Emergence of carbapenem-resistant Enterobacteriaceae in a UK paediatric hospital

R.J. Drew, J.F. Turton, R.L.R.. Hill, David Livermore, N. Woodford, S. Paulus, N.A. Cunliffe

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Abstract

Background
Carbapenem-resistant Enterobacteriaceae are an emerging global infection threat. However, there are few data describing their clinical importance in children.

Aim
This retrospective study reviewed the prevalence and resistance mechanisms of carbapenem-resistant Enterobacteriaceae grown from clinical and surveillance samples in a large tertiary referral children's hospital in the UK.

Methods
Carbapenem-resistant Enterobacteriaceae were sought in specimens submitted for diagnostic and surveillance purposes at Alder Hey Children's NHS Foundation Trust, Liverpool, between September 2011 and August 2012. Mechanisms of resistance were identified using phenotypic and/or molecular methods. Variable number tandem repeat profiling was used to type carbapenemase-producing strains.

Findings
During the 12-month study period, carbapenem-resistant Enterobacteriaceae were recovered from 24 patients. Five isolates were from clinical diagnostic specimens whereas 19 of 421 patients had positive rectal surveillance swabs (4.5%). Of the 24 isolates, seven (all Klebsiella spp.) harboured carbapenemases: three had blaKPC and four blaNDM, whereas 17 had resistance due to combinations of AmpC or extended-spectrum ß-lactamase activity plus impermeability.

Conclusion
Carbapenem-resistant Enterobacteriaceae and, in particular, those with carbapenemases, are an emerging infection problem in a major paediatric hospital in the UK. Active surveillance is required to monitor and control their spread.
Original languageEnglish
Pages (from-to)300-304
Number of pages5
JournalJournal of Hospital Infection
Volume84
Issue number4
DOIs
Publication statusPublished - 1 Aug 2013

Keywords

  • Antimicrobial resistance
  • Carbapenemases
  • KPC
  • NDM

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