S, Isaacs D. Incidence, aetiology and resistance of late-onset neonatal sepsis: a five-year prospective study. J Paediatr Child Health. 2012;48(7):604–9. Scholar
  36. 36.
    Huynh BT, Padget M, Garin B, Herindrainy P, Kermorvant-Duchemin E, Watier L, et al. Burden of bacterial resistance among neonatal infections in low income countries: how convincing is the epidemiological evidence? BMC Infect Dis. 2015;15(1):127. Scholar
  37. 37.
    Imade PE, Eghafona NO. Incidence of bacteremia in antiretroviral-naive HIV-positive children less than five years of age in Benin City, Nigeria. Libyan J Med. 2010;5
  38. 38.
    •• International Nosocomial Infection Control Consortium. International Nosocomial Infection Control Consortium (INICC). Care bundles to prevent central and peripheral line-related bloodstream infections. 2017. Accessed 4 Nov 2017. Data from LMIC about effective measures to prevent central line bloodstream infections.
  39. 39.
    Jameel NA, Ejaz H, Zafar A, Amin H. Detection of AmpC betalactamase in clinical isolates of Escherichia coli among children. Pak J Med Sci. 2012;28(5)
  40. 40.
    Jyothi P, Basavaraj MC, Basavaraj PV. Bacteriological profile of neonatal septicemia and antibiotic susceptibility pattern of the isolates. J Nat Sci Biol Med. 2013;4(2):306–9. Scholar
  41. 41.
    Kayange N, Kamugisha E, Mwizamholya DL, Jeremiah S, Mshana SE. Predictors of positive blood culture and deaths among neonates with suspected neonatal sepsis in a tertiary hospital, Mwanza-Tanzania. BMC Pediatr. 2010;10(1):39. Scholar
  42. 42.
    Kruse AY, Thieu Chuong do H, Phuong CN, Duc T, Graff Stensballe L, Prag J, et al. Neonatal bloodstream infections in a pediatric hospital in Vietnam: a cohort study. J Trop Pediatr. 2013;59(6):483–8. Scholar
  43. 43.
    Kumarasamy KK, Toleman MA, Walsh TR, Bagaria J, Butt F, Balakrishnan R, et al. Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study. Lancet Infect Dis. 2010;10(9):597–602. Scholar
  44. 44.
    Lau WC, Murray M, El-Turki A, Saxena S, Ladhani S, Long P, et al. Impact of pneumococcal conjugate vaccines on childhood otitis media in the United Kingdom. Vaccine. 2015;33(39):5072–9. Scholar
  45. 45.
    • Laxminarayan R, Duse A, Wattal C, Zaidi AK, Wertheim HF, Sumpradit N, et al. Antibiotic resistance-the need for global solutions. Lancet Infect Dis. 2013;13(12):1057–98. Comprehensive review about the urgency for global strategies to prevent antimicrobial resistance. Scholar
  46. 46.
    •• Le Doare K, Bielicki J, Heath PT, Sharland M. Systematic review of antibiotic resistance rates among gram-negative bacteria in children with sepsis in resource-limited countries. J Pediatr Infect Dis Soc. 2015;4(1):11–20. Authors review concerning antimicrobial resistance rates in gram negative bacteria in children with sepsis. Scholar
  47. 47.
    • Lee CR, Cho IH, Jeong BC, Lee SH. Strategies to minimize antibiotic resistance. Int J Environ Res Public Health. 2013;10(9):4274–305. Similar review article of general prevention strategies which are revelant to this article. Scholar
  48. 48.
    Liu L, Oza S, Hogan D, Perin J, Rudan I, Lawn JE, et al. Global, regional, and national causes of child mortality in 2000–13, with projections to inform post-2015 priorities: an updated systematic analysis. Lancet. 2015;385(9966):430–40. CrossRefPubMedGoogle Scholar
  49. 49.
    Lofti T, et al. Knowledge, beliefs and attitudes of physicians in low and middle-income countries regarding interacting with pharmaceutical companies: a systematic review. BMC Health Serv Res. 2016;Google Scholar
  50. 50.
    Lubell Y, Ashley EA, Turner C, Turner P, White NJ. Susceptibility of community-acquired pathogens to antibiotics in Africa and Asia in neonates—an alarmingly short review. Trop Med Int Health : TM & IH. 2011;16(2):145–51. Scholar
  51. 51.
    Luepke KH, Mohr JF 3rd. The antibiotic pipeline: reviving research and development and speeding drugs to market. Expert Rev Anti-Infect Ther. 2017;15(5):425–33. Scholar
  52. 52.
    Lushniak BD. Antibiotic resistance: a public health crisis. Public Health Rep (Washington, DC : 1974). 2014;129(4):314–6. Scholar
  53. 53.
    Marathe NP, Pal C, Gaikwad SS, Jonsson V, Kristiansson E, Larsson DGJ. Untreated urban waste contaminates Indian river sediments with resistance genes to last resort antibiotics. Water Res. 2017;124:388–97. Scholar
  54. 54.
    Meeker D, Knight TK, Friedberg MW, Linder JA, Goldstein NJ, Fox CR, et al. Nudging guideline-concordant antibiotic prescribing: a randomized clinical trial. JAMA Intern Med. 2014;174(3):425–31. Scholar
  55. 55.
    • Meeker D, Linder JA, Fox CR, Friedberg MW, Persell SD, Goldstein NJ, et al. Effect of behavioral interventions on inappropriate antibiotic prescribing among primary care practices: a randomized clinical trial. JAMA. 2016;315(6):562–70. Authors present results of how behavioral interventions in the primary care clinical practice, are effective in reducing inapropiate antibiotic prescribing rates. Scholar
  56. 56.
    Mensah SE, Koudande OD, Sanders P, Laurentie M, Mensah GA, Abiola FA. Antimicrobial residues in foods of animal origin in Africa: public health risks. Rev Sci Tech (International Office of Epizootics). 2014;33(3):987–96. 75-86Google Scholar
  57. 57.
    Messina AF, Katz-Gaynor K, Barton T, Ahmad N, Ghaffar F, Rasko D, et al. Impact of the pneumococcal conjugate vaccine on serotype distribution and antimicrobial resistance of invasive Streptococcus pneumoniae isolates in Dallas, TX, children from 1999 through 2005. Pediatr Infect Dis J. 2007;26(6):461–7. Scholar
  58. 58.
    Mohanan M, Vera-Hernández M, Das V, Giardili S, Goldhaber-Fiebert JD, Rabin TL, et al. The know-do gap in quality of health care for childhood diarrhea and pneumonia in rural India. JAMA Pediatr. 2015;169(4):349–57. Scholar
  59. 59.
    Monjur F, Rizwan F, Asaduzzaman M, Nasrin N, Ghosh NK, Apu AS, et al. Antibiotic sensitivity pattern of causative organisms of neonatal septicemia in an urban hospital of Bangladesh. Indian J Med Sci. 2010;64(6):265–71. Scholar
  60. 60.
    Munoz-Price LS, Poirel L, Bonomo RA, Schwaber MJ, Daikos GL, Cormican M, et al. Clinical epidemiology of the global expansion of Klebsiella pneumoniae carbapenemases. Lancet Infect Dis. 2013;13(9):785–96. Scholar
  61. 61.
    •• Murni IK, et al. Prevention of nosocomial infections in developing countries, a systematic review. Paediatr Int Child Health. 2013; Metanalisis which showed that Multifaceted interventions including hand-hygiene campaigns, antibiotic stewardship and other elementary infection control practices are effective in preventing nosocomial infections developing countries. Google Scholar
  62. 62.
    •• Murni IK, Duke T, Kinney S, Daley AJ, Soenarto Y. Reducing hospital-acquired infections and improving the rational use of antibiotics in a developing country: an effectiveness study. Arch Dis Child. 2015;100(5):454–9. Similar study with multifaceted intervention approach to prevent nosocomial infections and improve antibiotic used in a resource limited country. Scholar
  63. 63.
    Nwadioha SI, Kashibu E, Alao OO, Aliyu I. Bacterial isolates in blood cultures of children with suspected septicaemia in Kano: a two-year study. Niger Postgrad Med J. 2011;18(2):130–3.PubMedGoogle Scholar
  64. 64.
    Ocan M, Obuku EA, Bwanga F, Akena D, Richard S, Ogwal-Okeng J, et al. Household antimicrobial self-medication: a systematic review and meta-analysis of the burden, risk factors and outcomes in developing countries. BMC Public Health. 2015;15(1):742. Scholar
  65. 65.
    Padget M, Tamarelle J, Herindrainy P, Ndir A, Diene Sarr F, Richard V, et al. A community survey of antibiotic consumption among children in Madagascar and Senegal: the importance of healthcare access and care quality. J Antimicrob Chemother. 2017;72(2):564–73. CrossRefPubMedGoogle Scholar
  66. 66.
    Pardo L, Vola M, Macedo-Vinas M, Machado V, Cuello D, Mollerach M, et al. Community-associated methicillin-resistant Staphylococcus aureus in children treated in Uruguay. J Infect Dev Ctries. 2013;7(1):10–6. Scholar
  67. 67.
    Partridge SR. Resistance mechanisms in Enterobacteriaceae. Pathology. 2015;47(3):276–84. Scholar
  68. 68.
    Paterson DL, Bonomo RA. Extended-spectrum beta-lactamases: a clinical update. Clin Microbiol Rev. 2005;18(4):657–86. Scholar
  69. 69.
    Pérez G, Martiren S, Reijtman V, Romero R, Mastroianni A, Casimir L, et al. Community-acquired Staphylococcus aureus bacteremia in children: a cohort study for 2010–2014. Arch Argent Pediatr. 2016;114(6):508–13. PubMedGoogle Scholar
  70. 70.
    Prestinaci F, Pezzotti P, Pantosti A. Antimicrobial resistance: a global multifaceted phenomenon. Pathog Glob Health. 2015;109(7):309–18. Scholar
  71. 71.
    Rijal KR, Pahari N, Shrestha BK, Nepal AK, Paudel B, Mahato P, et al. Prevalence of methicillin resistant Staphylococcus aureus in school children of Pokhara. Nepal Med Coll J: NMCJ. 2008;10(3):192–5.PubMedGoogle Scholar
  72. 72.
    Rizwan F, Monjur F, Asaduzzaman M, Nasrin N, Ghosh N, Samsuzzaman AKM, et al. Antibiotic susceptibility patterns of uropathogens isolated from pediatric patients in a selected Hospital of Bangladesh. Int J Pharm Sci Rev Res. 2012;14(1):1–3.Google Scholar
  73. 73.
    Robinson TP, Wertheim HF, Kakkar M, Kariuki S, Bu D, Price LB. Animal production and antimicrobial resistance in the clinic. Lancet. 2016;387(10014):e1–3. Scholar
  74. 74.
    Rosenthal VD, Ramachandran B, Villamil-Gómez W, Armas-Ruiz A, Navoa-Ng JA, Matta-Cortés L, et al. Impact of a multidimensional infection control strategy on central line-associated bloodstream infection rates in pediatric intensive care units of five developing countries: findings of the International Nosocomial Infection Control Consortium (INICC). Infection. 2012;40(4):415–23.
  75. 75.
    Saleem AF, Qamar FN, Shahzad H, Qadir M, Zaidi AK. Trends in antibiotic susceptibility and incidence of late-onset Klebsiella pneumoniae neonatal sepsis over a six-year period in a neonatal intensive care unit in Karachi, Pakistan. Int J Infect Dis: IJID: Off Publ Int Soc Infect Dis. 2013;17(11):e961–5. Google Scholar
  76. 76.
    Siddiqui NU, Qamar FN, Jurair H, Haque A. Multi-drug resistant gram negative infections and use of intravenous polymyxin B in critically ill children of developing country: retrospective cohort study. BMC Infect Dis. 2014;14(1):626. Scholar
  77. 77.
    Singhi S, Ray P, Mathew JL, Jayashree M. Nosocomial bloodstream infection in a pediatric intensive care unit. Indian J Pediatr. 2008;75(1):25–30. Scholar
  78. 78.
    Skariyachan S, Mahajanakatti AB, Grandhi NJ, Prasanna A, Sen B, Sharma N, et al. Environmental monitoring of bacterial contamination and antibiotic resistance patterns of the fecal coliforms isolated from Cauvery River, a major drinking water source in Karnataka, India. Environ Monit Assess. 2015;187(5):279. CrossRefPubMedGoogle Scholar
  79. 79.
    Soroush S, Haghi-Ashtiani MT, Taheri-Kalani M, Emaneini M, Aligholi M, Sadeghifard N, et al. Antimicrobial resistance of nosocomial strain of Acinetobacter baumannii in Children’s Medical Center of Tehran: a 6-year prospective study. Acta Med Iran. 2010;48(3):178–84.PubMedGoogle Scholar
  80. 80.
    Sosa Ávila LM, Santander UID, Machuca Pérez MA, Santander UID, Sosa Ávila CA, Santander UID, et al. Methicillin-resistant Staphylococcus aureus infections in children in Bucaramanga Colombia. Rev Univ Ind Santander Salud. 2010;42(3):248–55.Google Scholar
  81. 81.
    Spellberg B. Antibiotic judo working gently with prescriber psychology to overcome inappropriate use. JAMA Intern Med. 2014;174(3):432–3. CrossRefPubMedPubMedCentralGoogle Scholar
  82. 82.
    Sutter DE, Milburn E, Chukwuma U, Dzialowy N, Maranich AM, Hospenthal DR. Changing susceptibility of Staphylococcus aureus in a US pediatric population. Pediatrics. 2016;137(4)
  83. 83.
    Tallur SS, Kasturi AV, Nadgir SD, Krishna BV. Clinico-bacteriological study of neonatal septicemia in Hubli. Indian J Pediatr. 2000;67(3):169–74. Scholar
  84. 84.
    Thacker N, Pereira N, Banavali SD, Narula G, Vora T, Chinnaswamy G, et al. Epidemiology of blood stream infections in pediatric patients at a tertiary care cancer centre. Indian J Cancer. 2014;51(4):438–41. Scholar
  85. 85.
    Thaver D, Ali SA, Zaidi AK. Antimicrobial resistance among neonatal pathogens in developing countries. Pediatr Infect Dis J. 2009;28(1 Suppl):S19–21. Scholar
  86. 86.
    Tong SY, Davis JS, Eichenberger E, Holland TL, Fowler VG Jr. Staphylococcus aureus infections: epidemiology, pathophysiology, clinical manifestations, and management. Clin Microbiol Rev. 2015;28(3):603–61. Scholar
  87. 87.
    Trehan A, Totadri S, Gautam V, Bansal D, Ray P. Invasive bacterial infections in a pediatric oncology unit in a tertiary care center. Indian J Cancer. 2014;51(4):428–31. Scholar
  88. 88.
    Uchil RR, Kohli GS, Katekhaye VM, Swami OC. Strategies to combat antimicrobial resistance. J Clin Diagn Res: JCDR. 2014;8(7):Me01–4. Scholar
  89. 89.
    Wang HK, Huang CY, Huang YC. Clinical features and molecular characteristics of childhood community-associated methicillin-resistant Staphylococcus aureus infection in a medical center in northern Taiwan, 2012. BMC Infect Dis. 2017;17(1):470. CrossRefPubMedPubMedCentralGoogle Scholar
  90. 90.
    Waters D, Jawad I, Ahmad A, Lukšić I, Nair H, Zgaga L, et al. Aetiology of community-acquired neonatal sepsis in low and middle income countries. J Glob Health. 2011;1(2):154–70.PubMedPubMedCentralGoogle Scholar
  91. 91.
    •• Watkins RR, Bonomo RA. Overview: global and local impact of antibiotic resistance. Infect Dis Clin N Am. 2016;30(2):313–22. This article summarizes the trends in antibiotic resistance, discusses the impact of antibiotic resistance on society, and reviews the use of antibiotics in agriculture. Scholar
  92. 92.
    Woolhouse M, Ward M, van Bunnik B, Farrar J. Antimicrobial resistance in humans, livestock and the wider environment. Phil Trans R Soc B. 2015;370(1670):2140083. Scholar
  93. 93.
    World Health Organization. Antimicrobial resistance: global report on surveillance. 2014. Available from Accessed 21 Oct 2017.
  94. 94.
    •• World Health Organization. Global action plan on antimicrobial resistance. World Health Organization. 2015. Accessed 21 Oct 2017. Compendium of strategies proposed by WHO to prevent antimicrobial resistance.
  95. 95.
    World Health Organization. Global priority list of antibiotic-resistant bacteria to guide research, discovery, and development of new antibiotics. In: WHO. World Health Organization. 2017a. Accessed 28 Oct 2017.
  96. 96.
    World Health Organization. Pocket book of hospital care for children: guidelines for the management of common illnesses with limited resources. 1st edn. World Health Organization. 2005.
  97. 97.
    World Health Organization. Substandard and falsified (SF) medical products. Available at: Accessed 3 Dec 2017.
  98. 98.
    World Health Organization. WHO monitoring of Xpert MTB/RIF roll-out—TB diagnostics and laboratory strengthening. Accessed 11 Nov 2017.
  99. 99.
    Zaidi AK, Thaver D, Ali SA, Khan TA. Pathogens associated with sepsis in newborns and young infants in developing countries. Pediatr Infect Dis J. 2009;28(1 Suppl):S10–8. Scholar
  100. 100.
    Zhou F, Shefer A, Kong Y, Nuorti JP. Trends in acute otitis media-related health care utilization by privately insured young children in the United States, 1997–2004. Pediatrics. 2008;121(2):253–60. Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018
corrected publication March/2018

Authors and Affiliations

  • Alejandro Diaz
    • 1
  • Stella Antonara
    • 1
  • Theresa Barton
    • 2
  1. 1.Nationwide Children’s HospitalColumbusUSA
  2. 2.Baylor College of Medicine and Texas Children’s HospitalHoustonUSA

Personalised recommendations