ArticleThe Pediatric infectious disease journal2019
Community Origins and Regional Differences Highlight Risk of Plasmid-mediated Fluoroquinolone Resistant Enterobacteriaceae Infections in Children.
Article in The Pediatric infectious disease journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 25 citations in OpenAlex.
- Role of Households with Children in Community Spread of Multidrug-Resistant Enterobacterales, St. Louis, Missouri, USA.Emerging infectious diseases · 2026Article
- Community-based household surface sampling: A citizen science approach for recovery of multidrug-resistant Enterobacterales.Journal of microbiological methods · 2026Article
- Unilateral Palpebral Edema as a Central Sign of Acute Enterobacter-Associated Rhinosinusitis in a 5-Year-Old: A Rare Pediatric Case.Reports (MDPI) · 2025Article
- Three simple and cost-effective assays for AAC(6')-Ib-cr enzyme activity.Frontiers in microbiology · 2025Article
- Carbapenem-Resistant and Extended-Spectrum β-Lactamase-Producing Enterobacterales in Children, United States, 2016-2020.Emerging infectious diseases · 2024Article
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- Factors associated with plasmid antibiotic resistance gene carriage revealed using large-scale multivariable analysis.Scientific reports · 2023Article
- The role of the plasmid-mediated fluoroquinolone resistance genes as resistance mechanisms in pediatric infections due to Enterobacterales.Frontiers in cellular and infection microbiology · 2023Article
- Treatment and Epidemiology of Third-Generation Cephalosporin-Resistant Urinary Tract Infections.Pediatrics · 2022Article
- Bacterial Species and Antimicrobial Resistance of Clinical Isolates from Pediatric Patients in Yangon, Myanmar, 2020.Infectious disease reports · 2022Article
- Resistome and microbial profiling of pediatric patient's gut infected with multidrug-resistant diarrhoeagenicThe Libyan journal of medicine · 2021Article
- Whole Genome Sequencing Detects Minimal Clustering Among Escherichia coli Sequence Type 131-H30 Isolates Collected From United States Children's Hospitals.Journal of the Pediatric Infectious Diseases Society · 2021Article
- Emerging Carbapenem-ResistantInfection and drug resistance · 2021Review
- A Pilot Study of Chicago Waterways as Reservoirs of Multidrug-ResistantAntimicrobial agents and chemotherapy · 2020Article
- The Clinical and Molecular Epidemiology of CTX-M-9 Group Producing Enterobacteriaceae Infections in Children.Infectious diseases and therapy · 2019Article
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Authors and funding
13 authors at 7 institutions in 1 country.
Funding
Abstract
backgroundFluoroquinolones are uncommonly prescribed in children, yet pediatric multidrug resistant (MDR) enterobacteriaceae (Ent) infections often reveal fluoroquinolone resistance (FQR). We sought to define the molecular epidemiology of FQR and MDR-Ent in children.
methodsA case-control analysis of children with MDR-Ent infections at 3 Chicago hospitals was performed. Cases were children with third-generation cephalosporin-resistant and/or carbapenem-resistant Ent infections. Polymerase chain reaction and DNA analysis assessed bla and plasmid-mediated FQR (PMFQR) genes. Controls were children with third-generation cephalosporin, fluoroquinolone, and carbapenem-susceptible Ent infections matched by age, source and hospital. We assessed clinical-epidemiologic predictors of PMFQR Ent infection.
resultsOf 169 third-generation cephalosporin-resistant and/or carbapenem-resistant Ent isolates from children (median age, 4.8 years), 85 were FQR; 56 (66%) contained PMFQR genes. The predominant organism was Escherichia coli, and most common bla gene blaCTX-M-1 group. In FQR isolates, PMFQR gene mutations included aac6'1bcr, oqxA/B, qepA and qnrA/B/D/S in 83%, 15%, 13% and 11% of isolates, respectively. FQR E. coli was often associated with phylogroup B2, ST43/ST131. On multivariable analysis, PMFQR Ent infections occurred mostly in outpatients (odds ratio, 33.1) of non-black-white-Hispanic race (odds ratio, 6.5). Residents of Southwest Chicago were >5 times more likely to have PMFQR Ent infections than those in the reference region, while residence in Central Chicago was associated with a 97% decreased risk. Other demographic, comorbidity, invasive-device, antibiotic use or healthcare differences were not found.
conclusionsThe strong association of infection with MDR organisms showing FQR with patient residence rather than with traditional risk factors suggests that the community environment is a major contributor to spread of these pathogens in children.
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