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Volume 21, Number 11—November 2015

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 3

Co-resistance of 266 carbapenem-resistant Enterobacteriaceae isolates, The Surveillance Network–USA Database 1999–2012*

Drug class or drug No. nonsusceptible/no. tested (%)
Aminoglycosides 139/266 (52.26)
Gentamicin 108/265 (40.75)
Tobramycin 116/235 (49.36)
Amikacin 49/230 (21.30)
β-lactam/β-lactamase inhibitors 236/249 (94.78)
Ampicillin/sulbactam† 188/194 (96.91)
Piperacillin/tazobactam 201/231 (87.01)
Cefepime 125/241 (51.87)
Ciprofloxacin 122/253 (48.22)
Trimethoprim/sulfamethoxazole 142/263 (53.99)
Multidrug resistant‡ 127/263 (48.29)

*Rows showing drug classes (aminoglycosides, β-lactam/β-lactamase inhibitors) indicate number of isolates that were tested against >1 drug listed in the class and the number of isolates that were nonsusceptible to >1 drug listed in the class. Tigecycline susceptibility test results were not recorded in the database. Polymyxin B and colistin susceptibility test results were recorded in the database, but none of the carbapenem-resistant Enterobacteriaceae (CRE) isolates were tested against those drugs. Only 1 CRE-positive isolate was tested against fosfomycin. 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.
Citrobacter (n = 8) and Enterobacter (n = 98) species are intrinsically resistant (22) to ampicillin/sulbactam. However, they have been included in the table.
‡These CRE isolates were nonsusceptible to >1 drug from each of the following 3 drug classes: aminoglycosides (gentamicin, tobramycin, amikacin), β-lactams (ampicillin/sulbactam, piperacillin/tazobactam), fluoroquinolones (ciprofloxacin), and trimethoprim/sulfamethoxazole.

Main Article

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