A multicenter investigation of two types of carbapenem-resistant Enterobacteriaceae in pediatric patients in Jiangxi Province for three consecutive years_West China Medical Journal

Authors：

CHEN Xiuwen ¹ ,  XIE Chengfeng ¹ , ZHANG Xinping ¹ , ZHOU Yan ² , ZHOU Zhiqiu ¹ , WAN Xiaohua ¹ , LI Sisi ¹ , FU Rui ¹

1. Infection Control and Public Health Department, Jiangxi Provincial Children’s Hospital, Nanchang, Jiangxi 330006, P. R. China;
2. Clinical Laboratory, Jiangxi Provincial Children’s Hospital, Nanchang, Jiangxi 330006, P. R. China;

Corresponding author：

XIE Chengfeng, Email: XCF815699165@163.com

Keywords：

Pediatric patient; Carbapenem-resistant Enterobacteriaceae; Carbapenem-resistant Klebsiella pneumoniae; Carbapenem-resistant Escherichia coli; Investigation

DOI：

10.7507/1002-0179.202102066

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the burden of carbapenem-resistant Klebsiella pneumoniae (CRKPN) and carbapenem-resistant Escherichia coli (CRECO), two types of carbapenem-resistant Enterobacteriaceae (CRE), in pediatric patients in Jiangxi Province.Methods A retrospective investigation was carried out for the distribution of CRKPN/CRECO in pediatric (neonatal group and non-neonatal group) and adult patients in 30 hospitals in Jiangxi Province from January 2016 to December 2018, and the changing trends and detection situations of different patients and types of hospitals were compared and analyzed.Results From 2016 to 2018, the annual resistance rates of Klebsiella pneumoniae and Escherichia coli to carbapenem in pediatric patients were 5.89%, 4.03%, and 4.24%, respectively, showed a downward trend (χ²_trend=5.568, P=0.018). The resistance rate of Klebsiellae pneumoniae and Escherichia coli to carbapenem in neonatal group was higher than that in non-neonatal group (8.44% vs. 3.40%; χ²=63.155, P<0.001) and adult group (8.44% vs. 3.45%; χ²=97.633, P<0.001). In pediatric patients, the 3-year carbapenem resistance rate of Klebsiella pneumoniae was higher than that of Escherichia coli (9.10% vs. 2.48%; χ²=128.177, P<0.001). In non-neonatal pediatric patients, the 3-year resistance rate of Klebsiella pneumoniae and Escherichia coli to carbapenem in maternity and children hospitals was higher than that in general hospitals (4.35% vs. 1.36%; χ²=25.930, P<0.001). CRKPN/CRECO detected in pediatrics were mainly isolated from sputum (31.64%), blood (24.36%), urine (13.82%), and pus (8.36%).Conclusion Although the overall resistance rate of Klebsiella pneumoniae and Escherichia coli to carbapenem in pediatric patients showed a downward trend, that in neonatal patients was still high, and the monitoring and prevention and control measures of CRE should be strengthened in neonatal patients.

Citation： CHEN Xiuwen, XIE Chengfeng, ZHANG Xinping, ZHOU Yan, ZHOU Zhiqiu, WAN Xiaohua, LI Sisi, FU Rui. A multicenter investigation of two types of carbapenem-resistant Enterobacteriaceae in pediatric patients in Jiangxi Province for three consecutive years. West China Medical Journal, 2021, 36(3): 322-327. doi: 10.7507/1002-0179.202102066 Copy

1.	胡付品, 郭燕, 朱德妹, 等. 2018年CHINET中国细菌耐药性监测. 中国感染与化疗杂志, 2020, 20(1): 1-10.
2.	郑少微, 李萍, 张正良, 等. 2005-2017年中国CHINET常见革兰阴性菌对碳青霉烯类抗生素耐药的监测结果. 临床急诊杂志, 2019, 20(1): 40-44.
3.	刘卫平, 海云婷, 杨丽芳, 等. 某三级综合医院耐碳青霉烯肠杆菌科细菌流行特征及耐药性分析. 中华医院感染学杂志, 2020, 30(19): 2943-2948.
4.	谢伟, 景春梅. 2010-2015年重庆市某三甲儿童医院新生儿感染细菌的变迁及耐药性分析. 中国感染与化疗杂志, 2017, 17(4): 428-432.
5.	祝俊英, 王春, 孙燕, 等. 儿科患者中分离的碳青霉烯类耐药肺炎克雷伯菌分子流行病学分析及耐药机制研究. 中国感染与化疗杂志, 2016, 16(05): 578-582.
6.	Logan LK, Renschler JP, Gandra S, et al. Carbapenem-resistant enterobacteriaceae in children, United States, 1999-2012. Emerg Infect Dis, 2015, 21(11): 2014-2021.
7.	全国细菌耐药监测网. 2014至2017年中国儿童及新生儿患者细菌耐药监测研究. 中华医学杂志, 2018, 98(40): 3279-3287.
8.	Rahal JJ. The role of carbapenems in initial therapy for serious Gram-negative infections. Crit Care, 2008, 12(Suppl 4): S5.
9.	Cassini A, Högberg LD, Plachouras D, et al. Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis. Lancet Infect Dis, 2019, 19(1): 56-66.
10.	徐英春, 肖永红, 卓超, 等. 中国碳青霉烯类耐药肠杆菌科细菌的流行病学和防控策略. 中国执业药师, 2013, 10(4): 3-8.
11.	Han R, Shi Q, Wu S, et al. Dissemination of carbapenemases (KPC, NDM, OXA-48, IMP, and VIM) among carbapenem-resistant enterobacteriaceae isolated from adult and children patients in China. Front Cell Infect Microbiol, 2020, 10: 314.
12.	Montagnani C, Prato M, Scolfaro C, et al. Carbapenem-resistant Enterobacteriaceae infections in children: an Italian retrospective multicenter study. Pediatr Infect Dis J, 2016, 35(8): 862-868.
13.	Han JH, Goldstein EJ, Wise J, et al. Epidemiology of carbapenem-resistant Klebsiella pneumoniae in a network of long-term acute care hospitals. Clin Infect Dis, 2017, 64(7): 839-844.
14.	Haller S, Eller C, Hermes J, et al. What caused the outbreak of ESBL-producing Klebsiella pneumoniae in a neonatal intensive care unit, Germany 2009 to 2012? Reconstructing transmission with epidemiological analysis and whole-genome sequencing. BMJ Open, 2015, 5(5): e007397.
15.	胡付品, 郭燕, 朱德妹, 等. 2017年CHINET中国细菌耐药性监测. 中国感染与化疗杂志, 2018, 18(3): 241-251.
16.	Zhu J, Sun L, Ding B, et al. Outbreak of NDM-1-producing Klebsiella pneumoniae ST76 and ST37 isolates in neonates. Eur J Clin Microbiol Infect Dis, 2016, 35(4): 611-618.
17.	李丽娟, 赵丹洋, 黄雪敏, 等. 全球新生儿医院感染暴发事件数据分析. 中华医院感染学杂志, 2020, 30(18): 2859-2863.
18.	张琴, 许健, 宋培培. 儿科患者检出耐碳青霉烯类抗菌药物肠杆菌科细菌分布特征及耐药性分析. 中国抗生素杂志, 2020, 45(12): 1273-1278.
19.	边程鹏, 张月, 庄晓玲, 等. 新生儿肺炎克雷伯菌肺炎临床及耐药性分析. 热带医学杂志, 2020, 20(7): 959-962.
20.	姚佳峰, 李楠, 姜锦. 单中心血液肿瘤患儿合并感染病原菌分布及耐药性病例系列报告. 中国循证儿科杂志, 2019, 14(2): 112-117.
21.	付盼, 王传清, 俞蕙, 等. 中国儿童细菌耐药监测组2017年儿童细菌感染及耐药监测. 中国循证儿科杂志, 2018, 13(6): 406-411.
22.	周静芳, 凌勇, 刘伟江, 等. 耐碳青霉烯类肠杆菌科细菌的感染特征和危险因素分析. 中华医院感染学杂志, 2017, 27(1): 16-19.
23.	Ara-Montojo MF, Escosa-García L, Alguacil-Guillén M, et al. Predictors of mortality and clinical characteristics among carbapenem-resistant or carbapenemase-producing Enterobacteriaceae bloodstream infections in Spanish children. J Antimicrob Chemother, 2021, 76(1): 220-225.
24.	Nabarro LB, Shankar C, Pragasam AK, et al. Clinical and bacterial risk factors for mortality in children with carbapenem-resistant Enterobacteriaceae bloodstream infections in India. Pediatr Infect Dis J, 2017, 36(6): e161-e166.

1. 胡付品, 郭燕, 朱德妹, 等. 2018年CHINET中国细菌耐药性监测. 中国感染与化疗杂志, 2020, 20(1): 1-10.
2. 郑少微, 李萍, 张正良, 等. 2005-2017年中国CHINET常见革兰阴性菌对碳青霉烯类抗生素耐药的监测结果. 临床急诊杂志, 2019, 20(1): 40-44.
3. 刘卫平, 海云婷, 杨丽芳, 等. 某三级综合医院耐碳青霉烯肠杆菌科细菌流行特征及耐药性分析. 中华医院感染学杂志, 2020, 30(19): 2943-2948.
4. 谢伟, 景春梅. 2010-2015年重庆市某三甲儿童医院新生儿感染细菌的变迁及耐药性分析. 中国感染与化疗杂志, 2017, 17(4): 428-432.
5. 祝俊英, 王春, 孙燕, 等. 儿科患者中分离的碳青霉烯类耐药肺炎克雷伯菌分子流行病学分析及耐药机制研究. 中国感染与化疗杂志, 2016, 16(05): 578-582.
6. Logan LK, Renschler JP, Gandra S, et al. Carbapenem-resistant enterobacteriaceae in children, United States, 1999-2012. Emerg Infect Dis, 2015, 21(11): 2014-2021.
7. 全国细菌耐药监测网. 2014至2017年中国儿童及新生儿患者细菌耐药监测研究. 中华医学杂志, 2018, 98(40): 3279-3287.
8. Rahal JJ. The role of carbapenems in initial therapy for serious Gram-negative infections. Crit Care, 2008, 12(Suppl 4): S5.
9. Cassini A, Högberg LD, Plachouras D, et al. Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis. Lancet Infect Dis, 2019, 19(1): 56-66.
10. 徐英春, 肖永红, 卓超, 等. 中国碳青霉烯类耐药肠杆菌科细菌的流行病学和防控策略. 中国执业药师, 2013, 10(4): 3-8.
11. Han R, Shi Q, Wu S, et al. Dissemination of carbapenemases (KPC, NDM, OXA-48, IMP, and VIM) among carbapenem-resistant enterobacteriaceae isolated from adult and children patients in China. Front Cell Infect Microbiol, 2020, 10: 314.
12. Montagnani C, Prato M, Scolfaro C, et al. Carbapenem-resistant Enterobacteriaceae infections in children: an Italian retrospective multicenter study. Pediatr Infect Dis J, 2016, 35(8): 862-868.
13. Han JH, Goldstein EJ, Wise J, et al. Epidemiology of carbapenem-resistant Klebsiella pneumoniae in a network of long-term acute care hospitals. Clin Infect Dis, 2017, 64(7): 839-844.
14. Haller S, Eller C, Hermes J, et al. What caused the outbreak of ESBL-producing Klebsiella pneumoniae in a neonatal intensive care unit, Germany 2009 to 2012? Reconstructing transmission with epidemiological analysis and whole-genome sequencing. BMJ Open, 2015, 5(5): e007397.
15. 胡付品, 郭燕, 朱德妹, 等. 2017年CHINET中国细菌耐药性监测. 中国感染与化疗杂志, 2018, 18(3): 241-251.
16. Zhu J, Sun L, Ding B, et al. Outbreak of NDM-1-producing Klebsiella pneumoniae ST76 and ST37 isolates in neonates. Eur J Clin Microbiol Infect Dis, 2016, 35(4): 611-618.
17. 李丽娟, 赵丹洋, 黄雪敏, 等. 全球新生儿医院感染暴发事件数据分析. 中华医院感染学杂志, 2020, 30(18): 2859-2863.
18. 张琴, 许健, 宋培培. 儿科患者检出耐碳青霉烯类抗菌药物肠杆菌科细菌分布特征及耐药性分析. 中国抗生素杂志, 2020, 45(12): 1273-1278.
19. 边程鹏, 张月, 庄晓玲, 等. 新生儿肺炎克雷伯菌肺炎临床及耐药性分析. 热带医学杂志, 2020, 20(7): 959-962.
20. 姚佳峰, 李楠, 姜锦. 单中心血液肿瘤患儿合并感染病原菌分布及耐药性病例系列报告. 中国循证儿科杂志, 2019, 14(2): 112-117.
21. 付盼, 王传清, 俞蕙, 等. 中国儿童细菌耐药监测组2017年儿童细菌感染及耐药监测. 中国循证儿科杂志, 2018, 13(6): 406-411.
22. 周静芳, 凌勇, 刘伟江, 等. 耐碳青霉烯类肠杆菌科细菌的感染特征和危险因素分析. 中华医院感染学杂志, 2017, 27(1): 16-19.
23. Ara-Montojo MF, Escosa-García L, Alguacil-Guillén M, et al. Predictors of mortality and clinical characteristics among carbapenem-resistant or carbapenemase-producing Enterobacteriaceae bloodstream infections in Spanish children. J Antimicrob Chemother, 2021, 76(1): 220-225.
24. Nabarro LB, Shankar C, Pragasam AK, et al. Clinical and bacterial risk factors for mortality in children with carbapenem-resistant Enterobacteriaceae bloodstream infections in India. Pediatr Infect Dis J, 2017, 36(6): e161-e166.

West China Medical Journal

A multicenter investigation of two types of carbapenem-resistant Enterobacteriaceae in pediatric patients in Jiangxi Province for three consecutive years

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content