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Volume 21, Number 11—November 2015
Research

Carbapenem-Resistant Enterobacteriaceae in Children, United States, 1999–2012

Latania K. LoganComments to Author , John P. Renschler, Sumanth Gandra, Robert A. Weinstein, Ramanan Laxminarayan, and for the Centers for Disease Control and Prevention Epicenters Program
Author affiliations: Rush University Medical Center, Chicago, Illinois, USA (L.K. Logan, R.A. Weinstein); John H. Stroger, Jr. Hospital of Cook County, Chicago (L.K. Logan, R.A. Weinstein); Center for Disease Dynamics, Economics and Policy, Washington, DC, USA (J.P. Renschler, S. Gandra, R. Laxminarayan); Public Health Foundation of India, New Delhi, India (R. Laxminarayan); Princeton University, Princeton, New Jersey, USA (R. Laxminarayan)

Main Article

Table 1

Characteristics of Enterobacteriaceae isolates and children from which they were isolated, The Surveillance Network–USA database, 1999–2012*

Characteristic No. (%) isolates analyzed, N = 316,253 No. (%) CRE isolates analyzed, n = 266 % CRE, 266/316,253 (0.084) Met inclusion criteria,†
316,253/438,600 (72.11)
Organism
Escherichia coli 23,9274 (75.66) 58 (21.80) 0.02 70.60
Klebsiella pneumoniae 23,442 (7.41) 83 (31.20) 0.35 76.91
Proteus mirabilis 19,506 (6.17) 2 (0.75) 0.01 71.35
Enterobacter species‡ 17,215 (5.44) 98 (36.84) 0.57 80.84
Serratia marcescens 10,086 (3.19) 17 (6.39) 0.17 85.77
Citrobacter species§
 6,730 (2.13)
 8 (3.01)
 0.12
 76.42
Health care setting
Outpatient 245,257 (77.55) 89 (33.46) 0.04 71.28
Inpatient 53,832 (17.02) 116 (43.61) 0.22 71.71
Inpatient–ICU 10,048 (3.18) 55 (20.68) 0.55 88.12
Unknown 6,041 (1.91) 5 (1.88) 0.08 88.09
Nursing home
 1,075 (0.34)
 1 (0.38)
 0.09
 90.34
Isolate source
Urine 265,690 (84.01) 85 (31.95) 0.03 70.30
Wound 23,269 (7.36) 66 (24.81) 0.28 80.16
Lower respiratory tract 14,400 (4.55) 74 (27.82) 0.51 86.64
Blood 8,605 (2.72) 37 (13.91) 0.43 87.56
Other¶
 4,289 (1.36)
 4 (1.50)
 0.09
 82.91
Age group, y
1–5 120,500 (38.10) 145 (54.51) 0.12 72.43
6–12 100,198 (31.68) 63 (23.68) 0.06 71.68
13–17
 95,555 (30.21)
 58 (21.80)
 0.06
 72.14
Sex
F 255,181 (80.69) 154 (57.89) 0.06 70.49
M 56,105 (17.74) 105 (39.47) 0.19 78.76
Unknown
 4,967 (1.57)
 7 (2.63)
 0.14
 5.37
Region
West 78,795 (24.92) 47 (17.67) 0.06 73.62
South Atlantic 69,066 (21.84) 53 (19.92) 0.08 78.97
East North Central 57,846 (18.29) 18 (6.77) 0.03 56.13
South Central 44,414 (14.04) 28 (10.53) 0.06 82.22
North East 41,892 (13.25) 63 (23.68%) 0.15 71.35
West North Central 24,240 (7.66) 57 (21.43) 0.24 67.49

*Data for patients <1 year of age were not available for all years and excluded from analysis. CRE, carbapenem-resistant Enterobacteriaceae. CRE is defined as resistance to all tested third-generation cephalosporins (ceftriaxone, cefotaxime, or ceftazidime), and nonsusceptiblity to >1 carbapenem (ertapenem, imipenem, meropenem, or doripenem). For bacteria with intrinsic imipenem nonsusceptibility (P. mirabilis), the CRE criteria required nonsusceptibility to >2 of the carbapenems listed. ICU, intensive care unit.
†Isolates were tested against >1 third-generation cephalosporin and >1 carbapenem of those considered for the CRE phenotype.
‡E. aerogenes and E. cloacae.
§C. freundii and C. koseri.
¶Includes upper respiratory tract and skin cultures.

Main Article

Page created: October 29, 2015
Page updated: October 29, 2015
Page reviewed: October 29, 2015
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