Clinical features and molecular epidemiology of carbapenem-resistant Enterobacterales infection in children.
10.7499/j.issn.1008-8830.2203145
- Author:
Long YE
1
;
Li-Yan ZHANG
;
Yue ZHAO
;
Bing GU
;
Zhu WU
;
Yong-Zheng PENG
1
Author Information
1. Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China.
- Publication Type:Journal Article
- Keywords:
Carbapenem-resistant Enterobacterales;
Child;
Drug resistance;
Molecular epidemiology
- MeSH:
Adolescent;
Anti-Bacterial Agents;
Bacterial Proteins;
Carbapenems;
Child;
Child, Preschool;
Escherichia coli;
Female;
Humans;
Infant;
Infant, Newborn;
Inosine Monophosphate;
Klebsiella pneumoniae;
Male;
Microbial Sensitivity Tests;
Molecular Epidemiology;
Retrospective Studies;
beta-Lactamases
- From:
Chinese Journal of Contemporary Pediatrics
2022;24(8):881-886
- CountryChina
- Language:English
-
Abstract:
OBJECTIVES:To study the clinical features of children with carbapenem-resistant Enterobacterales (CRE) infection and the molecular characteristics of isolated strains.
METHODS:A retrospective analysis was performed on the clinical data and infection status of the children who were hospitalized in Guangdong Provincial People's Hospital from January 2018 to June 2021. A total of 1 098 non-repetitive strains of Enterobacterales were obtained. Drug sensitivity test, PCR amplification, and resistance-related gene sequencing were performed for 66 isolated CRE strains to observe molecular epidemiology.
RESULTS:Among the 1 098 strains of Enterobacterales, the detection rate of CRE was 6.01% (66/1 098). The 66 CRE strains were isolated from 66 children, among whom there were 37 boys (56%) and 29 girls (44%), with an age of 2 days to 14 years. Among these 66 children, 16 (24%) had an age of <1 month, 28 (42%) had an age of 1-12 months, 11 (17%) had an age of 12-36 months, and 11 (17%) had an age of >36 months. The children with CRE were mainly distributed in the department of neonatology (38 children, 58%) and the pediatric intensive care unit (17 children, 26%). The top three types of specimens with CRE detection were respiratory specimens (48%), midstream urine specimens (21%), and blood specimens (17%). The CRE strains were mainly Klebsiella pneumoniae (45 strains, 68%), Escherichia coli (12 strains, 18%), and Enterobacter cloacae (6 strains, 9%), with high resistance to carbapenems (such as imipenem and ertapenem), penicillin, and cephalosporins, slightly high resistance to commonly used antibiotics, and relatively low resistance to amikacin (14%), levofloxacin (23%), and tobramycin (33%). The carbapenemase genotypes of Klebsiella pneumoniae strains were mainly blaNDM (20 strains, 44%), blaIMP (10 strains, 22%), and blaKPC (5 strains, 11%), and the carbapenemase genotypes of Escherichia coli strains were mainly blaNDM (10 strains, 83%). After sequencing, there were 24 blaNDM-1 strains, 6 blaNDM-5 strains, 5 blaIMP-4 strains, and 3 blaKPC-2 strains, and some genotypes were not identified.
CONCLUSIONS:There is a high incidence rate of CRE infection among children, mainly those aged 1-12 months. CRE generally has high resistance to antibacterial drugs, and metalloenzymes are the main type of carbapenemases for CRE strains in children.
