Background: Pediatric colonization and infections caused by Carbapenem-resistant enterobacteriaceae (CRE) are on the rise worldwide. Nevertheless, data in pediatric population is limited.
Objective: To describe the epidemiological, clinical, phenotypic and genotypic characteristics of CRE isolation in a tertiary pediatric center in Israel.
Methods: Data of all children with CRE isolation (colonization and infection) between 2007 and 2015 were retrospectively reviewed. Clinical characteristics and outcomes were recorded.
Results: During the study period there were 73 CRE isolations; 45 (61.6%) colonized patients and 28 (38.4%) infected children. Median age and range at the time of first isolation of all children was 19 (0.13-244.43) months; 19.53 (0.13-195.43) months for colonized and 79 (0.2-224.43) months for infected children. All patients had at least one major risk factor for multidrug resistant bacterial acquisition (premorbid condition, antibiotic treatment in the past three months, use of indwelling devices and previous different health care facilities admission). Among the infected children, urinary tract infection and bacteremia were the most common clinical sources of infection. All cause overall mortality was 26% and was lower than recently reported; only 1 case could be attributed directly to CRE infection.
Conclusions: CRE colonization and infection has emerged as an important threat in pediatric population. Children with comorbidities and prolonged hospital stay are a specific risk group for CRE acquisition. Our report may help in designing screening, intervention and treatment strategies among this emerging group of hospitalized children.
