Carbapenem-resistant Gram-negative pathogens (CRPs) are emerging as major causes of nosocomial infections that increase morbidity, mortality and healthcare costs. Little is known about CRP infections in children.
All newly detected infections caused by carbapenem-resistant Klebsiella spp, Pseudomonas spp or Acinetabocater spp in hospitalized patients are prospectively reported to the Hellenic Center for Disease Control and Prevention. All children <15 years old with a CRP infection reported from November 1, 2010, through March 30, 2012, were included in this study.
Between November 2010 and March 2012, 71 CRP infections in 65 children (median age: 1 year) were reported. Underlying conditions existed in 50 (76.9%) children. Cases included pneumonia (25 [35.2%], including 20 ventilator-associated pneumonias), bacteremia (32.4%), urinary tract infection (19.7%) and surgical site infection (12.7%). Isolates were Pseudomonas spp (41.1%), Acinetobacter spp (39.7%) and Klebsiella spp (19.2%). The first positive culture occurred a median of 20 days (range: 0–313 days) after admission. Twenty-four (33.8%) infections occurred in patients with a history of hospitalization the previous 6 months; 42 (59.2%) and 36 (50.7%) infections occurred among patients who had received broad-spectrum antibiotics including carbapenems the previous 6 months, respectively. The crude mortality at 28 days after the first positive CRP culture was 21.1%.
Infections caused by CRPs among children are associated with significant morbidity and mortality.
From the *Department for Interventions in Health-Care Facilities, Hellenic Center for Disease Control and Prevention; †First Department of Propaedeutic Medicine, University of Athens, Athens; ‡Third Department of Paediatrics, Aristotle University School of Medicine, Thessaloniki; and §First Department of Pediatrics, University of Athens, Athens, Greece.
Accepted for publication November 28, 2012.
The authors have no funding or conflicts of interest to disclose.
Address for correspondence: Helena C. Maltezou, MD, PhD, Department for Interventions in Health-Care Facilities, Hellenic Center for Diseases Control and Prevention, 3–5 Agrafon Street, Athens, 15123 Greece. E-mail: email@example.com.