ArticleThe Journal of antimicrobial chemotherapy2023
Carbapenem resistance in Enterobacterales bloodstream infections among children with cancer or post-haematopoietic stem cell transplant: a retrospective cohort study.
Article in The Journal of antimicrobial chemotherapy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed, 9 citations in OpenAlex.
- Simultaneous quantitation of tigecycline, meropenem, polymyxin B in plasma, and protein-binding analysis in HSCT patients.Bioanalysis · 2025Trial
- Carbapenem-resistant Enterobacterales infection at a South African paediatric hospital.BMC infectious diseases · 2026Article
- Clinical, microbiological characteristics and outcomes of carbapenemase-producing enterobacterales bloodstream infections in a pediatric hospital in Brazil.BMC infectious diseases · 2025Observational
- Whole Genome Sequencing ofAntibiotics (Basel, Switzerland) · 2025Article
- Prevalence and Associated Mortality of Infections by Multidrug-Resistant Organisms in Pediatric Intensive Care Units in Argentina (PREV-AR-P).Antibiotics (Basel, Switzerland) · 2025Article
- Carbapenem-ResistantAntibiotics (Basel, Switzerland) · 2024Review
- Infections withJournal of clinical medicine · 2024Article
- Development a risk prediction nomogram for multidrug-resistant bacterial and fungal infection in gastrointestinal fistula patients during the perioperative period.Frontiers in cellular and infection microbiology · 2024Article
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20 authors at 10 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRisk factors for carbapenem resistance in Enterobacterales bloodstream infections among children with cancer or post-HSCT have not been thoroughly explored.
methodsAll children with cancer or post-HSCT who developed Enterobacterales bloodstream infections in two cancer referral centres in major Colombian cities between 2012 and 2021 were retrospectively examined. When the infection episode occurred, carbapenem resistance mechanisms were evaluated according to the available methods. Data were divided in a training set (80%) and a test set (20%). Three internally validated carbapenem-resistant Enterobacterales (CRE) prediction models were created: a multivariate logistic regression model, and two data mining techniques. Model performances were evaluated by calculating the average of the AUC, sensitivity, specificity and predictive values.
resultsA total of 285 Enterobacterales bloodstream infection episodes (229 carbapenem susceptible and 56 carbapenem resistant) occurred [median (IQR) age, 9 (3.5-14) years; 57% male]. The risk of CRE was 2.1 times higher when the infection was caused by Klebsiella spp. and 5.8 times higher when a carbapenem had been used for ≥3 days in the previous month. A model including these two predictive variables had a discriminatory performance of 77% in predicting carbapenem resistance. The model had a specificity of 97% and a negative predictive value of 81%, with low sensitivity and positive predictive value.
conclusionsEven in settings with high CRE prevalence, these two variables can help early identification of patients in whom CRE-active agents are unnecessary and highlight the importance of strengthening antibiotic stewardship strategies directed at preventing carbapenem overuse.
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