Bal ZS, et al. - Researchers here aimed to determine the epidemiologic and clinical risk characteristics, risk factors, and outcome of Carbapenem-resistant gram-negative (CRGN) infections and to compare with carbapenem-sensitive gram-negative (CSGN) infections in children. They recognized prior carbapenem exposure and prolonged hospitalization as the most significant risk factors for acquiring CRGN infections in their hospital. Findings supported the previous reports that carbapenem resistance increases morbidity, mortality, and health care costs.

Methods

• From April 1, 2014, to December 31, 2014, newly diagnosed CRGN infections in hospitalized children younger than age 18 years were prospectively recorded.
• All patients infected with a CSGN pathogen in the same unit within 48 hours of diagnosis were included in a control group.

Results

• This study enrolled twenty-seven patients with CRGN infections and 28 patients with CSGN infections.
• Both groups had ventilator-associated pneumonia as the most common type of infection.
• Independent risk factors for acquiring CRGN infections included prior exposure to carbapenems (relative risk [RR], 11.368; 95% confidence interval [CI], 1.311-98.589), prolonged hospitalization (RR, 5.100; 95% CI, 1.601-16.242).
• In the CRGN group, septic shock was markedly more frequent (RR, 9.450; 95% CI, 1.075-83.065).
• Higher in-hospital mortality was observed in the CRGN group (RR, 7.647; 95% CI, 1.488-39.290).