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Published on: February 17, 2023
Metallo-β-Lactamase (MBL)-Producing Enterobacteriaceae in United States Children
Latania K Logan1, Robert A Bonomo2
1Pediatrics, Rush University Medical Center, Rush Medical College, Chicago, Illinois; Research Service, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Ohio.
Abstract:
Metallo-β-lactamases (MBLs) are emerging as the most notable resistance determinants in Enterobacteriaceae. In many cases, the genes encoding MBLs are part of complex, mobile genetic elements that carry other resistance determinants. In the United States, there are increasing reports of MBL-producing Enterobacteriaceae, with New Delhi MBLs (NDMs) accounting for the majority of transmissible MBL infections. Many infections caused by NDM-producing bacteria are associated with international travel and medical tourism. However, little recognition of the introduction of MBL-producing Enterobacteriaceae into the pediatric community has followed. Reports suggest that this occurred as early as 2002. Here, we reflect on the unwelcome emergence of MBL-producing Enterobacteriaceae in US children and the available clinical and molecular data associated with spread. Since 2002, there have been disturbing reports that include the most readily transmissible MBLs, bla IMP, bla VIM, and bla NDM types. In the majority of children with available data, a history of foreign travel is absent.
Insights
Metallo-β-lactamases (MBLs) are increasingly found in U.S. children, often without a travel history. These resistant bacteria pose a growing public health concern, particularly New Delhi metallo-β-lactamases (NDMs).
Area of Science:
- Microbiology
- Infectious Diseases
- Pediatrics
Background:
- Metallo-β-lactamases (MBLs) are significant resistance determinants in Enterobacteriaceae.
- MBL genes are often on mobile genetic elements, co-carrying other resistance genes.
- Increasing reports of MBL-producing Enterobacteriaceae, especially New Delhi MBLs (NDMs), are noted in the U.S.
Purpose of the Study:
- To highlight the emergence of MBL-producing Enterobacteriaceae in the U.S. pediatric population.
- To review available clinical and molecular data on the spread of these resistant bacteria in children.
- To underscore the challenges in identifying the source of MBL infections in pediatric cases.
Main Methods:
- Review of existing clinical and molecular data on MBL-producing Enterobacteriaceae in U.S. children.
- Analysis of reported cases since 2002, focusing on MBL types (bla IMP, bla VIM, bla NDM).
- Examination of patient travel history and other epidemiological factors.
Main Results:
- MBL-producing Enterobacteriaceae, including NDM types, have been reported in U.S. children since 2002.
- The majority of pediatric cases reviewed lacked a history of international travel.
- Commonly reported MBL types include bla IMP, bla VIM, and bla NDM.
Conclusions:
- MBL-producing Enterobacteriaceae represent a growing threat in U.S. children.
- The absence of travel history in most pediatric cases complicates infection source identification.
- Continued surveillance and research are crucial to combat the spread of MBLs in pediatric populations.
