Carbapenem resistance on the rise in children




The prevalence of carbapenem-resistant Enterobacteriaceae (CRE) in children is low but has increased significantly since 1999, particularly among isolates from intensive care units and from blood and lower respiratory tract cultures, new data suggest.

Analysis of 316,253 Enterobacteriaceae isolates reported to 300 U.S. laboratories participating in the Surveillance Network-USA database between 1999 and 2012 showed 0.08% of isolates were carbapenem resistant, with the most common resistant isolates being Enterobacter species isolated from urinary sources and from the inpatient non-ICU setting.

©CDC/James Archer

“Unlike for adults, where increases were greater than for children, we did not find that the increase in CRE in children appeared to be related to residence in long-term care facilities, because only 0.1% of CRE isolates came from this setting,” wrote Dr. Latania K. Logan, director of pediatric infectious diseases at Rush University Medical Center, Chicago, and her coauthors.

The study, published Oct. 14 in Emerging Infectious Diseases, showed a significant overall increase from 0% to 0.47% in carbapenem-resistant Enterobacteriaceae over the 12-year study period; among ICU isolates, the prevalence increased from 0% to 4.5% over the same period.

Many of the carbapenem-resistant isolates also were resistant to other antimicrobial drugs, such as trimethoprim/sulfamethoxazole and ciprofloxacin, and nearly half (48.3%) were resistant to more than three antimicrobial drug classes (Emerg Infect Dis. 2015 Oct 14. doi: 10.3201/eid2111.150548).

The study was supported by the National Institutes of Health, the Children’s Foundation, the Global Antibiotic Resistance Partnership, the Bill and Melinda Gates Foundation, and the Health Grand Challenges Program at Princeton University. No conflicts of interest were declared.

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