ArticleBMC microbiology2025
Intestinal colonization of carbapenem-resistant gram-negative bacteria in pediatric hematology patients: risk factors and molecular characteristics, a multicenter case-control study.
Article in BMC microbiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05002582 (Carbapenem-resistant Organisms), which is not on this map. Cited by 2 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Carbapenem-resistant Organisms (CRO) Screening From Rectal Swabs and the Relationship Between Colonization and Infection in Patients With Hematological Diseases in China
Who cites it
2 citing papers in PubMed.
- Molecular and phenotypic profiles of carbapenem- and third-generation cephalosporin-resistant Klebsiella pneumoniae isolates from the fecal microbiota of pediatric patients with COVID-19.BMC microbiology · 2026Article
- Characteristics of the resistome and the potential for bloodstream infections in patients with gut colonization byFrontiers in cellular and infection microbiology · 2026Article
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Authors and funding
10 authors.
Funding
Abstract
objectivesAims to investigate the prevalence, risk factors, and molecular characteristics of intestinal colonized carbapenem-resistant gram-negative bacteria (CR-GNB) in pediatric hematology inpatients across China.
methodsIn this multicenter case control study, 412 pediatric inpatients with hematological diseases across China were screened for CR-GNB intestinal colonization. Antimicrobial susceptibility testing and whole-genome sequencing were performed on colonizing isolates. Logistic regression models were used to identify risk factors and construct a predictive nomogram. Comparative analyses between pediatric and adult patients were conducted to assess differences in colonization rates, resistance phenotypes, and resistance gene profiles.
resultsA total of 13.3% (55/412) of pediatric inpatients were colonized with CR-GNB, with carbapenem-resistant Enterobacterales (CRE) being the dominant group (10.0%, 41/412), followed by carbapenem-resistant Pseudomonas aeruginosa (CRPA) (3.2%, 13/412) and carbapenem-resistant Acinetobacter baumannii (CRAB) (0.2%, 1/412). Independent risk factors for colonization included younger age, acute leukemia, lymphoma, and hematopoietic stem cell transplantation (HSCT). Phylogenetic analyses showed no clonal dissemination and no regional clustering. NDM enzyme was prevalent in carbapenem-resistant E. coli (CREC) and Enterobacter spp., while CRKP isolates were mostly non-carbapenemase-producing, with resistance likely driven by extended-spectrum beta-lactamases (ESBLs) overexpression and porin loss. Compared with adults, pediatric CRE isolates exhibited significantly lower resistance to aminoglycosides and β-lactamase inhibitor combinations.
conclusionsThis large-scale multicenter study highlights the substantial burden and molecular diversity of CR-GNB colonization in children with hematological diseases. Our findings underscore the need for pediatric-focused surveillance and infection control strategies that reflect species-specific resistance patterns and clinical vulnerabilities unique to this population.
trial registrationClinicalTrials.gov, registration number NCT05002582. (Registration date: 08 April 2021).
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