Molecular epidemiology of carbapenemase encoding genes in infections in children: a systematic review.

BACKGROUND

complex is the leader pathogen for the World Health Organization's list due to the escalating prevalence of multidrug-resistant strains. Insights into the molecular characterization of carbapenemase genes in complex infections among children are scarce. To address this gap, we conducted a systematic review to describe the molecular epidemiology of the carbapenemase genes in complex infections in the pediatric population.

METHODS

Adhering to the PRISMA 2020 guidelines for reporting systematic reviews, we conducted a review of in chore bibliographic databases published in English and Spanish, between January 2020 and December 2022. All studies conducted in patients ≤6 years with molecular characterization of carbapenemase-encoding genes in infections were included.

RESULTS

In total, 1129 cases were reviewed, with an overall carbapenem-resistance rate of 60.3%. was isolated from blood cultures in 66.6% of cases. Regionally, the Eastern Mediterranean exhibited the highest prevalence of carbapenem resistance (88.3%). Regarding the carbapenemase genes, bla displayed an overall prevalence of 1.2%, while class B bla had a prevalence of 10.9%. Class D bla reported a prevalence of 64%, bla and bla had a prevalence of 33% and 18.1%, respectively. Notably, the Americas region showed a prevalence of bla at 91.6%.

CONCLUSION

Our work highlights the high prevalence of carbapenem-resistant and class D carbapenemase genes in children. Of note the distribution of different carbapenemase genes reveals considerable variations across WHO regions. To enhance epidemiological understanding, further extensive studies in children are imperative.