Microbiological Characteristics, Risk Factors, and Short-Term Mortality of Carbapenem-Resistant Enterobacteriaceae Bloodstream Infections in Pediatric Patients in China: A 10-Year Longitudinal Study

作者：Yujian Liang, Chenfeng Zhao, Yuhang Lu, Kang Liao, Yannan Kong, Mengzhi Hong, Liubing Li, Chen Yi-li · 发表于：Infection and Drug Resistance · 年份：2024 · DOI：10.2147/idr.s485001 · 被引用次数：4 · 研究领域：Antibiotic Resistance in Bacteria、Neonatal and Maternal Infections、Antibiotics Pharmacokinetics and Efficacy

Background: Carbapenem-resistant Enterobacteriaceae (CRE) is rapidly becoming a major threat to hospitalized children worldwide. The purpose of this study was to summarize etiological characteristics and identify risk factors relevant to CRE bloodstream infection (BSI) and short-term mortality among pediatric patients in China. Methods: In this study, we included 370 inpatients ≤ 17 years old with BSI caused by Enterobacteriaceae in China from January 2013 to December 2022. By collecting data on demographics, etiological features, and clinical outcomes, we conducted an in-depth analysis. Results: Among the 370 BSI patients with infections caused by Enterobacteriaceae , 35 patients (9.46%) were caused by CRE. Among these CRE strains, Klebsiella pneumoniae (49.46%) was the most important pathogen of BSI in pediatric patients, followed by Escherichia coli (31.62%) and Enterobacter cloacae (5.95%). The most frequent carbapenemase was NDM (23/35, 65.71%), followed by KPC (8/35, 22.86%). The overall 28-day mortality rate of children with an Enterobacteriaceae BSI episode was 1.89% (7/370), of which CRE BSI patients (3/35, 8.57%) were significantly higher than CSE patients (4/335, 1.19%, P < 0.001). Congenital malformation (OR: 8.162, 95% CI: 3.859– 16.680, P < 0.001) and catheter-related (OR: 6.645, 95% CI: 3.159– 13.28, P: < 0.001) were associated with the development of CRE BSI in pediatric patients. A multivariate analysis showed that the infection of CRE (OR 7.758, 95% CI 1.869...