Emergence of carbapenem-resistant Enterobacteriaceae in a UK paediatric hospital

Area of Science:

• Medical Microbiology
• Infectious Diseases
• Paediatric Healthcare

Background:

• Carbapenem-resistant Enterobacteriaceae (CRE) pose a significant and increasing global infection risk.
• Limited data exist on the clinical impact and prevalence of CRE infections specifically within paediatric populations.
• Understanding CRE epidemiology in children is vital for effective infection control.

Purpose of the Study:

• To determine the prevalence of CRE in clinical and surveillance samples from a UK tertiary children's hospital.
• To identify the resistance mechanisms employed by CRE isolates in this paediatric setting.
• To characterize carbapenemase-producing strains using molecular typing.

Main Methods:

• Retrospective analysis of clinical and surveillance specimens collected between September 2011 and August 2012.
• Phenotypic and molecular methods were used to ascertain carbapenem resistance mechanisms.
• Variable number tandem repeat (VNTR) profiling was employed for typing carbapenemase-producing isolates.

Main Results:

• CRE were identified in 24 patients over a 12-month period.
• The prevalence of CRE detected via rectal surveillance was 4.5% (19/421 patients).
• Seven isolates harboured carbapenemases (three blaKPC, four blaNDM); 17 exhibited resistance via AmpC/ESBLs and impermeability.

Conclusions:

• CRE, particularly carbapenemase-producers, represent an emerging infectious challenge in UK paediatric hospitals.
• The findings underscore the need for robust active surveillance programs to manage and mitigate CRE spread in children.
• Early detection and characterization of CRE are essential for guiding clinical management and public health interventions.