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Carbapenem-Resistant Gram-Negative Bacteria Colonization in Immunocompromised and Critically Ill Pediatric Patients:

Naveeya Pimtimanon1, Surapat Assawawiroonhakarn2, Sophida Boonsathorn1

  • 1Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Sage Open Pediatrics
|August 27, 2025
PubMed

Insights

Carbapenem-resistant Gram-negative bacteria (CRGNB) colonization affects nearly 10% of high-risk pediatric patients. This colonization is linked to longer hospital stays and increased mortality, highlighting the need for early detection and control.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Public Health

Background:

  • Carbapenem-resistant Gram-negative bacteria (CRGNB), encompassing carbapenem-resistant Enterobacteriaceae (CRE) and carbapenem-resistant Acinetobacter baumannii (CRAB), present a substantial threat to vulnerable patient populations.
  • Immunocompromised and critically ill individuals are particularly at risk from CRGNB infections.

Purpose of the Study:

  • To determine the prevalence of CRGNB colonization in hospitalized pediatric patients who are immunocompromised or critically ill.
  • To identify risk factors associated with CRGNB colonization in this high-risk group.
  • To investigate the clinical outcomes, including hospital stay duration and mortality, associated with CRGNB colonization.

Main Methods:

  • A cross-sectional study was conducted at a tertiary care university hospital in Bangkok, Thailand.
  • Rectal swabs were collected from 302 hospitalized patients under 20 years of age within 48 hours of admission.
  • Statistical analysis was performed to identify independent risk factors and compare outcomes between colonized and non-colonized patients.

Main Results:

  • CRGNB colonization was detected in 9.6% of the study participants (29 out of 302).
  • The prevalence included 65.5% CRE and 34.5% CRAB.
  • Independent risk factors for colonization were recent surgery (aOR 7.6), hospital referral (aOR 3.03), and younger age (aOR 0.86).
  • Colonized patients experienced significantly longer hospital stays (12 days vs. 6 days) and higher mortality rates (17.2% vs. 5.5%) compared to non-colonized patients.

Conclusions:

  • CRGNB colonization is a significant issue in high-risk pediatric populations, affecting nearly 10% of those studied.
  • Colonization with CRGNB is associated with adverse clinical outcomes, including prolonged hospitalization and increased mortality.
  • Early identification and implementation of targeted infection control strategies are crucial for managing CRGNB in these vulnerable patients.
Abstract

Keywords:
carbapenem-resistant acinetobacter baumannii (CRAB)carbapenem-resistant enterobacteriaceae (CRE)colonizationimmunocompromised pediatric patients

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