Journal Article

Carbapenem-Resistant and Extended-Spectrum β-Lactamase–Producing Enterobacterales in Children, United States, 2016–2020

Lynfield, Ruth, O’Malley, Sean, Evenson, Bailey, Smith, Gillian, Grass, Julian E., Czaja, Christopher A., Masters, Thao, Dumyati, Ghinwa, Maloney, Meghan, Phipps, Erin, Grome, Heather N., Janelle, Sarah J., Gargis, Amy S., Wilson, Christopher D., Lutgring, Joseph D., Ansari, Uzma, Campbell, Davina, Kent, Alyssa G., McKay, Susannah L., Flores, Kristina, Vaeth, Elisabeth, Bulens, Sandra N., Vagnone, Paula Snippes, Johnston, Helen, Wilson, Lucy E., Duffy, Nadezhda, Nadle, Joelle, Guh, Alice Y., Tsay, Rebecca

2024

Overview

We conducted surveillance for carbapenem-resistant Enterobacterales (CRE) during 2016–2020 at 10 US sites and extended-spectrum β-lactamase–producing Enterobacterales (ESBL-E) during 2019–2020 at 6 US sites. Among 159 CRE cases in children (median age 5 years), CRE was isolated from urine for 131 (82.4%) and blood from 20 (12.6%). Annual CRE incidence rate (cases/100,000 population) was 0.47–0.87. Among 207 ESBL-E cases in children (median age 6 years), ESBL-E was isolated from urine of 196 (94.7%) and blood of 8 (3.9%). Annual ESBL-E incidence rate was 26.5 in 2019 and 19.63 in 2020. CRE and ESBL-E rates were >2-fold higher among infants than other age groups. Most CRE and ESBL-E cases were healthcare-associated community-onset (68 [43.0%] for CRE vs. 40 [23.7%] for ESBL-E) or community-associated (43 [27.2%] for CRE vs. 109 [64.5%] for ESBL-E). Programs to detect, prevent, and treat multidrug-resistant infections must include pediatric populations (particularly the youngest) and outpatient settings.

• Publisher: Centers for Disease Control and Prevention
• Subject: Adolescent / Age groups / Anti-Bacterial Agents - pharmacology / Antibiotics / Antimicrobial agents / antimicrobial resistance / Bacteria / Bacterial infections / beta-Lactamases - genetics / Blood / carbapenem-resistant Enterobacterales / Carbapenem-Resistant Enterobacteriaceae - drug effects / Carbapenem-Resistant Enterobacteriaceae - genetics / Carbapenem-Resistant Enterobacteriaceae - isolation & purification / Carbapenems - pharmacology / Case reports / Child / Child, Preschool / Disease control / E coli / Enterobacterales / Enterobacteriaceae - drug effects / Enterobacteriaceae - enzymology / Enterobacteriaceae - genetics / Enterobacteriaceae Infections - epidemiology / Enterobacteriaceae Infections - microbiology / Epidemiology / extended-spectrum β-lactamase-producing Enterobacterales / History, 21st Century / Hospitals / Humans / Infant / Infections / Long term health care / Male / Medical laboratories / Microbial Sensitivity Tests / Pediatrics / Population / Public health / Surveillance / United States - epidemiology / Urine