Clinical outcomes and the impact of treatment modalities in children with carbapenem-resistant Enterobacteriaceae bloodstream infections: a retrospective cohort study from a tertiary university hospital

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dc.authorid0000-0002-0562-3544
dc.authorid0000-0002-2464-0892
dc.authorid0000-0002-4762-0747
dc.authorid0000-0001-6965-0886
dc.authorid0000-0001-7111-4214
dc.authorid0000-0001-5707-2986
dc.authorid0000-0002-0970-6582
dc.authorid0000-0003-3993-3396
dc.authorid0000-0001-9189-8220
dc.contributor.authorAvcu, Gulhadiye
dc.contributor.authorErci, Ece
dc.contributor.authorBilen, Nimet Melis
dc.contributor.authorErsayoglu, Irem
dc.contributor.authorOzek, Gulcihan
dc.contributor.authorCeltik, Ulgen
dc.contributor.authorTerek, Demet
dc.contributor.authorCilli, Feriha
dc.contributor.authorBal, Zumrut Sahbudak
dc.date.accessioned2025-04-11T11:28:25Z
dc.date.available2025-04-11T11:28:25Z
dc.date.issued2024
dc.departmentEge Üniversitesi, Tıp Fakültesi, Dahili Bilimler Bölümü, Çocuk Sağlığı ve Hastalıkları Ana Bilim Dalı
dc.description.abstractBackground: The increasing prevalence of carbapenem-resistant Enterobacteriaceae (CRE) infections among children represents a significant global concern, leading to elevated mortality rates. The aim of this study was to evaluate the risk factors, outcomes, 30-day mortality rates and contributing factors in children with CRE bloodstream infections (CRE-BSIs). Methods: Data regarding demographic characteristics, treatment approaches and outcomes of hospitalized children aged 0-18 years diagnosed with CRE-BSIs between January 2018 and December 2022 were extracted from medical records. Mortality within 30 days of diagnosis and the predictive factors were analysed. Results: A total of 114 children, with a median age of 11 months (range: 6-69.5), were included. All cases of CRE-BSIs were either healthcare associated or hospital acquired and presented with at least one underlying comorbidity. A previous history of CRE colonization or infection rate was 48.2% (55/114). Klebsiella pneumoniae 87.7% (100/114) was the most frequently isolated microorganism, with a 30-day mortality rate of 14% (16/114). Multivariate analysis identified paediatric intensive care unit admission, invasive mechanical ventilation, inotropic support and thrombocytopenia due to CRE-BSIs as the most discriminative predictors for 30-day mortality (P < 0.001). Central venous catheter (CVC) removal was associated with a reduced mortality rate (P = 0.012). High-dose prolonged infusion of MEM-based or polymyxin-based antibiotic combinations did not impact survival. Lower MEM MIC values were associated with improved survival. Conclusions: The mortality rate of CRE-BSI is notably high in childhood. The use of antibiotic combination strategies did not demonstrate a significant impact on 30-day survival; however, the removal of CVCs was found to lower mortality rates.
dc.identifier.citationAvcu, G., Erci, E., Bilen, N. M., Ersayoglu, I., Ozek, G., Celtik, U., Terek, D., Cilli, F., & Bal, Z. S. (2025). Clinical outcomes and the impact of treatment modalities in children with carbapenem-resistant enterobacteriaceae bloodstream infections: A retrospective cohort study from a tertiary university hospital. Journal of Antimicrobial Chemotherapy, 80(1), 147-153.
dc.identifier.doi10.1093/jac/dkae387
dc.identifier.endpage153
dc.identifier.issn03057453
dc.identifier.issue1
dc.identifier.pmid39475360
dc.identifier.scopus2-s2.0-85214552007
dc.identifier.scopusqualityQ1
dc.identifier.startpage147
dc.identifier.urihttps://doi.org/10.1093/jac/dkae387
dc.identifier.urihttps://hdl.handle.net/11454/117055
dc.identifier.volume80
dc.identifier.wosWOS:001347956900001
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorAvcu, Gulhadiye
dc.institutionauthorErci, Ece
dc.institutionauthorBilen, Nimet Melis
dc.institutionauthorErsayoglu, Irem
dc.institutionauthorOzek, Gulcihan
dc.institutionauthorCeltik, Ulgen
dc.institutionauthorTerek, Demet
dc.institutionauthorCilli, Feriha
dc.institutionauthorBal, Zumrut Sahbudak
dc.institutionauthorid0000-0002-0562-3544
dc.institutionauthorid0000-0002-2464-0892
dc.institutionauthorid0000-0002-4762-0747
dc.institutionauthorid0000-0001-6965-0886
dc.institutionauthorid0000-0001-7111-4214
dc.institutionauthorid0000-0001-5707-2986
dc.institutionauthorid0000-0002-0970-6582
dc.institutionauthorid0000-0003-3993-3396
dc.institutionauthorid0000-0001-9189-8220
dc.language.isoen
dc.publisherOxford University Press
dc.relation.ispartofJournal of Antimicrobial Chemotherapy
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.titleClinical outcomes and the impact of treatment modalities in children with carbapenem-resistant Enterobacteriaceae bloodstream infections: a retrospective cohort study from a tertiary university hospital
dc.typeArticle

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