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Carbapenem Resistant Enterobacteriaceae (CRE), a particularly potent superbug, is an emerging as a potent health threat across America. One out of two patients who develop sepsis caused by CRE will die. Now, new data shows that this deadly intruder is afflicting children at an alarming rate.
CRE is resistant to the majority of antibiotics and in particular, as the name implies, carbapenems. This class of antibiotics is considered vital in any physician's arsenal against infectious diseases, because in many cases Carbapenems are a last resort, a card only to be played when the bacteria is resistant to more standard drugs. But this in no longer the trump card that it used to be.
The data is from a new study conducted by researchers from Rush University Medical Center in Chicago. They analyzed 316,253 samples from children ranging from age 1 to 17 years. The data set covered the period from January 1999 through June 2012 and included statistics from the following settings: outpatient; inpatient intensive care; non-intensive care; and long-term care. The network includes approximately 300 clinical microbiology laboratories.
The study found that although overall CRE prevalence in children remained low, it's steadily increasing, with the figures climbing from zero percent in 1999-2000 to 5.2 percent in 2011-2012.
Additionally, CRE disproportionately affected males and younger children aged 1 to 5 years. Samples taken from blood and the lower respiratory tract also showed significantly higher increases of CRE, from zero percent in 1999 2000 (for both sites) to 3.2 percent and 2.3 percent in 2011 2012, respectively. This is particularly important given the very high mortality rate for blood infections.
With increasing prevalence, proponents of the study encourage initiatives to address tackling this superbug, and antibiotic resistance in general. The authors also noted that these superbugs have been extensively studied in adult populations, but much still remains to be explored as to how CRE may uniquely impact children, including the risk factors that make them more susceptible. Furthermore, the data show how antibiotic stewardship needs to improve in particular in pediatric care.
According to the CDC, more than 9,000 healthcare-associated infections caused by CRE occur annually, and at least one type of CRE has been detected in healthcare facilities in 44 states across the U.S. Furthermore, around 600 deaths per year result from infections caused by the two most common types of CRE, carbapenem-resistant Klebsiella spp. and carbapenem-resistant E. coli.
