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Carbapenem-Resistant and Extended-Spectrum β-Lactamase-Producing Enterobacterales in Children, United States, 2016-2020

Heather N Grome et al. Emerg Infect Dis. 2024 Jun.

Abstract

2019–2020 at 6 US sites. Among 159 CRE cases in children (median age 5 years), CRE was isolated from urine for 131 (82.4%) and blood from 20 (12.6%). Annual CRE incidence rate (cases/100,000 population) was 0.47–0.87. Among 207 ESBL-E cases in children (median age 6 years), ESBL-E was isolated from urine of 196 (94.7%) and blood of 8 (3.9%). Annual ESBL-E incidence rate was 26.5 in 2019 and 19.63 in 2020. CRE and ESBL-E rates were >2-fold higher among infants than other age groups. Most CRE and ESBL-E cases were healthcare-associated community-onset (68 [43.0%] for CRE vs. 40 [23.7%] for ESBL-E) or community-associated (43 [27.2%] for CRE vs. 109 [64.5%] for ESBL-E). Programs to detect, prevent, and treat multidrug-resistant infections must include pediatric populations (particularly the youngest) and outpatient settings.

Keywords: Enterobacterales; United States; antimicrobial resistance; bacteria; carbapenem-resistant Enterobacterales; child; communicable diseases; epidemiology; extended-spectrum β-lactamase-producing Enterobacterales; public health.

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Figures

Figure
Figure
Annual crude incidence rates (cases/100,000 pediatric population) for incident pediatric carbapenem-resistant Enterobacterales (A) and extended-spectrum β-lactamase–producing Enterobacterales (B) cases, by age group, United States, 2016–2020. Incidence rate denominators are also stratified by age group.
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