TY - JOUR
T1 - Carbapenem-resistant enterobacteriaceae infections in children: An Italian retrospective multicenter study
AU - Montagnani, Carlotta
AU - Prato, M.
AU - Scolfaro, Carlo
AU - Colombo, S.
AU - Esposito, S.
AU - Tagliabue, C.
AU - Vecchio, A.
AU - Bruzzese, E.
AU - Loy, A.
AU - Cursi, L.
AU - Vuerich, M.
AU - Martino, M.
AU - Galli, L.
N1 - Cited By :1
Export Date: 30 March 2017
CODEN: PIDJE
Correspondence Address: Galli, L.; Department of Health Sciences, University of Florence, Anna Meyer Children's University Hospital, viale Gaetano Pieraccini 24, Italy; email: luisa.galli@unifi.it
References: Yigit, H., Queenan, A.M., Anderson, G.J., Novel carbapenem-hydrolyzing beta-lactamase, KPC-1, from a carbapenem-resistant strain of Klebsiella pneumoniae (2000) Antimicrob Agents Chemother, 45, pp. 1151-1161; Antimicrobial Resistance Surveillance in Europe 2013, , http://ecdc.europa.eu/en/activities/surveillance/EARS-Net/.Pages/index.aspx, European Center for Disease Prevention and Control. Annual report of the European antimicrobial resistance surveillance network (EARS-Net). Stockholm: ECDC 2014. Available at Accessed August 14, 2015; Logan, L.K., Carbapenem-resistant enterobacteriaceae: An emerging problem in children (2012) Clin Infect Dis, 55, pp. 852-859; Giani, T., Pini, B., Arena, F., Epidemic diffusion of KPC carbapenemaseproducing Klebsiella pneumoniae in Italy: Results of the first countrywide survey (2013) Euro Surveill, p. 18. , 15 May to 30 June 2011; Maltezou, H.C., Kontopidou, F., Katerelos, P., Infections caused by carbapenem-resistant Gram-negative pathogens in hospitalized children (2013) Pediatr Infect Dis J., 32, pp. e151-e154; Doi, Y., Paterson, D.L., Carbapenemase-producing enterobacteriaceae (2015) Semin Respir Crit Care Med, 36, pp. 74-84; Sheng, W.H., Liao, C.H., Lauderdale, T.L., A multicenter study of risk factors and outcome of hospitalized patients with infections due to carbapenemresistant Acinetobacter baumannii (2010) Int J Infect Dis, 14, pp. e764-e769; Marchaim, D., Chopra, T., Perez, F., Outcomes and genetic relatedness of carbapenem-resistant enterobacteriaceae at Detroit medical center (2011) Infect Control Hosp Epidemiol, 32, pp. 861-871; Grundmann, H., Livermore, D.M., Giske, C.G., Carbapenem-non-susceptible Enterobacteriaceae in Europe: Conclusions from a meeting of national experts (2010) Euro Surveill, p. 15. , CNSE Working Group; Glasner, C., Albiger, B., Buist, G., Carbapenemaseproducing Enterobacteriaceae in Europe: A survey among national experts from 39 countries (2013) Euro Surveill, p. 18. , European Survey on Carbapenemase-Producing Enterobacteriaceae (EuSCAPE) Working Group. February 2013; Dirajlal-Fargo, S., DeBiasi, R., Campos, J., Carbapenem-resistant Enterobacteriaceae in pediatric patients: Epidemiology and risk factors (2014) Infect Control Hosp Epidemiol, 35, pp. 447-449; Folgori, L., Livadiotti, S., Carletti, M., Epidemiology and clinical outcomes of multidrug-resistant, gram-negative bloodstream infections in a European tertiary pediatric hospital during a 12-month period (2014) Pediatr Infect Dis J., 33, pp. 929-932; Vergara-López, S., Domínguez, M.C., Conejo, M.C., Lessons from an outbreak of metallo-β-lactamase-producing Klebsiella oxytoca in an intensive care unit: The importance of time at risk and combination therapy (2015) J Hosp Infect, 89, pp. 123-131; Pannaraj, P.S., Bard, J.D., Cerini, C., Pediatric carbapenem-resistant enterobacteriaceae in los angeles, California, a high-prevalence region in the United States (2015) Pediatr Infect Dis J., 34, pp. 11-16; Kumar, P.P., Giri, S.R., Shaikh, F.A., Safety and efficacy of intravenous colistin in children (2015) Indian Pediatr, 52, pp. 129-130; Karbuz, A., Özdemir, H., Yaman, A., The use of colistin in critically ill children in a pediatric intensive care unit (2014) Pediatr Infect Dis J., 33, pp. e19-e24; Hsu, A.J., Tamma, P.D., Treatment of multidrug-resistant Gram-negative infections in children (2014) Clin Infect Dis, 58, pp. 1439-1448; Tumbarello, M., Viale, P., Viscoli, C., Predictors of mortality in bloodstream infections caused by Klebsiella pneumoniae carbapenemase-producing K pneumoniae: Importance of combination therapy (2012) Clin Infect Dis, 55, pp. 943-950; Daikos, G.L., Tsaousi, S., Tzouvelekis, L.S., Carbapenemase-producing Klebsiella pneumoniae bloodstream infections: Lowering mortality by antibiotic combination schemes and the role of carbapenems (2014) Antimicrob Agents Chemother, 58, pp. 2322-2328; Zarkotou, O., Pournaras, S., Tselioti, P., Predictors of mortality in patients with bloodstream infections caused by KPC-producing Klebsiella pneumoniae and impact of appropriate antimicrobial treatment (2011) Clin Microbiol Infect, 17, pp. 1798-1803
PY - 2016
Y1 - 2016
N2 - Background: The spread of carbapenem-resistant Enterobacteriaceae (CRE) is a health problem of major concern. CRE-related infections have significant morbidity and mortality, but data on CRE infection in pediatric population are limited. The aim of this study was to analyze epidemiologic and clinical characteristics, risk factors, therapeutic options and outcome of CRE infections in children in Italy. Methods: We performed a retrospective, multicenter, observational study of children with confirmed CRE infection or colonization admitted between January 1, 2011, and March 1, 2014, to 7 Italian pediatric centers. Results: Sixty-nine patients presenting 74 CRE infections and/or colonization were included. The most frequently isolated strain was Klebsiella pneumoniae carbapenemase-producing K. pneumoniae. Children with CRE infections had longer length of stay in hospital (P <0.001), duration of disease (P = 0.001) and antimicrobial treatment (P <0.001) than colonized children. Oncologic/immunosuppressive conditions are one of the factors significantly associated with a fatal outcome among children with CRE infections. Conclusions: Our study confirms that CRE infections affect mostly children with oncologic diseases and immunosuppression. Controlled studies in large cohorts are needed to evaluate the best therapeutic options and to assess further risk factors influencing outcomes and the survival of pediatric patients with infections caused by CRE. © 2016 Wolters Kluwer Health, Inc.
AB - Background: The spread of carbapenem-resistant Enterobacteriaceae (CRE) is a health problem of major concern. CRE-related infections have significant morbidity and mortality, but data on CRE infection in pediatric population are limited. The aim of this study was to analyze epidemiologic and clinical characteristics, risk factors, therapeutic options and outcome of CRE infections in children in Italy. Methods: We performed a retrospective, multicenter, observational study of children with confirmed CRE infection or colonization admitted between January 1, 2011, and March 1, 2014, to 7 Italian pediatric centers. Results: Sixty-nine patients presenting 74 CRE infections and/or colonization were included. The most frequently isolated strain was Klebsiella pneumoniae carbapenemase-producing K. pneumoniae. Children with CRE infections had longer length of stay in hospital (P <0.001), duration of disease (P = 0.001) and antimicrobial treatment (P <0.001) than colonized children. Oncologic/immunosuppressive conditions are one of the factors significantly associated with a fatal outcome among children with CRE infections. Conclusions: Our study confirms that CRE infections affect mostly children with oncologic diseases and immunosuppression. Controlled studies in large cohorts are needed to evaluate the best therapeutic options and to assess further risk factors influencing outcomes and the survival of pediatric patients with infections caused by CRE. © 2016 Wolters Kluwer Health, Inc.
KW - carbapenem-resistant
KW - children
KW - Enterobacteriaceae
U2 - 10.1097/INF.0000000000001188
DO - 10.1097/INF.0000000000001188
M3 - Article
SN - 0891-3668
VL - 35
SP - 862
EP - 868
JO - Pediatric Infectious Disease Journal
JF - Pediatric Infectious Disease Journal
IS - 8
ER -