Logan Latania K, Renschler John P, Gandra Sumanth, Weinstein Robert A, Laxminarayan Ramanan
Emerg Infect Dis. 2015 Nov;21(11):2014-21. doi: 10.3201/eid2111.150548.
The prevalence of carbapenem-resistant Enterobacteriaceae (CRE) infections is increasing in the United States. However, few studies have addressed their epidemiology in children. To phenotypically identify CRE isolates cultured from patients 1-17 years of age, we used antimicrobial susceptibilities of Enterobacteriaceae reported to 300 laboratories participating in The Surveillance Network-USA database during January 1999-July 2012. Of 316,253 isolates analyzed, 266 (0.08%) were identified as CRE. CRE infection rate increases were highest for Enterobacter species, blood culture isolates, and isolates from intensive care units, increasing from 0.0% in 1999-2000 to 5.2%, 4.5%, and 3.2%, respectively, in 2011-2012. CRE occurrence in children is increasing but remains low and is less common than that for extended-spectrum β-lactamase-producing Enterobacteriaceae. The molecular characterization of CRE isolates from children and clinical epidemiology of infection are essential for development of effective prevention strategies.
在美国，耐碳青霉烯类肠杆菌科细菌（CRE）感染的患病率正在上升。然而，很少有研究涉及它们在儿童中的流行病学情况。为了从表型上鉴定从1至17岁患者中培养出的CRE分离株，我们利用了1999年1月至2012年7月期间向参与美国监测网络数据库的300个实验室报告的肠杆菌科细菌的抗菌药敏数据。在分析的316,253株分离株中，266株（0.08%）被鉴定为CRE。肠杆菌属、血培养分离株以及重症监护病房分离株的CRE感染率上升幅度最大，分别从1999 - 2000年的0.0%增至2011 - 2012年的5.2%、4.5%和3.2%。儿童中CRE的发生率正在上升，但仍然很低，且比产超广谱β-内酰胺酶的肠杆菌科细菌少见。对儿童CRE分离株进行分子特征分析以及感染的临床流行病学研究对于制定有效的预防策略至关重要。
