Carbapenem-Resistant Enterobacteriaceae Infections in Children in Latin America
Author Information
Author(s): Ruvinsky Silvina, Voto Carla, Roel Macarena, Portillo Victoria, Naranjo Zuñiga Gabriela, Ulloa-Gutierrez Rolando, Comandé Daniel, Ciapponi Agustín, Aboud Gabriela, Brizuela Martín, Bardach Ariel
Primary Institution: Hospital de Pediatría Dr. Juan P. Garrahan, Buenos Aires, Argentina
Hypothesis
What is the impact of carbapenem-resistant Enterobacteriaceae bloodstream infections in pediatric populations from Latin America and the Caribbean?
Conclusion
CRE bloodstream infections pose a significant threat to children with underlying conditions in Latin America and the Caribbean, leading to high morbidity and mortality.
Supporting Evidence
- 14 studies involving 189 patients were analyzed.
- Most cases were reported from Brazil, Argentina, Colombia, and Paraguay.
- The median age of the patients was 35 months.
- Key risk factors included immunocompromised status and invasive procedures.
- The infections were predominantly hospital-acquired.
- Klebsiella pneumoniae was the most common pathogen.
- The mortality rate was found to be 34%.
- Most patients received combination antimicrobial therapy for a median of 17 days.
Takeaway
This study shows that a type of bacteria that is hard to treat is making kids very sick in Latin America, especially those who are already sick.
Methodology
This systematic review followed Cochrane methodology and PRISMA/MOOSE guidelines, analyzing studies on hospitalized patients under 19 years with CRE bloodstream infections.
Potential Biases
Most studies had a low risk of bias, but challenges included determining whether cases were consecutive.
Limitations
The included studies often had a limited number of patients, and the clinical heterogeneity may affect the generalizability of results.
Participant Demographics
Patients had a median age of 35 months, with 56% being male and 62% immunocompromised.
Statistical Information
Confidence Interval
95% CI: 16–76 months
Digital Object Identifier (DOI)
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