Emerging Infectious Diseases (Jun 2024)

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

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

DOI
https://doi.org/10.3201/eid3006.231734
Journal volume & issue
Vol. 30, no. 6
pp. 1104 – 1114

Abstract

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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.

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